CQC report explained · a residential care home
What the CQC found at Highcroft Hall Residential Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found that some prescribed creams and other treatments were not given as directed. People felt safe overall, and staff understood safeguarding and risk management.
- Effective?
- Good
- People and relatives were involved in assessments and care planning. Staff had training and supervision, and people had access to food, drinks and healthcare.
- Caring?
- Good
- Staff were observed to be kind and attentive, and to support privacy, dignity and independence. However, one person felt staff disapproved of them and did not always help them.
- Responsive?
- Good
- Care was planned around people's needs and preferences, and complaints were addressed. Comments about social activities were mixed, and not everyone felt there were enough opportunities to take part.
- Well-led?
- Requires improvement
- The manager understood people's needs and encouraged people and relatives to give their views. However, the provider's checks did not reliably identify or prevent problems with prescribed creams and medicines.
What inspectors found, February 2020
Rated Requires Improvement; inspectors found kind and effective care, but medicines management and service oversight were not reliable enough.
This was an unannounced planned inspection because of the previous rating. Inspectors spoke with people living in the home, relatives and staff. They also reviewed care records, medicine records and management documents.
People generally felt safe. Staff understood safeguarding, risks were assessed, the home was clean and equipment was maintained. However, some prescribed creams were not given as often as directed, which put people's health at risk. Comments about staffing levels were mixed.
The home was rated Good for Effective, Caring and Responsive. People were supported with food, drinks and healthcare, and staff were usually kind and respectful. The home remained Requires Improvement for Safe and Well-led because medicine systems and quality checks were not fully effective.
The overall rating was Requires Improvement. It was unchanged from the previous inspection. Effective improved from Requires Improvement to Good, while Caring and Responsive remained Good.
Kind and respectful staff
Inspectors saw staff supporting people kindly, including during mobility support. People were involved in decisions and their privacy and dignity were respected.
“We observed staff were kind and attentive to people's needs.” from the report
Good care planning
People and relatives were involved in assessments and care plans. Staff had information about people's needs, preferences and risks.
“Information obtained from assessments were used when developing the care plan and risk assessment.” from the report
Access to healthcare
People could access healthcare when needed. The home worked with other agencies and had links with healthcare professionals.
“People told us they had access to healthcare services when needed.” from the report
Complaints were acted on
The report gives examples of concerns about glasses, dentures and bedroom cleaning being addressed after they were raised.
“Complaints were listened to, taken seriously and addressed.” from the report
Prescribed medicines and creams
seriousRecords showed that some people did not receive prescribed creams and other treatments at the required frequency. Inspectors said this placed people's health at risk.
“This placed people's health at risk.” from the report
Quality checks were not reliable
seriousThe provider's governance systems did not fully identify and resolve the medicines problem. This contributed to the Requires Improvement rating for Well-led.
“The provider's governance was not entirely effective to ensure people received their prescribed creams at the frequency directed.” from the report
Mixed views about staffing
needs fixingSome people said staff were not always available when needed, particularly at night. Other people said their care needs were met promptly.
“We received mixed comments about staffing levels in the home.” from the report
Some people did not feel valued
needs fixingOne person felt staff disapproved of them and did not help them. Inspectors asked the manager to address this.
“Not everyone who used the service felt valued or important.” from the report
Limited activities for some people
minorComments about social activities were mixed, and not everyone felt there were enough opportunities to take part.
“We found that not everyone we spoke with felt there were sufficient opportunities to engage in social activities.” from the report
End of life training
needs fixingOnly 29% of staff had received end of life training at the inspection. No one needed end of life care at that time, so inspectors said there was no immediate impact.
“This meant that not all the staff may have the skills to care and support people at the end of their life.” from the report
- 01How do you now check that every prescribed cream and medicine is given at the correct frequency?
- 02What evidence can you show that the new medicine alert system is working?
- 03How do you make sure there are enough staff on duty, especially at night?
- 04What activities are currently available, and how do you make sure people who want activities can take part?
- 05How many staff have now completed end of life care training?
This was an unannounced planned inspection covering all five CQC questions, following the previous Requires Improvement rating. This explanation was written from the published report of 1 February 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, October 2018
Highcroft Hall Residential Care Home was previously in special measures; it is now rated Requires Improvement, with caring and responsive care rated Good but safety, effectiveness and leadership still needing improvement.
This was an unannounced, comprehensive inspection on 21 and 22 August 2018. Inspectors spoke with people living at the home, relatives, staff and a visiting health professional. They observed care and mealtimes and checked care plans, medicines, staff records, accidents, complaints and quality checks.
The home had improved since its January 2018 inspection, when it was rated Inadequate overall and placed in special measures. Staffing, falls management, medicines records, care planning, activities and staff support had improved. However, some risks were still not managed consistently.
The home was rated Good for caring and responsive care. It was rated Requires Improvement for safe, effective and well-led care. The home was no longer in special measures, and the report says it was meeting the regulations at this inspection.
Kind and respectful staff
People were generally treated with kindness, compassion, dignity and respect. Inspectors saw staff respond sensitively to distress and support people's communication needs.
“People told us staff were kind and treated them with compassion, dignity and respect.” from the report
Improved staffing
The report says staffing levels had improved since the previous inspection. Inspectors observed staff responding to requests for support in a timely way.
“At this inspection in August 2018 the provider had taken steps to improve the staffing levels.” from the report
Safer moving and handling
Falls management and moving and handling had improved. Staff showed inspectors that they knew how to support people safely.
“We saw that staff had detailed knowledge and the skills to support people with their moving and handling needs and that people were supported in a safe way.” from the report
Personalised care
Care plans included information about people's lives, preferences and needs. People and relatives said they were involved in care planning.
“People received personalised care that was responsive to their needs.” from the report
Call bells and repositioning
seriousSix people's rooms were missing call bell cords when inspectors checked. Records also did not clearly show skin checks, and some repositioning was recorded every three hours instead of the required two hours.
“call bell cords were missing from six people's rooms.” from the report
Consent and best-interest decisions
seriousThe home had not consistently recorded consent or best-interest decisions for bedrails and sensor mats used to reduce falls.
“There was no evidence that people had consented to these interventions and where people lacked capacity there was no evidence that the decision to use these interventions had been made in their best interests.” from the report
Medicines monitoring
seriousOne treatment had been stopped by a health professional but was still being given. The home's checks had not identified this, and some creams were not securely stored.
“The systems in place to check current medicine records against health professional's letters and advice was not robust as it had not identified this shortfall.” from the report
Staff induction records
needs fixingSome new staff had not completed their full induction, and some induction booklets had not been signed off.
“We found some staff had not completed a full induction and some induction booklets had not been signed off as completed by the registered manager.” from the report
Activities were not always consistent
needs fixingThe home offered activities that people enjoyed, but regular meaningful activities were not maintained during the activity coordinator's absence.
“the provider had not taken adequate steps to make sure regular and meaningful activities continued during the activity co-ordinators absence from work.” from the report
Limited residents' meetings
minorPeople had not regularly been given meetings where they could share their views about living at the home.
“The registered manager informed us that resident meetings had not been carried out with people who lived at the home.” from the report
- 01How do you now make sure every resident has a working call bell and that repositioning and skin checks are recorded correctly?
- 02How are consent and best-interest decisions recorded for bedrails, sensor mats and any other restrictive equipment?
- 03What checks now make sure medicines are changed or stopped promptly when healthcare professionals give new instructions?
- 04How do you confirm that every new staff member has completed and had their induction signed off before working independently?
- 05How will residents and relatives be given regular opportunities to share their views, and how will meaningful activities continue during staff absence?
This was an unannounced comprehensive follow-up inspection covering all five key questions and checking improvements since the January 2018 inspection. This explanation was written from the published report of 23 October 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Highcroft Hall Residential Care Home
5 rated inspections over 4 years: the service has slipped, from Good to Requires improvement.
- February 2020Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Highcroft Hall Residential Care Home →
- October 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Highcroft Hall Residential Care Home →
- March 2018Inadequatestayed InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- October 2017Inadequatedown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- October 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2013
Report published without a new overall rating.
- August 2012
Registered with the Care Quality Commission on 2 August 2012.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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