CQC report explained · a residential care home
What the CQC found at Highfield Hall
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and risks were identified and managed. Inspectors noted mixed feedback about staffing, some incorrectly worn masks on the first day, and less detailed records for some medicines given as required.
- Effective?
- Good
- People had clear, person-centred care plans and risk assessments. Their nutrition, healthcare, training and support needs were being met, although signage around the home was limited.
- Caring?
- Good
- Most people said staff were kind, respectful and helpful. Two people raised concerns about personal care, and the home took immediate action which left them satisfied with the outcome.
- Responsive?
- Good
- Care was personalised and people had activities both in the home and the wider community. Families were kept informed during lockdowns and visiting restrictions, and complaints were investigated.
- Well-led?
- Good
- The provider had detailed audits and an improvement plan, and inspectors found good oversight. However, there was no registered manager in post while the provider recruited and inducted a permanent manager.
What inspectors found, September 2022
Rated Good; inspectors found kind, safe care, but staffing and management arrangements were still changing.
Inspectors visited on 22, 24 and 26 August 2022. They spoke with people living at the home, relatives and staff. They observed care, toured the building and checked care plans, medicines records, staff files and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people were protected from abuse, received their medicines as prescribed, had their health and nutrition needs met, and were supported to make choices.
There was mixed feedback about staffing. On the first day, some people waited too long for help and some call bells rang for long periods. The provider had closed the nursing unit, was recruiting staff and was taking action to improve staffing consistency.
Inspectors found some smaller shortfalls, including less detailed records for some medicines given when needed, limited signage and one recruitment file without evidence that employment gaps had been checked. The report says these issues were being addressed. The previous inspection rating was also Good.
People felt safe
Staff had safeguarding training and knew how to raise concerns. Risks, accidents and incidents were monitored, with action taken to reduce future risks.
“Risks to individuals, staff and within the environment were identified and well managed.” from the report
Kind and respectful care
Most people spoke positively about staff and said they were treated with kindness, dignity and respect. Staff also encouraged people to remain independent.
“Most people told us they felt they were treated well by staff and spoke positively about living at the home.” from the report
Personalised support
Care records described people's preferences and support needs. Staff reviewed these needs regularly and changed support after incidents.
“Care records were person centred and gave information about what was important to and for the person.” from the report
Activities and community links
People could take part in a range of activities inside the home and in the wider community. People told inspectors they enjoyed these activities.
“There was a range of activities on offer for people both within the home and in the wider community.” from the report
Quality monitoring
The provider had thorough audits, spot checks and a detailed improvement plan. Inspectors found that identified issues were addressed.
“Audits and spot checks were thorough, and records demonstrated any issues identified were addressed.” from the report
Staffing consistency
needs fixingPeople and staff gave mixed views about staffing. On the first day, some people did not receive help promptly and call bells rang for long periods, although inspectors saw improvement on the following days.
“On the first day of inspection we observed some people did not receive support in a timely manner.” from the report
No registered manager in post
needs fixingThe home had an interim manager while a permanent manager was being recruited and inducted. A temporary registration application had started, but the management arrangements were not yet settled.
“At the time of our inspection there was not a registered manager in post.” from the report
As-required medicines records
minorSome records did not explain clearly enough how staff would know that an as-required medicine was needed or what they should try first. The provider later confirmed that the records had been updated.
“Some records relating to medicines that were to be given 'as required' needed to be more detailed” from the report
Limited signage
minorThere was limited signage to help people find their way around the home, including outside bedrooms. The provider had plans to improve this.
“There was limited signage to aid people to orientate themselves within the home, including on the outside of bedrooms.” from the report
- 01What are the current staffing levels on each unit and at night, following the closure of the nursing unit?
- 02How do you make sure call bells are answered promptly when staffing is under pressure?
- 03Has a permanent registered manager now been appointed and registered with CQC?
- 04Have the detailed instructions for all as-required medicines been updated and checked?
- 05What progress has been made with improving signage and the planned building improvements?
This was an unannounced inspection covering all five key questions, including infection prevention and control, and it also examined concerns about staffing, safeguarding, falls, medicines and pressure care. This explanation was written from the published report of 13 September 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, August 2021
Rated Good in all five areas; inspectors found kind, personalised care, with some mask-use and minor recruitment-record issues.
This was an unannounced inspection on 6 and 7 July 2021. Inspectors spoke with 13 people living at the home, five relatives, staff and health professionals. They reviewed care plans, medicines records, recruitment files, audits and other records.
The home was rated Good for Safe, Effective, Caring, Responsive and Well-led. People generally felt safe and well cared for. Inspectors found that staff understood people's needs, managed medicines safely, supported healthcare and nutrition, and provided personalised care.
There were a few minor points to address. Some people said staff did not always wear masks correctly. Minor improvements were needed in recruitment records. Three people also said there was not always a staff member in the residential lounge, although the manager said people were checked regularly and had call bells.
Kind and respectful staff
Inspectors observed staff supporting people in a friendly, professional and respectful way. People and relatives also gave positive feedback about the care.
“During the inspection we observed staff being friendly and professional with people and visitors. Staff supported people in a kind and respectful way.” from the report
Personalised care
Staff knew people well and care plans included their needs, preferences, abilities and risks. Plans were reviewed when needs changed.
“People's care plans were detailed and individualised. They included information to guide staff about people's needs, risks, abilities and preferences.” from the report
Medicines managed safely
People received their medicines at the right times. Staff were trained and checks of medicines and records were completed.
“People received their medicines as and when they should.” from the report
Good management and checks
Managers and the provider carried out regular quality and safety audits. Feedback from people, relatives and staff was sought and acted on.
“The audits completed were effective in ensuring that appropriate standards of quality and safety were maintained at the home.” from the report
Masks were not always worn correctly
needs fixingThree people said staff sometimes pulled masks down when speaking with people. The manager said this would be addressed with staff.
“However, three people told us staff did not always wear their masks as they should and sometimes pulled them down to speak with people.” from the report
Minor recruitment-record gaps
minorSome recruitment documents needed minor improvements. The manager dealt with this during the inspection.
“Some minor improvements were needed to recruitment documentation and the registered manager addressed this during the inspection.” from the report
No staff member always in the lounge
minorThree people said the residential lounge was not always staffed. The manager said staff checked people regularly and that call bells were available.
“Three people told us there was not always a staff member in the residential unit lounge.” from the report
Some refurbishment was delayed
minorFurther improvements, including bathroom refurbishment, were planned. Some work had been delayed during the COVID-19 pandemic.
“Some improvements had been delayed due to the COVID-19 pandemic.” from the report
- 01What action has been taken to make sure staff wear masks correctly at all times?
- 02How do you decide whether the residential lounge needs a staff member present, and how often are people checked there?
- 03What recruitment-record improvements were made during the inspection?
- 04Which bathroom and other refurbishment work is still outstanding, and when is it expected to be completed?
- 05How are people's views about meals, activities and care used to make further improvements?
This was an unannounced planned inspection covering all five key questions, including infection prevention and control under Safe. This explanation was written from the published report of 12 August 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 Hall
5 rated inspections over 8 years: the service has held its Good rating throughout.
- September 2022Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2021GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2021Inspected but not ratedSafe: Inspected but not rated
- August 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2017Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2015Inspected but not ratedSafe: Good
- February 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2020
Registered with the Care Quality Commission on 3 March 2020.
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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85 live-in carers within about an hour of Lancashire
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 £1,260 a week. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
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.