CQC report explained · a residential care home
What the CQC found at Highlands Borders Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors were assured that the home was preventing infection, using PPE safely, following social distancing and shielding guidance, and managing outbreaks.
- Effective?
- Good
- This question was not assessed in this targeted inspection.
- Caring?
- Good
- This question was not assessed in this targeted inspection.
- Responsive?
- Good
- This question was not assessed in this targeted inspection.
- Well-led?
- Good
- This question was not assessed in this targeted inspection.
What inspectors found, December 2020
Highlands Borders Care Home: Inspected but not rated; inspectors found good infection prevention and control arrangements during a coronavirus outbreak.
Inspectors visited on 27 November 2020. This was an announced, targeted inspection focused on infection prevention and control during a coronavirus outbreak.
They found that staff were following infection control guidance. The home had suitable personal protective equipment, increased cleaning, testing arrangements, risk assessments and procedures for isolation and social distancing.
Staff supported people in their rooms, including with one-to-one activities and contact with family and friends. The home was not accepting new admissions or visitors at that time, but it was preparing for safe visiting.
The service was inspected but not rated. This means the visit did not give an overall quality rating or a rating for safe care.
Infection control
Inspectors found that the home had strong arrangements to reduce the spread of infection, including PPE, cleaning and testing.
“We were assured that this service met good infection prevention and control guidelines.” from the report
Clean environment
The home had increased its cleaning schedule and inspectors described it as very clean.
“The home was very clean throughout and the domestics were working hard to maintain an increased cleaning schedule.” from the report
Support during isolation
Staff provided frequent visits and one-to-one activities for people staying in their rooms, including people living with dementia.
“Staff allocated to named people were providing additional one to one activity with people in their rooms and visited them frequently.” from the report
Staff support
The report describes a long-standing team working together to cover shifts and meet people's needs during the outbreak.
“This is a home with a long standing, small and loyal staff team who know the people they support well.” from the report
Inspectors raised no specific concerns in this report.
- 01How are people supported with activities and regular contact when communal areas are not being used?
- 02What visiting arrangements are currently in place, and how do you keep visits safe?
- 03How do you maintain staffing levels if staff are absent or people need to isolate?
- 04How are new staff and agency staff trained before they work in the home?
- 05How do you support people living with dementia who need to isolate in their rooms?
This was a targeted inspection of infection prevention and control during a coronavirus outbreak; the service was inspected but not rated and the other care questions were not assessed. This explanation was written from the published report of 18 December 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, May 2020
Rated Good; inspectors found safe, kind and personalised care, but staffing pressures and some overdue training needed attention.
This was an unannounced inspection on 17 and 23 January 2020. One inspector spoke with people living at the home, visitors, staff and the manager. They observed care and reviewed care records, staff files, medicines, accident records, complaints and quality checks.
The home was caring, clean and well organised. People said they felt safe and received their medicines on time. Staff knew people well, respected their choices and worked with health professionals when people's needs changed. Activities, meals and care were adapted to individual preferences.
The inspectors found staffing levels were being maintained partly because the manager worked extra hours. Staff also said they were tired when supporting people at the end of life. Some training and supervision records were not up to date. A full-time deputy manager had started since the inspection.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. This was the same overall rating as the previous inspection, published in July 2017. The report says all regulatory requirements were being met and no concerns were identified with the care provided.
Safe medicines and safeguarding
People said they felt safe and received medicines on time. Staff understood safeguarding duties, and medicines were stored, administered and checked safely.
“People said they felt safe; they received their medicines on time.” from the report
Kind, individual care
Staff built warm relationships with people and families. They understood people's histories, emotions and preferences, and supported choice and independence.
“Positive, meaningful relationships had been developed between staff, people and their families.” from the report
Good food and support
People's dietary needs and preferences were understood. Meals were offered at a relaxed pace, with alternatives available.
“People ate in a leisurely manner without being rushed, choosing how they preferred to eat their meal” from the report
Activities and complaints
The home offered activities suited to people's interests and abilities. Complaints were investigated and dealt with in a timely way.
“Formal complaints had been well managed in a timely way with comprehensive investigation, communication and appropriate actions taken.” from the report
Quality monitoring
The home had regular reviews, meetings, surveys and checks on staff practice. The inspectors found these systems effective.
“The quality assurance process was effective. It reduced the risk of harm to people and promoted reflective and person centred practice.” from the report
Staffing pressure
needs fixingStaffing levels were maintained partly because the manager worked extra hours. This may be important for families whose relative needs close support or is approaching the end of life.
“Staffing levels were only maintained because of the registered manager working additional hours” from the report
End of life support
needs fixingThree people needed end of life care during the inspection. Staff said they were tired and wanted more time with people, so the provider was asked to review staffing and practice.
“Staff told us they were tired and would like to have more time to spend with people at the end of their life.” from the report
Training and supervision records
needs fixingThe manager said staff departures had made it difficult to keep training and supervision up to date. This was reflected in staff records.
“they were finding it difficult to ensure training and supervisions were up to date, which was reflected in staff records.” from the report
Building and garden issues
minorOne lift needed regular repairs and was sometimes unavailable. The report also said the provider had sometimes responded to garden safety problems after incidents rather than preventing them earlier.
“There were two lifts in the home, but one required regular repair and was sometimes not available for people to use.” from the report
Staff consultation
minorSome staff felt undervalued because the provider made decisions without consulting them. Issues involving the staff room and training payments were addressed during the inspection.
“staff expressed how they did not always feel valued by the provider as they took decisions without consultation” from the report
- 01How are staffing levels now managed when several people need end of life care at the same time?
- 02Have all staff training and supervision records been brought up to date since the inspection?
- 03What action has been taken to keep the lift available and reduce the distance people may need to walk?
- 04How are staff now consulted about changes that affect them?
- 05How are activities and care adapted for a person living with dementia who has difficulty communicating?
This was an unannounced inspection of the care, premises and all five CQC key questions, involving discussions, observations and checks of records and medicines. This explanation was written from the published report of 6 May 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.
Every inspection of Highlands Borders Care Home
3 rated inspections over 5 years: the service has held its Good rating throughout.
- December 2020Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- May 2020Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- November 2013
Registered with the Care Quality Commission on 4 November 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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