CQC report explained · a nursing home
What the CQC found at Highfield Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, September 2018
Highfield Care Home was rated Good overall, but inspectors found that safety practices were not always consistent.
Inspectors visited without notice on 25 and 26 June 2018 and followed up information on 25 July. They spoke with people living there, visitors and staff. They reviewed care and staff records, observed care and medicines, and checked how the home monitored safety and quality.
The overall rating was Good. Effective care, kindness, responsiveness and management were all rated Good. People were generally treated with dignity, supported to make choices, given suitable food and drinks, and helped to access healthcare and activities.
Safe was rated Requires Improvement. Inspectors found that some risk assessments and records did not contain enough detail, and one person was transferred using another person's sling. The manager said records were updated and staff were reminded about safe moving and handling.
The home had improved since the previous inspection, when it was rated Requires Improvement overall and breached two legal requirements. Inspectors found clearer equipment checks, better care plans and stronger management oversight at this inspection.
Kind and respectful care
Staff knew people's histories and supported them in a kind and compassionate way. Inspectors saw staff respond promptly when people became anxious or distressed.
“Staff knew people well and supported people in a kind and compassionate way.” from the report
Improved care planning
Care plans were more detailed than at the previous inspection and gave staff clearer guidance about individual needs, preferences and communication.
“At this inspection we found that improvements had been made and care plans were more detailed and informative.” from the report
Food and healthcare
People were supported with meals, specialist diets and drinks. The home monitored weight and worked with healthcare professionals, including GPs and dieticians.
“People were supported to eat and drink and maintain a balanced diet.” from the report
Activities and interests
People could take part in varied activities, including virtual activities, hair appointments and events in communal areas.
“People were supported to follow their interests and take part in activities that were appropriate for them.” from the report
Stronger management oversight
The home had clearer responsibilities, regular audits and quality checks. The manager worked with outside quality improvement services to drive change.
“At this inspection, we found improvements had been made and the levels of oversight strengthened.” from the report
Inconsistent risk records
needs fixingSome risks did not have detailed assessments explaining what staff should do. Inspectors gave examples involving epilepsy and possible self-harm, although staff understood the actions required and records were later updated.
“Some risks did not have a detailed assessment in place to record the actions which staff needed to take to reduce the likelihood of an incident occurring.” from the report
Moving and handling
seriousInspectors saw one person transferred using another person's sling. The manager agreed to investigate, changed how information was recorded and reminded staff about safe procedures.
“We also saw one person being transferred using another individual's sling.” from the report
Dementia-friendly environment
minorSome people had no clear way to recognise their bedrooms, and mirrors could startle people living with dementia. Inspectors recommended seeking specialist advice.
“We have recommended that the registered manager seek advice from a reputable source on creating environments for people with a diagnosis of dementia.” from the report
Complaint outcomes
needs fixingWritten complaints were investigated, but the outcomes were not always clearly recorded. Inspectors recommended reviewing the process, including how verbal complaints were handled.
“However, outcomes were not always clearly recorded.” from the report
- 01How do you make sure every person's risk assessment contains clear, current instructions for staff?
- 02How do you check that the correct sling and other moving and handling equipment are used for each person?
- 03What changes have you made to help people living with dementia recognise their bedrooms and feel comfortable in the home?
- 04How are verbal complaints recorded, investigated and reported back to families?
- 05What actions have been completed since this inspection, and how do you check that they have worked?
This was a comprehensive inspection covering all five key questions, with follow-up information gathered on 25 July 2018. This explanation was written from the published report of 5 September 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.
What inspectors found, September 2017
Highfield Care Home is rated Requires Improvement; inspectors found some good care but unsafe equipment, incomplete care plans and inconsistent support.
Inspectors made an unannounced visit on 20 July 2017. They spoke with people living there, relatives and staff. They reviewed care and staff records, watched care and medicines being given, and checked how the service was monitored.
The home was not consistently safe, effective, caring, responsive or well-led. Some medicines, recruitment checks, health referrals, meals and activities worked well. However, equipment was out of date, some mattresses were set incorrectly, and care plans did not always give staff clear instructions.
Inspectors also found rushed, task-focused care in parts of the home, especially the dementia unit. Activities and complaints handling needed improvement. The overall rating and all five question ratings were Requires Improvement.
Medicines
Medicines were generally managed safely. Records and stock checks were completed, and regular medicine audits took place.
“People's medicines were generally well managed.” from the report
Recruitment and safeguarding
The home carried out checks on staff before employment. Staff had training and understood how to report abuse concerns.
“Checks were undertaken on staff to ensure that they were suitable for the role and they received training on safeguarding and abuse.” from the report
Activities
Some activities were very positive, including trips out, singing and exercise sessions, and links with local children.
“Some aspects of the activities provided had elements of outstanding practice but other areas, such as the activities in the dementia unit worked less well.” from the report
Unsafe equipment and risk checks
seriousSome clinical equipment was out of date and pressure-relieving mattresses were set incorrectly. Fire safety and water temperature checks were also not up to date.
“The systems in place for the oversight of equipment and management of risk were not effective.” from the report
Dementia unit staffing
seriousStaff were not always deployed effectively in the dementia unit. Inspectors saw people calling for help and some people at risk of falls while staff were busy elsewhere.
“Our observations were that staff were not always deployed effectively.” from the report
Dignity and kindness
needs fixingSome interactions were caring, but other care was rushed and task focused. Inspectors saw people being told to wait or sit down repeatedly, without enough time or explanation.
“Care delivery was task focused, and did not always meet individual needs.” from the report
Quality monitoring
needs fixingThe home had audits and improvement plans, but these did not find or resolve several problems identified by inspectors.
“There were systems in place to monitor the quality and safety of the service but these were not fully effective” from the report
- 01What has been done to make sure all clinical equipment is in date, maintained and correctly set for each person?
- 02How are care plans now checked to ensure they accurately describe catheter care, diabetes support, mobility equipment and other individual needs?
- 03How will staffing be deployed in the dementia unit, particularly at mealtimes and when people are at risk of falling?
- 04What changes have been made to provide more meaningful activities and better access to the garden for people living with dementia?
- 05How do audits now identify problems with care quality, skin tears, falls and dignity before they affect people?
This was an unannounced comprehensive inspection covering all five questions: Safe, Effective, Caring, Responsive and Well-led. This explanation was written from the published report of 1 September 2017 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 Home
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- September 2018Goodcurrent ratingup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2017Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- November 2016
Registered with the Care Quality Commission on 23 November 2016.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
35 live-in carers within about an hour of Essex
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,260 a week. 25 can care for a couple. 10 years' experience on average.
“Not only was she professional, polite and efficient but she bought a lovely smile and laughter to my parents home.”
“She brought fun and stimulation into mums life.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.