CQC report explained · a residential care home
What the CQC found at Highfield House Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and risks were assessed more effectively. Medicines were generally given safely, although records for some creams and ointments were not always completed.
- Effective?
- Good
- This key question was not inspected at this visit. Its rating was carried forward from the previous inspection.
- Caring?
- Good
- This key question was not inspected at this visit. Its rating was carried forward from the previous inspection.
- Responsive?
- Good
- This key question was not inspected at this visit. Its rating was carried forward from the previous inspection.
- Well-led?
- Requires improvement
- Leadership and the culture of the home had improved, but management audits had not always identified gaps in records. More time was needed to make the improvements consistent.
What inspectors found, August 2022
Rated Good and no longer in special measures; inspectors found safer care and a kinder culture, but leadership and record keeping still require improvement.
This was an unannounced comprehensive inspection on 14 June 2022. Inspectors checked the action plan after the previous inspection, reviewed care and medicines records, observed care, and spoke with people, relatives and staff.
The home had improved since its previous Inadequate rating. People were protected from abuse, medicines were generally managed safely, staffing had increased, and care plans had been rewritten. People and relatives described staff as caring and kind.
The home was rated Good overall and Good for Safe. It was rated Requires Improvement for Well-led because audits had not always found gaps in records, including some food and fluid, repositioning and topical medicines records. The home is no longer in special measures.
Safer risk management
Care plans had been updated and included identified risks and the actions staff needed to take. The home was no longer in breach of the regulation about safe care and treatment.
“The new versions were up to date and included details of any risks identified.” from the report
Medicines mostly managed safely
People received their medicines as prescribed. Medicine administration records were in place and had no gaps, and staff training and competency checks were completed.
“People received their medicines safely and as prescribed.” from the report
Caring staff
People and relatives spoke positively about staff, describing them as caring, kind and available. Staff also received induction training relevant to their roles.
“People using the service and relatives were complimentary about the staff who they felt were caring and kind.” from the report
Improved culture
Inspectors found a calmer and more welcoming culture. People, relatives and staff said managers were approachable and supportive.
“We found a welcoming and calm culture at the home.” from the report
Incomplete care records
needs fixingSome records for food and fluid intake and repositioning were incomplete. The report says there was no evidence that the care itself had not been delivered, but the records needed to be more consistent.
“Some gaps still occurred in the monitoring records in areas such as food and fluid and repositioning, where people were at risk of a pressure ulcer developing.” from the report
Management checks missed gaps
needs fixingAudits did not always identify problems in records, including errors in medicines recording. The home needed to show that its improved systems were working consistently over time.
“However, the management audits had not always identified and addressed gaps in records and recording.” from the report
Ongoing staffing pressures
minorStaffing numbers had increased and agency use had reduced, but recruitment remained difficult. Inspectors recommended close monitoring to ensure people continued to receive care promptly.
“We recommend that the provider continues closely monitoring and reviewing staffing levels using an effective tool” from the report
Some topical medicines records incomplete
needs fixingRecords for creams and ointments used during personal care were not always completed. The manager knew about this and was working with staff to improve it.
“Topical MAR charts for creams or ointments that were applied to people during personal care were not always completed.” from the report
- 01How are you checking that food, fluid and repositioning records are completed every time?
- 02What checks are now in place to make sure medicines records, including topical MAR charts, are complete?
- 03How are you monitoring staffing levels and recruitment, and what would you do if staffing fell again?
- 04How will you show that the improvements found at this inspection have been sustained?
- 05What action was taken after the previous warning notice, and how has this been kept in place?
This was a comprehensive inspection focused on Safe and Well-led; the other key-question ratings were carried forward from the previous inspection. 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, January 2022
Rated Inadequate and remains in special measures; inspectors found serious problems with staffing, medicines, risk management and leadership.
This was an unannounced focused inspection on 10 and 17 November 2021. Inspectors looked at Safe and Well-led, including medicines and infection control. They spoke with people, relatives and staff, observed care, and checked care, medicine and management records.
The home did not have enough staff. People sometimes waited for personal care and support. The home relied heavily on agency staff. Medicines were not managed safely, and care records were sometimes out of date or conflicting. This meant people were at risk of avoidable harm.
The home’s checks and leadership did not find or fix important problems. The inspection found breaches relating to safe care and treatment, staffing and good governance. Infection prevention was mostly satisfactory, but some cleaning, ventilation and closed-door practices needed improvement.
The overall rating fell from Requires Improvement to Inadequate. The home remains in special measures. CQC said it would monitor progress and re-inspect, usually within six months, to check for significant improvement.
Some consistent staff
The home had a core group of experienced care staff. People and relatives were mostly positive about the regular staff and recognised that they worked hard despite staffing pressures.
“Most people and relatives commented positively on the care they received from the regular and consistent staff team who they recognised worked hard under pressure due to staffing levels.” from the report
Safer recruitment
Inspectors found evidence that staff recruitment checks were completed, including references and Disclosure and Barring Service checks.
“People were supported by staff who had been recruited safely.” from the report
Some infection controls
The provider was assured in several areas of infection control, including PPE, testing, safe admissions and arranging visits.
“We were assured that the provider was using PPE effectively and safely.” from the report
Not enough staff
seriousPeople had to wait for care and support. The home used more than 200 hours of agency staff each week during September and October 2021, and language barriers affected communication for some people.
“There were insufficient staff to meet people's needs. This meant people had to wait for personal care and support, staff were not available to respond to people in a timely manner.” from the report
Unsafe medicines management
seriousInspectors found gaps in medicine records, missing guidance, unavailable medicines and discrepancies in stock records. These problems could have led to missed or incorrect doses.
“There were gaps in records of medicine administration and discrepancies in records against quantities of medicines available at the service.” from the report
Risks and care records not controlled
seriousRisk assessments and care records were sometimes out of date or contradictory. Nutrition and hydration were not consistently monitored, including for people who had lost weight.
“We were not assured that risks to the health, safety and well-being of people were suitably assessed or appropriately monitored within the home.” from the report
Weak leadership and checks
seriousThe provider’s monitoring systems did not identify or correct serious problems. The home had several management changes and no registered manager since July 2021.
“The provider's quality assurance systems were not robust. There was ineffective governance and poor oversight at manager, regional manager and provider level which had failed to fully identify shortfalls in the service putting people at risk of harm.” from the report
Communication about incidents
needs fixingSome relatives said they were not told promptly when accidents or falls happened. Inspectors found that the service did not always act openly when things went wrong.
“Several relatives told us the provider had not always acted openly when something had gone wrong.” from the report
- 01How many permanent care staff are now working at the home, and how much agency cover is still being used?
- 02What checks now make sure every person receives the right medicines, at the right time, and that records match the medicines in stock?
- 03How are nutrition, hydration, weight loss and other risks recorded and reviewed for each person?
- 04Who is currently managing the home, and when will the registered manager be in post?
- 05What action has been taken in response to the CQC warning notices and special measures?
This was a focused inspection of Safe and Well-led; the other three key question ratings were not assessed in this report. This explanation was written from the published report of 28 January 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.
Every inspection of Highfield House Care Home
5 rated inspections over 2 years: the service has held its Good rating throughout.
- August 2022Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2022Inadequatedown from Requires improvementSafe: InadequateWell-led: Inadequate
- July 2021Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- January 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- March 2020GoodSafe: GoodWell-led: Requires improvement
- January 2019
Registered with the Care Quality Commission on 21 January 2019.
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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23 live-in carers within about an hour of Suffolk
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. 17 can care for a couple. 7 years' experience on average.
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