CQC report explained · a nursing home
What the CQC found at Highfields Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, January 2024
Rated Requires Improvement; inspectors found kind, personalised care but serious problems with medicines, infection control, safeguarding and management.
This was an unannounced follow-up inspection over 26 and 27 September and 10 October 2023. Inspectors spoke with people, relatives, staff and health professionals. They reviewed care plans, medicines records, staff training, recruitment records and management systems.
The home was caring and responsive. Staff knew people well, treated them kindly and supported personalised care, activities and communication. People were supported with food, healthcare, end of life wishes and decision-making.
However, some important safety systems were not working well. Inspectors found poor cleaning and infection control, unsafe medicines practices, gaps in staff training, safeguarding concerns and ineffective quality checks. The overall rating was Requires Improvement. Safe, Effective and Well-led were also Requires Improvement, while Caring and Responsive were Good.
Kind staff
Staff knew people well and generally treated them with patience, dignity and compassion. People and relatives spoke positively about the staff team's approach.
“Staff knew people well and showed kindness and compassion towards people.” from the report
Personalised care
Care plans included people's histories, interests, preferences and communication needs. Relatives were involved in reviews of care.
“People and their relatives had been involved in reviews of their care.” from the report
Support with health needs
Staff arranged support from health professionals when people needed it. The home worked with visiting health and social care teams.
“Staff were attentive to people's health needs, we saw from records the service had identified when people required support” from the report
Food and nutrition
Staff understood people's dietary needs and supported people discreetly at mealtimes. People were weighed regularly and records were checked for concerns.
“People were weighed regularly, to ensure they maintained a healthy weight.” from the report
Infection control and cleanliness
seriousInspectors found poor cleaning, damaged areas and soiled pressure-relieving equipment. This increased the risk of infection for people, relatives and visitors.
“The home was visibly dirty in parts, with stains and malodour observed on some carpets, flooring, and mattresses.” from the report
Medicines safety
seriousMedicines were not always stored or administered safely. Staff had out-of-date competency checks, some records were inaccurate and one rescue medicine could not initially be given safely by trained staff.
“Medicines were not received, stored and administered safely.” from the report
Safeguarding concerns
seriousInspectors observed a disrespectful interaction and inappropriate moving of a person. Required records and welfare checks were not completed at the time.
“This placed the person at risk of harm.” from the report
Staff training and competence
seriousSome staff had not received required training, supervision or competency checks for their roles. Agency staff did not always receive a robust induction.
“The provider had failed to provide sufficient numbers of competent and trained staff, which increased the risk to people's safety.” from the report
Weak quality monitoring
seriousThe provider's audits did not reliably identify or fix problems. A mixed floor covering that created a falls risk had not been dealt with after the previous inspection.
“Systems and processes to monitor the quality of care and monitor staff were not being followed.” from the report
- 01What evidence can you show that all staff who handle medicines have completed recent training and competency checks?
- 02What has been done to replace or repair the stained carpets, flooring and mattresses, and how is cleaning now checked?
- 03How are soiled pressure-relieving equipment and other shared equipment identified, cleaned and allocated to specific people?
- 04What changes have been made to safeguard people after the incidents observed during the inspection, including staff handling and welfare checks?
- 05How do your current audits identify and quickly fix risks such as medicines errors, staff training gaps and falls hazards?
This was a follow-up inspection prompted by the previous breach and concerns about healthcare responsiveness, with detailed checks of Safe, Effective and Well-led; Caring and Responsive were also rated. This explanation was written from the published report of 10 January 2024 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, October 2022
Requires Improvement; inspectors found some important safety and management problems, although the home is no longer in Special Measures.
This was an unannounced, focused inspection on 17 August 2022. Inspectors looked mainly at Safe and Well-led. They spoke with people, relatives and staff, and checked care plans, medicines records, staffing information, recruitment records and management records.
The home had improved since its previous Inadequate rating. Staff were kind, respectful and safely recruited. Training, infection control, cleaning and some safety checks had improved. People told inspectors they felt safe and inspectors found no evidence that anyone had been harmed during this inspection.
However, care records and risk assessments were not always complete or up to date. Inspectors found problems with falls risk management, medicines storage, wound records, staffing levels on the first floor and the use of quality checks. The home was still in breach of Regulation 17 on good governance.
The overall rating changed from Inadequate to Requires Improvement. The home is no longer in Special Measures, but CQC will ask for an action plan and continue to monitor progress.
Kind and respectful staff
People told inspectors they felt safe. Staff were observed speaking to people respectfully and kindly.
“People were spoken to with respect and kindness by staff.” from the report
Safer recruitment and training
Staff recruitment checks were completed. Training had improved and included areas linked to people's clinical needs.
“Staff were safely recruited and had completed all training which the provider had identified as necessary.” from the report
Improved infection control
Inspectors found improvements in cleaning, PPE use and infection control arrangements.
“We were assured that the provider was using PPE effectively and safely.” from the report
Personalised support
The home had an activity coordinator and provided tailored activities. Staff also used signs and phrases to support people with communication needs.
“We saw evidence of an activity planner, and personalised support being provided to people who required tailored activities.” from the report
Falls risks were not managed consistently
seriousSome care plans did not give clear instructions about spectacles, shoes or walking aids. Two care plans did not have up-to-date mobility risk assessments, and flooring was identified as a significant falls risk.
“People were not always protected from the risk of falls.” from the report
Medicines storage problem
seriousThe medicines fridge temperature was outside the safe range for 15 consecutive days. The provider acted during and after the inspection, but CQC said it would check this again.
“Medicines were not always stored and managed safely.” from the report
Insufficient first-floor staffing
seriousInspectors found that there were not enough staff deployed on the first floor to meet people's identified needs. The provider reviewed staffing ratios after the inspection.
“There were insufficient staff deployed on the first floor of the building to support the identified needs of people using the service.” from the report
Incomplete records
needs fixingSome care information conflicted with information from health professionals. Inspectors also found gaps in wound-management records.
“Records of wound management were not always maintained.” from the report
Quality checks did not identify all risks
seriousAudits were in place but were not always used effectively. For example, call-bell checks did not analyse response times, and significant events were not always reported to CQC promptly.
“Quality monitoring systems and processes were in place but not always effectively used to reduce risks for people.” from the report
- 01What has been changed to make sure every person at risk of falling has a clear, current risk assessment and care plan?
- 02How do you check that staffing on the first floor is sufficient at all times?
- 03What checks now confirm that the medicines fridge stays within the required temperature range?
- 04How are wound records checked so that staff follow advice from health professionals?
- 05How do you measure call-bell response times and act when they are outside your own target?
This was an unannounced focused inspection of Safe and Well-led; the other key-question ratings were carried over from the previous inspection. This explanation was written from the published report of 21 October 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 Highfields Nursing Home
8 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- January 2024Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2022Requires improvementup from InadequateSafe: Requires improvementWell-led: Requires improvement
- December 2021Inadequatedown from Requires improvementSafe: InadequateWell-led: Inadequate
- April 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- June 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- September 2011
Registered with the Care Quality Commission on 16 September 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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