CQC report explained · a residential care home
What the CQC found at Highfield House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found good safeguarding, staffing, risk management and infection control. Medicine audits had discrepancies, although immediate changes were made.
- Effective?
- Good
- This question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Well-led?
- Requires improvement
- New auditing and improvement systems had been introduced, but they were not yet consistently applied. The new leadership structure and service culture also needed more time to develop.
What inspectors found, October 2020
Highfield House is rated Good overall, with safe care but improvements still needed in how the home is led and monitored.
This was a focused inspection. Inspectors checked Safe and Well-led, including infection control during COVID-19. They visited the home, spoke with people, staff, a relative and managers, and reviewed care, medicine, recruitment and management records.
The home was rated Good for Safe. Inspectors found enough trained staff, regular safety checks, safeguarding arrangements and good infection control. People received their medicines as prescribed, but medicine stock audits were not always accurate.
The home was rated Requires Improvement for Well-led. New quality systems and external auditing had been introduced, and the previous legal requirements were now being met. However, some audits were still inconsistent and the new leadership and culture needed more time to become established.
The overall rating was Good. This included ratings carried over from earlier comprehensive inspections for key questions that were not examined during this visit.
People felt safe
People told inspectors they felt safe. Relatives also said the home was safe and homely.
“I feel safe here.” from the report
Enough trained staff
Rotas showed there were enough staff to meet people's needs. Recruitment checks and staff induction were also described as robust and supportive.
“The service provided sufficient numbers of trained staff to meet people's needs.” from the report
Good infection control
The home was clean and tidy. Staff had infection control training, there was enough protective equipment and an outbreak plan was in place.
“There was an adequate supply of PPE to help minimise the risk of cross infection.” from the report
Person-centred support
Inspectors saw staff supporting people in a person-centred way. Care plans recorded people's preferences, values and interests.
“We observed staff interacting with people in a person-centred way.” from the report
Medicine stock audits
needs fixingMedicine stock audit records did not always match the medicines available. The home made immediate changes and arranged a pharmacy review.
“Systems for the auditing of medicines, in particular the stock of medicines were inconsistent and contained discrepancies that had not been picked up prior to our inspection.” from the report
Leadership and monitoring still developing
needs fixingSome quality audits were inconsistent. The new leadership structure, staff morale and service culture needed more time to settle.
“More time is needed to ensure that these changes have the desired effect on staff morale and service culture.” from the report
- 01How do you now check medicine stock, and can you show how discrepancies are identified and corrected?
- 02What progress has been made with the new manager's registration with CQC?
- 03How do you monitor staff morale and the effect of the new leadership structure?
- 04What did the external auditor recommend, and which actions from that review are still outstanding?
- 05How are the quality audits checked to make sure they are being completed consistently?
This was a focused inspection of Safe and Well-led, including infection control; the other key question ratings were carried over from previous comprehensive inspections. This explanation was written from the published report of 15 October 2020 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, July 2019
Highfield House was rated Requires Improvement because safety checks and quality monitoring were not reliable, although care was kind and responsive.
Inspectors made unannounced visits on 13, 15 and 20 May 2019. They spoke with people living in the home, a relative, staff and other professionals. They also observed care and checked care, medicines, staff and management records.
The home supported five people with learning disabilities, autism and/or mental health problems. People generally felt safe and supported. Staff knew people well, treated them with kindness, respected their choices and helped them stay active in the local community.
Inspectors found problems with fire and health and safety checks, medicines records, reviews of accidents and incidents, and some reports that should have been sent to CQC. The manager started making changes during the inspection, but inspectors could not yet check whether these changes worked.
The overall rating fell from Good at the previous inspection to Requires Improvement. Effective, Caring and Responsive were rated Good. Safe and Well-led were rated Requires Improvement.
Kind and respectful care
People were treated with kindness, dignity and respect. Staff built positive relationships and involved people in decisions about their support.
“People were supported in an inclusive caring environment where they were treated with respect and kindness.” from the report
Personalised support
Staff understood people's individual needs and adapted activities and support to their wishes. People were helped to stay connected with their community and important relationships.
“People received care and support which was personalised and responsive to their needs.” from the report
Stable staffing
There were enough staff with the right skills and experience. The home did not use agency staff, and required recruitment checks were completed.
“People were supported by a stable staff team who knew them well.” from the report
Good staff development
Staff received training, supervision and appraisals. They were encouraged to gain qualifications relevant to their roles.
“People were supported by staff who received suitable training for their role.” from the report
Safety checks were incomplete
seriousFire safety and health and safety checks had not always been completed. Inspectors said this could put people at risk.
“Environmental risks to people's health and safety were not always well managed.” from the report
Quality monitoring missed problems
seriousThe home's audits did not reliably identify shortfalls in safety, medicines management or incident reviews. This was a breach of Regulation 17.
“These shortfalls had not been identified by the audits carried out by the service.” from the report
Medicines checks needed improvement
needs fixingOne medicine was out of date. It was replaced immediately, and extra checks were introduced during the inspection.
“We found one medicine we looked at was out of date.” from the report
Some required notifications were missed
seriousThe home did not always tell CQC about safeguarding concerns and allegations when legally required. The report says this did not affect people's safety because other safeguarding action was taken.
“Safeguarding concerns and allegations had not always been reported to CQC as legally required.” from the report
- 01What changes have you made to ensure all fire safety and health and safety checks are completed on time?
- 02How do you now check medicines are in date and that the new medicines supply arrangements are being followed?
- 03How are accident and incident records reviewed promptly, and how are lessons shared with staff?
- 04What action was included in your CQC improvement plan for the Regulation 17 breach?
- 05How do you make sure all safeguarding concerns and other required events are reported to CQC on time?
This was an unannounced inspection of the care home covering all five CQC questions and the overall rating, with the previous Good rating from 2016 reassessed. This explanation was written from the published report of 12 July 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.
Every inspection of Highfield House
5 rated inspections over 6 years: the service has held its Good rating throughout.
- October 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2019Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- March 2017Goodstayed GoodSafe: Good
- October 2016Goodstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2014GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 20 January 2011.
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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