CQC report explained · a residential care home
What the CQC found at Highfield
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Risk assessments and care plans for known health conditions were out of date, and not all staff had the right training. Medicines, staffing levels, recruitment checks and infection control were found to be safe.
- Effective?
- Good
- This key question was not inspected during this focused visit, so its previous rating was carried forward.
- Caring?
- Good
- This key question was not inspected during this focused visit, so its previous rating was carried forward. Inspectors noted that people received kind and compassionate care.
- Responsive?
- Good
- This key question was not inspected during this focused visit, so its previous rating was carried forward. Inspectors found that people were not always supported towards meaningful quality-of-life outcomes.
- Well-led?
- Requires improvement
- Governance systems were not effective. Records, audits, staff supervision and the use of feedback did not consistently support safe, good-quality care.
What inspectors found, March 2023
Rated Requires Improvement; inspectors found unsafe gaps in risk management, staff training and service oversight.
This was an unannounced focused inspection over three days. One inspector spoke with people, relatives and staff, and checked care records, medicines records, staff files and management records.
The home was not always safe. Risk assessments and care plans were out of date, some staff lacked training in epilepsy and diabetes, and records of health events and incidents were not always accurate. Medicines were managed safely, staffing levels were sufficient, and recruitment checks were in place.
The home was not well-led. Management had been unstable, records and audits were not reliable, staff supervision was inconsistent, and feedback was not clearly used to improve the service. The provider made some immediate changes after the inspection, including updating care plans and risk assessments.
The overall rating changed from Good at the previous inspection in 2018 to Requires Improvement. Only Safe and Well-led were inspected during this visit. The other key question ratings carried over from the previous inspection.
Kind and respectful care
People received care from staff who knew them and used language people understood. People and relatives were positive about staff attitudes and behaviour.
“People received kind and compassionate care from staff who used positive, respectful language which people understood and responded well to.” from the report
Safe recruitment and staffing
The home carried out recruitment checks, including references and DBS checks. Inspectors found enough staff were available to meet people's needs.
“We found sufficient staff were deployed to maintain people's safety and meet individual needs.” from the report
Medicines management
The home had identified medicines concerns and acted on them. Audits were completed, errors were addressed, and information for giving as-required medicines was recorded.
“When people required 'as required' (PRN) medicines the reasons for administration were recorded and staff had all the information required to administer them as prescribed.” from the report
Safeguarding awareness
Staff understood how to recognise abuse and raise concerns. The manager understood responsibilities to report safeguarding concerns.
“Staff were knowledgeable in safeguarding people and understood the signs of abuse and how to raise concerns if they needed to inside and outside of the organisation.” from the report
Out-of-date health risk information
seriousCare plans and risk assessments did not reflect people's current health needs. Staff did not always follow the available guidance, increasing the risk of unsafe care.
“Risk assessments and care plans relating to people's known health conditions were out of date and not reflective of people's current needs.” from the report
Staff training gaps
seriousNot all staff had training in epilepsy or diabetes, or the knowledge needed to support people with learning disabilities and autism. The provider allocated new training after inspectors raised this.
“This placed people living at the service with these health conditions at risk of receiving unsafe care.” from the report
Weak management oversight
seriousRecords, audits and quality checks did not reliably identify and fix problems. The unstable management team had affected the quality and safety of the service.
“The provider had failed to have robust systems and processes to assess, monitor and improve the service.” from the report
Incomplete incident records
needs fixingSome incident forms were incomplete, and records did not always show what action was taken after health concerns. Inspectors could not confirm that lessons were learned from incidents.
“There was insufficient evidence at this inspection to confirm lessons were learned when things went wrong.” from the report
Inconsistent staff supervision
needs fixingStaff did not receive regular one-to-one supervision. Some staff said they felt unsupported and had not had enough opportunity to learn the skills needed for their roles.
“1:1 supervision to discuss staff progress, support, knowledge gaps and training requirements was inconsistent.” from the report
- 01What has been changed to keep each person's health risk assessment and care plan up to date?
- 02Which staff have completed epilepsy, diabetes, learning disability and autism training, and how is their competence checked?
- 03How are incidents, health appointments and follow-up actions now recorded and reviewed?
- 04How often do staff receive one-to-one supervision, and how are gaps in their knowledge identified?
- 05What action plan was sent to CQC, and what progress has been made since the inspection?
This was a focused inspection of Safe and Well-led only; the other key question ratings carried over from the previous inspection in 2018. This explanation was written from the published report of 4 March 2023 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, March 2018
Rated Good; inspectors found safe, kind and personalised care, with no serious risks or concerns identified.
This was a comprehensive announced inspection on 6 February 2018. One inspector spoke with people living at the home, staff and managers, and reviewed care records, medicines, recruitment, training, meetings and safety checks.
The home supported six adults with learning disabilities and mental health needs. Five people were living there at the time. Inspectors found that people were protected from abuse, medicines were managed safely, staff were trained, and people's health, diet, choices and relationships were supported.
People were treated with kindness and respect. Care was personalised, and people were supported with activities, work placements, day care and social opportunities. All five areas inspected were rated Good, the same overall rating as at the previous inspection in January 2016.
Safe medicines
Medicines were administered safely, records were accurate and regular audits checked that people received medicines safely.
“Records showed the medication administration records (MAR) were completed accurately by staff and regular medicines audits took place to check people consistently received their medicines safely.” from the report
Kind relationships
Inspectors saw warm relationships between staff and people. People said they were happy with the support they received.
“We observed staff treated people with warmth and kindness.” from the report
Personalised support
Staff knew people well and supported their individual routines, goals, hobbies and interests.
“The care plans contained information on people's backgrounds, which helped staff to understand people's conditions and how they could help people to follow their hobbies and interests.” from the report
Choice and involvement
People were involved in decisions about meals, activities, furnishings and how they spent their time.
“People told us they could choose how they wanted to spend their time and staff said they supported people to pursue their individual lifestyles.” from the report
Staff support and learning
Staff had induction and refresher training, as well as regular supervision and team meetings to discuss learning and service needs.
“These meetings gave staff the opportunity to discuss individual learning and development needs and the general needs of the service.” from the report
No lift
minorThe home has bedrooms on upper floors but no lift. Inspectors said this could restrict care for someone with a physical disability, so this is important to discuss if your relative has mobility needs or those needs may change.
“There was no lift facility, which would pose a restriction on providing care for people with a physical disability.” from the report
- 01How would you support my relative if they developed a physical disability or had difficulty using stairs?
- 02How will you involve my relative and our family in reviewing their care plan and personal goals?
- 03How do you check that medicines continue to be given correctly and that records remain accurate?
- 04What activities, work placements or social opportunities could my relative take part in?
- 05How will the new registered manager keep staff supervision, training and quality checks up to date?
This was a comprehensive announced inspection covering all five CQC questions, and the overall rating remained Good from January 2016. This explanation was written from the published report of 28 March 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.
Every inspection of Highfield
3 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- March 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2018Goodstayed GoodSafe: GoodWell-led: Good
- February 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 13 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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What to check when you visit
At least 100 live-in carers within about an hour of West Northamptonshire
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 £1,280 a week. 87 can care for a couple. 12 years' experience on average.
“We can all fully relax around Nyarai and she feels like part of our family, which is no mean feat!”
“If you bump into her in the night on her way to the bathroom she will still inquire how you are and if everything is alright.”
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.