CQC report explained · a residential care home
What the CQC found at Highfield Cottage
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and risks were assessed. Medicines were generally managed safely, but some as-required medicines lacked protocols and one medicine cabinet was in an unsuitable location.
- Effective?
- Good
- Staff had suitable training, supervision and experience, and people's health and nutritional needs were met. Inspectors found one restriction that was not covered by the person's DoLS authorisation.
- Caring?
- Good
- Staff were kind, patient and respectful. People were supported to communicate, maintain relationships and develop their independence.
- Responsive?
- Good
- Support plans were detailed and based on individual needs and preferences. People were supported with communication, activities, family relationships and community involvement.
- Well-led?
- Good
- Relatives and professionals reported good communication and positive leadership. Inspectors said some audits were not robust enough and recommended that policies be reviewed and kept up to date.
What inspectors found, December 2019
Rated Good; inspectors found kind, person-centred care, with some medicine, legal and record-keeping issues to address.
This was an unannounced inspection on 3 December 2019. One inspector spoke with relatives, staff and professionals, observed the two people living there, and checked care, medicine, recruitment and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people appeared settled, staff understood their needs, and relatives were positive about the care and communication.
There were some shortfalls. Some as-required medicines did not have protocols, one medicine cabinet was in an unsuitable place, and one restriction was not covered by the person's DoLS authorisation. Inspectors also said some policies and audits needed strengthening.
The overall Good rating was unchanged from the previous inspection, published on 30 June 2017. The provider said it had moved the medicine cabinet and reviewed the policies inspectors had raised.
Kind and respectful staff
Inspectors observed caring support, including reassurance, praise and patience. Relatives and professionals also described staff as caring and respectful.
“I have witnessed staff treat service users with genuine respect and kindness.” from the report
Personalised support
Support plans described people's individual preferences and the practical steps staff should take. Staff understood how changes to routines could affect people.
“Plans of support were very detailed and person centred.” from the report
Independence and community life
People were encouraged to do as much as possible for themselves, take part in activities and be involved in their local community.
“People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.” from the report
Good communication
Relatives and professionals said communication was good. Staff used pictures and other approaches to help people make choices and express themselves.
“People and relatives told us the service was well led. They told us communication with the service was good.” from the report
As-required medicine protocols
needs fixingSome as-required medicines did not have individual protocols explaining when and how they should be used. The provider said it would clarify and complete the missing protocols.
“We identified people did not always have protocols in place for each 'as required' medicine they were prescribed.” from the report
Legal authorisation for a restriction
seriousInspectors found that a restriction for one person was not covered by the person's DoLS authorisation. The manager said this would be addressed.
“We found staff had made a best interests decision for one person which restricted them but was not covered in their DoLS.” from the report
Policies and audits
needs fixingSome policies needed updating and the auditing process was not robust enough in some areas. The provider later sent information showing that the policies inspected had been reviewed and updated.
“We recommend the provider review the policies for the service to ensure they are up to date and meet all legislative requirements.” from the report
Support plan reviews
needs fixingFor one person, the actions needed to reduce risks were not always reflected in support plan reviews. The manager said this would be addressed.
“We found for one person this was not always reflected in their support plan reviews.” from the report
- 01What protocols are now in place for each person's as-required medicine?
- 02How do you check that any restrictions on a person's care have the correct DoLS authorisation?
- 03What changes have been made to support plan reviews where risks are identified?
- 04How have the home's audits been strengthened since the inspection?
- 05Which policies were updated after the inspection, and when will they next be reviewed?
This was an unannounced planned inspection covering all five key questions; the previous rating was Good and was published on 30 June 2017. This explanation was written from the published report of 20 December 2019 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, June 2017
Rated Good; inspectors found safe, kind and personalised care, with all five areas rated Good.
Inspectors visited on 2 June 2017. The visit was announced at short notice because people living at the home were often out during the day. They reviewed care plans, medicines records, staff files and other records, and spoke with staff and professionals.
The home supported two people with learning disabilities. Inspectors found that risks and medicines were managed safely, staffing levels were sufficient, and staff had suitable training and support. People were supported with food, health appointments, communication and daily activities.
Inspectors saw kind and respectful care. Staff understood people's individual communication needs and encouraged independence. Care plans were personalised and regularly reviewed. The home was rated Good in Safe, Effective, Caring, Responsive and Well-led, and remained Good since the previous inspection in March 2015.
Safe medicines and staffing
Medicines were managed safely, with correctly completed administration records. Staffing levels were reviewed and increased when people needed support with activities.
“People's medicines were managed safely. Before they started using the service people's medicine support needs were assessed and a care plan drawn up.” from the report
Kind communication
Staff knew how people communicated without speech and used this knowledge to understand their choices and provide caring support.
“Staff were very familiar with people's individual communication needs, and used this knowledge to deliver kind and caring support.” from the report
Personalised care
Care plans included people's preferences, life histories, communication needs and goals. Staff followed the guidance and reviewed plans regularly.
“People's care plans also contained personal details such as their life history, photographs of their family and what was important to them.” from the report
Activities and independence
People were supported to take part in activities they enjoyed and to develop everyday skills and independence.
“People were supported to access activities they enjoyed.” from the report
Quality checks
The provider and manager carried out regular checks of care plans, medicines, incidents and staffing. Records showed action was taken when issues were found.
“Where issues were identified records confirmed that remedial action was taken.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you assess and update my relative's communication needs and preferences?
- 02What staffing would be available for my relative during the day and at night?
- 03How would you support my relative to make choices and build independence?
- 04Which activities could my relative take part in, based on their interests and support needs?
- 05How would you manage my relative's medicines, including any 'as and when required' medicines?
This was an announced inspection of all five CQC areas, with a short-notice visit because the two people living at the home were often out during the day. This explanation was written from the published report of 30 June 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 Cottage
3 rated inspections over 5 years: the service has held its Good rating throughout.
- December 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 26 November 2010.
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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35 live-in carers within about an hour of Middlesbrough
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 £980 to £1,230 a week. 31 can care for a couple. 9 years' experience on average.
“I found Alison to be kind , caring helpful concencious... Alison has a heart of gold”
“Petty introduced herself to Mum every time she was caring for her and responded very quickly to Mum if she was distressed in the night.”
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.