CQC report explained · a residential care home
What the CQC found at Highgrove House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse, avoidable harm and infection. There were enough staff, risks were reviewed and medicines were generally managed safely, although thickener records were not always complete.
- Effective?
- Good
- People's needs were assessed and reviewed. Staff had suitable training, supported people with food and healthcare, and improved their recording of mental capacity decisions.
- Caring?
- Good
- This question was not inspected during this visit. The rating carried over from the previous inspection.
- Responsive?
- Good
- This question was not inspected during this visit. The rating carried over from the previous inspection.
- Well-led?
- Good
- Governance systems had improved. The manager used audits, reviewed risks and incidents, involved relatives and staff, and monitored the service.
What inspectors found, June 2023
Highgrove House was rated Good; inspectors found safe, effective and well-led care, with some medicine records needing improvement.
This was an unannounced, focused inspection on 24 May 2023. The inspector and an Expert by Experience spoke with people, relatives and staff, and checked care records, medicines, recruitment files, audits and safety documents.
The home was rated Good for Safe, Effective and Well-led. Inspectors found enough staff, safer recruitment, suitable training, regular risk checks and improved management systems. People were supported with food, healthcare, consent and mental capacity decisions.
There was one recommendation about recording the amount of thickener added to drinks. Inspectors also found that call bells had been removed from a communal area, but the registered manager retrieved them immediately.
The previous rating was Requires Improvement, published in June 2022. The report says improvements had been made and the home was no longer in breach of regulations. This inspection did not cover Caring or Responsive, so those ratings carried over from the previous inspection.
Enough permanent staff
Inspectors found enough staff and less reliance on agency workers. Relatives reported good continuity and consistency.
“There were enough staff to keep people safe with less reliance on agency staff.” from the report
Improved oversight
The home had improved its audits and checks after the previous inspection. The manager monitored risks, medicines and the environment.
“We saw that governance systems had been improved following the last inspection.” from the report
Support with health and nutrition
Staff understood people's dietary and health needs. They worked with outside professionals and supported people to attend healthcare appointments.
“Staff worked well with other agencies and supported people to live healthy lives and access further support.” from the report
Positive relationships
Inspectors saw positive relationships between staff and people. Relatives spoke highly of the support and communication.
“We observed positive relationships between staff and people that used the service.” from the report
Incomplete thickener records
needs fixingStaff recorded when thickener was added to drinks but did not always record how much was used. The CQC made a recommendation for the provider to review current guidance.
“Staff recorded when they added thickener to people's drinks, however, did not always record the amount added.” from the report
Call bell removed from communal area
minorCall bells were available in bedrooms, but had been removed from a communal area. The manager retrieved them immediately when inspectors raised this.
“Nurse call bells were now in place in people's bedrooms however the call bells had been removed from the communal area.” from the report
- 01How do you record the amount of thickener added to each person's drinks, and how do you check those records?
- 02Are call bells now available and working in every bedroom and communal area?
- 03What audits do you carry out to check medicines are recorded and managed safely?
- 04How do you make sure mental capacity decisions and any covert medicines remain properly recorded and reviewed?
- 05What are the current ratings and findings for Caring and Responsive, which were not inspected in this visit?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings carried over. This explanation was written from the published report of 16 June 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, June 2022
Highgrove House was rated Requires Improvement; inspectors found risks with call bells, medicines records, mental capacity checks and quality monitoring.
This was an unannounced focused inspection on 28 April 2022. Two inspectors spoke with people, relatives, staff and managers. They reviewed care records, medicines records, staff files and health and safety checks, and observed the home.
People generally said they felt safe and staff were caring and available. The home had enough staff, followed safe recruitment procedures, supported people with health needs and had suitable infection control practices. However, some bedrooms and communal areas did not have accessible call bells, and some medicines records were incomplete.
Inspectors also found that mental capacity assessments had not always been completed for specific decisions. The home's checks and audits had not found these problems promptly. The overall rating changed from Good at the previous inspection to Requires Improvement. The inspection only covered Safe, Effective and Well-led. Caring and Responsive were not inspected.
Enough staff
Inspectors found adequate staffing levels and saw staff respond promptly to requests for help.
“We observed staff responding to people's requests for support promptly.” from the report
Safeguarding
People were protected from abuse risks. Staff had safeguarding training and the manager followed procedures when concerns were reported.
“People were protected from the risk of abuse and their human rights were respected and upheld by staff who had received training on safeguarding adults.” from the report
Health support
Staff worked with GPs, social workers and other health professionals. Care records showed that professional advice was recorded and acted on.
“The registered manager and their staff worked effectively with healthcare professionals to ensure people's healthcare needs were met.” from the report
Infection control
The home was visibly clean and inspectors were assured that infection prevention arrangements were in place.
“People were protected against the risk of infection. The service was visibly clean, and people said they thought the home was kept clean.” from the report
Call bells and environmental safety
seriousEight bedrooms and one ensuite toilet did not have usable call bells. A communal call bell was also out of reach for some people, which could have prevented them summoning help in an emergency.
“We could not be assured people would be able to summon for help should they require support in an emergency.” from the report
Medicines records
seriousFive of the medicines records checked had missing signatures. One person's record had not been signed for three days, so inspectors could not confirm that medicines had been given as prescribed.
“We could not be assured that people had received their medicines as prescribed.” from the report
Mental capacity checks
seriousSpecific mental capacity assessments were missing for several decisions, including moving bedrooms, a relationship and covert medicines.
“There was a failure to seek consent and assess people's mental capacity to make specific decisions.” from the report
Management oversight
seriousAudits and governance systems had not identified important problems before the inspection. This included environmental checks, medicines records and mental capacity assessments.
“We identified shortfalls that had not been identified by the audit system before our inspection.” from the report
- 01Have all bedroom and communal-area call bells been made accessible and included in regular safety checks?
- 02What changes have been made to ensure every medicines record is signed accurately, including topical creams and thickening powders?
- 03How are you now completing and recording mental capacity assessments for specific decisions and covert medicines?
- 04What checks now make sure audits identify problems quickly and that action is followed through?
- 05What progress has been made on the action plan requested by CQC?
This was an unannounced focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and the overall rating used the findings from this inspection alongside the existing ratings. This explanation was written from the published report of 11 June 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 Highgrove House
4 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- June 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2022Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- February 2021Inspected but not ratedSafe: Inspected but not rated
- October 2017Goodup from Requires improvementSafe: GoodEffective: Requires improvementWell-led: Good
- October 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
- January 2015
Report published without a new overall rating.
- July 2014
Report published without a new overall rating.
- May 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- September 2013
Registered with the Care Quality Commission on 26 September 2013.
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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