CQC report explained · a residential care home
What the CQC found at Highfield Care Centre
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 improvements in risk management, staffing, safeguarding, medicines administration and accident reporting. However, medicine awaiting removal was not documented or stored safely, allergies were not always recorded and there were gaps in cleaning records.
- Effective?
- Good
- This question was not rated during this targeted inspection.
- Caring?
- Good
- This question was not rated during this targeted inspection.
- Responsive?
- Good
- This question was not rated during this targeted inspection.
- Well-led?
- Requires improvement
- Quality checks and management oversight had improved, and the manager acted on issues raised during the inspection. These systems still needed to be more firmly established, and communication with staff could be better.
What inspectors found, August 2022
Rated Requires Improvement; the home improved enough to leave special measures, but inspectors still found medicines, cleaning records and communication issues.
This was an unannounced targeted inspection on 9 June 2022. Inspectors checked concerns about safety and management, including infection prevention and control. They spoke with people, relatives, staff and healthcare professionals, and reviewed care records, medicines records, staff recruitment files and quality checks.
The home had improved since its previous inadequate rating. Inspectors found safer staffing, medicines administration, risk management, safeguarding and accident reporting. Building work and maintenance improvements were also under way.
Some problems remained. Medicine awaiting removal was not documented or stored safely, allergies were not always recorded and there were gaps in cleaning records. One healthcare professional also said communication with staff could be better. The home was rated Requires Improvement for Safe and Well-led, but it was no longer in breach of regulations or in special measures.
Improved safety systems
Risk assessments and care plans gave staff guidance about people's health and wellbeing. Staff were observed using techniques to reduce agitation safely.
“Risks were assessed appropriately. The service had measures in place to manage risk associated with eating, drinking, mobility and skin integrity.” from the report
Staffing and recruitment
Inspectors found enough staff to meet people's needs and saw staff responding promptly. Recruitment checks were in place.
“There were enough staff employed to ensure people's needs were being met.” from the report
Accidents were followed up
Incidents and accidents were recorded, reviewed and used to reduce the risk of them happening again. Learning was shared with staff.
“Incidents or accidents were recorded and managed effectively.” from the report
Open management
The manager was open with inspectors and acted quickly when concerns were raised. People and relatives said improvements had continued.
“Throughout the inspection the registered manager was honest and open with us.” from the report
Medicines awaiting removal
needs fixingMost medicines were managed safely, but medicines waiting to be removed were not documented or stored safely. The manager acted immediately after inspectors raised this.
“Most medicines were stored safely, however medicine for removal was not documented or stored safely.” from the report
Allergy records
needs fixingAllergies were not recorded consistently for everyone. The manager took immediate action after this was identified.
“Allergies were not consistently recorded for all people.” from the report
Agency staff
needs fixingThe home relied on agency staff. One staff member said it could be difficult because agency workers did not know people well.
“It can be difficult working with so much agency, they don't know the people.” from the report
- 01How are medicines awaiting removal now documented, stored and checked?
- 02How do you make sure every person's allergies are recorded accurately and kept up to date?
- 03How are agency staff introduced to each person's needs, risks and care plan?
- 04What checks now show that cleaning records are complete?
- 05How are you improving communication between care staff and external healthcare professionals?
This was an unannounced targeted inspection focused on concerns about Safe and Well-led, with infection prevention and control also checked; the other key questions were not rated in this report. This explanation was written from the published report of 6 August 2022 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, December 2021
Highfield Care Centre is rated Inadequate and is in special measures; inspectors found unsafe medicines, insufficient staffing and weak oversight.
This was a focused inspection on 24 August and 2 September 2021. Inspectors checked whether the provider had followed its improvement plan and met legal requirements. They reviewed 30 medicines records and nine care records, observed care, and spoke with people, relatives and staff.
The home was not safe. Some medicines were missed, given incorrectly or not recorded properly. Staff numbers were not enough, risk records were sometimes inaccurate, and the home did not learn effectively from falls, altercations and other safety concerns.
The home was also not well-led. Management had changed several times, audits did not identify important risks, and many improvement actions were overdue. People and relatives generally described staff as kind and caring, and infection control had improved, but the overall rating fell from Requires Improvement to Inadequate.
An Inadequate rating means the CQC found serious problems that needed significant improvement. The home was placed in special measures and the CQC said it would monitor progress and re-inspect.
Kind and respectful staff
Most people and relatives said they felt safe and were happy with the care. People described staff as kind, caring and respectful.
“People told us they liked the staff and said they were kind and caring.” from the report
Recruitment checks
The home's recruitment systems included the required checks to help ensure suitable staff were recruited.
“Recruitment systems were robust and made sure that the right staff were recruited to support people.” from the report
Improved infection control
The home had improved its infection prevention and control arrangements and was no longer in breach of this part of the medicines and care safety regulation.
“At this inspection we found improvements had been made and the provider was no longer in breach of this element of Regulation 12.” from the report
Communication with relatives
Relatives said they were involved in their family member's care and were contacted when there were changes.
“Relatives told us they felt involved in the care of their family members and staff communicated well with them when there were any changes.” from the report
Medicines
seriousSome doses were missed because medicines were not in stock. Records were incomplete or inaccurate, some guidance was missing, two people received out-of-date eye drops, and insulin was stored outside the recommended temperature range.
“People missed some doses of their prescribed medicines because there was no stock available for them.” from the report
Staffing levels
seriousThere were not enough staff across the home. Inspectors saw times when no staff were in communal areas, creating a risk that people needing help would not be supported quickly.
“Not enough staff were deployed across the service to meet people's needs.” from the report
Risk and care records
needs fixingSome records contained conflicting or missing information about people's needs. Records also showed gaps in repositioning and food and fluid monitoring.
“Some of these contained inconsistent and incorrect information. This could lead to needs being missed or overlooked.” from the report
Weak management oversight
seriousAudits did not identify important problems with medicines, staffing, records, safety checks and the premises. The action plan had many overdue actions and no clear plan for completing them.
“Governance and quality checks were not robust enough and had failed to identify areas of risk which had placed people at risk of harm.” from the report
Learning from incidents
seriousThe home received many safeguarding concerns, falls and reports of physical altercations, but did not consistently close concerns or record learning to prevent them happening again.
“There continued to be a high number of falls and physical altercations between people.” from the report
Limited activities
needs fixingPeople had limited opportunities for meaningful, person-centred activities. Staff said staffing pressures reduced the time available for activities and conversation.
“We observed there were limited opportunities for people to engage in person centred activities.” from the report
- 01What has changed since the inspection to make sure every medicine is in stock, given correctly and recorded accurately?
- 02How do you now calculate the number of staff needed on each shift, and how do you check that staffing is sufficient?
- 03How are falls, physical altercations and safeguarding concerns reviewed, closed and used to prevent repeat incidents?
- 04Which overdue actions from the previous improvement plan have been completed, and what evidence can you show?
- 05What meaningful activities are now available, and how do you make sure people can take part regularly?
This was a focused inspection of Safe and Well-led, with infection control also reviewed; the other key-question ratings were carried over from the previous comprehensive inspection. This explanation was written from the published report of 21 December 2021 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 Highfield Care Centre
4 rated inspections over 3 years: the service has slipped, from Good to Requires improvement.
- August 2022Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2021Inadequatedown from Requires improvementSafe: InadequateWell-led: Inadequate
- August 2020Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- February 2019GoodSafe: GoodWell-led: Good
- February 2018
Registered with the Care Quality Commission on 12 February 2018.
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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