CQC report explained · a residential care home
What the CQC found at Highlands Deben
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks such as falls, pressure ulcers, mobility and eating and drinking were assessed and reduced. Medicines, staffing, equipment and infection control were also managed safely.
- Effective?
- Good
- People's needs were assessed before they moved in. Staff had training and supervision, and people's food, drink and healthcare needs were supported.
- Caring?
- Good
- People described staff as kind and caring. Inspectors saw staff listen to choices, protect privacy and dignity, and support independence.
- Responsive?
- Good
- Care plans had been improved and were person-centred. People had activities, accessible information and a complaints process, and this rating had improved from Requires Improvement.
- Well-led?
- Good
- The management team used audits, meetings and people's feedback to identify and address shortfalls. Inspectors found a positive culture and good links with health and social care professionals.
What inspectors found, October 2019
Highlands Deben is rated Good across all five areas; inspectors found safe, kind and personalised care, but noted a serious past safety incident.
This was an unannounced inspection on 1 October 2019. One inspector spoke with six people, one relative and eight staff. They observed care and reviewed care plans, medicine records, staff files, training records and management checks.
The inspectors found that people were safe, received medicines properly and had enough staff to help them. Staff were kind and respected people's choices, privacy and independence. People's health, food and drink needs were assessed, and there were activities, complaint arrangements and end of life plans.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The Responsive rating had improved from Requires Improvement at the previous inspection. The report also records a previous serious incident and prosecution, but found that the home had strengthened its safety checks and risk management by this inspection.
Stronger safety checks
The home had systems to assess risks and take action to reduce avoidable harm. Equipment, fire safety and the environment were checked.
“At this inspection of 1 October 2019, we checked that people were safe and found the service assessed risks to people and took sufficient action to reduce the risks.” from the report
Kind and respectful staff
Inspectors saw staff communicate respectfully and support people's dignity, choices and independence.
“We saw that the staff interacted with people in a caring and respectful way.” from the report
Activities and social contact
People could join group activities or receive one-to-one support if they did not want to take part. Inspectors also saw people spending time with visitors.
“There was a programme of group activities, including songs of praise, manicures, beetle drive and visiting entertainers.” from the report
Serious past safety incident
seriousBefore the previous inspection, a person fell down the stairs and died. The provider later pleaded guilty and was fined. The current inspection found that safety and risk controls had been strengthened.
“Prior to our last inspection a person fell down stairs at the service and died.” from the report
End of life training
needs fixingThe report says some staff had received end of life training, while further training was due. Ask how this training was completed and kept up to date.
“Some staff had received end of life training.” from the report
- 01What changes were made to the stairs, environmental checks and risk assessments after the previous fatal fall?
- 02How many staff are normally on duty during the day and night, and how quickly do they respond to call bells?
- 03How would you record and review my relative's preferences, life history, mobility and health needs?
- 04Has all relevant staff completed end of life training, and how are their skills checked?
- 05The report says the home does not provide nursing care. What healthcare needs can you support, and when would another service be needed?
This was an unannounced planned inspection that looked at the premises, care provided and all five CQC questions; the previous inspection was published on 12 April 2017. This explanation was written from the published report of 22 October 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.
What inspectors found, April 2017
Highlands Deben was rated Good overall, but inspectors found care was not always personalised or responsive.
Inspectors visited unannounced on 23 February 2017. They spoke with six people, observed care, spoke with managers and staff, and reviewed nine people's care records, risk assessments, medicines records and other documents.
The home was rated Good for being safe, effective, caring and well-led. People felt safe, staff had suitable training, medicines were managed properly, and people were supported with healthcare, food, choices and contact with relatives.
The home Requires Improvement for being responsive. Care plans did not always explain people's history, preferences, emotional needs or the support they needed. People's hobbies and independence were not always supported, and activity records were incomplete.
The inspection was prompted partly by an incident after which a person died. The report says this was subject to a criminal investigation and that inspectors did not examine the circumstances of the incident, but they did examine related environmental risks.
People felt safe
People said they felt safe. Staff understood how to recognise and report abuse, and risk assessments covered areas such as falls, nutrition and moving and handling.
“People told us they felt safe living at the service.” from the report
Medicines were managed
Medicines were stored securely. Staff were trained, records were checked and regular audits were used to identify and address problems.
“Regular audits of medicines and MAR's were carried out and action taken to address any problems identified” from the report
Support for health and nutrition
People received healthcare support and referrals when needed. The home monitored weight and used additional nutritional support where appropriate.
“People were supported to eat sufficient amounts and maintain a balanced diet.” from the report
Contact with relatives
People were supported to keep in touch with friends and family. The home offered a guest room and tablet computers for video calls.
“This provided an opportunity for people to have contact with relatives to help keep them involved and connected with relatives and friends.” from the report
Feedback was acted on
People, relatives and staff were asked for their views through surveys and meetings. The home used this feedback to make changes.
“Once these surveys had been completed and returned, they were analysed and action plans were created to respond to any issues raised.” from the report
Care plans lacked personal detail
needs fixingCare plans used tick lists and did not always explain how people wanted to live, their history, emotional needs or the support they required when their condition changed.
“Care plans were not fully focussed on a person's whole life, including their emotional and social care needs.” from the report
Independence was not always supported
needs fixingMobility frames were moved away from the dining room, meaning some people had to wait for staff. Inspectors also found that routines could suit staff rather than people's preferences.
“People were not always supported to be as independent as they were able.” from the report
Activities and interests were not consistently supported
needs fixingSome people had no activity entries, and records did not always show what people had done. Individual interests were not always included in care plans or supported.
“People's individual interests were not always supported and encouraged.” from the report
Some staff interactions lacked dignity
needs fixingInspectors observed some brusqueness when staff served refreshments and were told about inappropriate language between staff when discussing a person's needs.
“However, we did observe some brusqueness from staff towards people when serving them with refreshments.” from the report
- 01How have you changed care plans so they record each person's history, preferences, emotional needs and changing support needs?
- 02How do you make sure mobility aids are available so people can move around independently?
- 03How do you record and review activities for each person, including their individual hobbies and interests?
- 04What dignity training have staff completed since the inspection, and how do you monitor staff interactions?
- 05What action was taken after the external health and safety assessment mentioned in the report?
This was an unannounced inspection covering all five CQC questions; it did not examine the circumstances of the death linked to the incident because that was subject to a criminal investigation. This explanation was written from the published report of 13 April 2017 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 Deben
3 rated inspections over 4 years: the service has held its Good rating throughout.
- October 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- June 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 23 November 2010.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
23 live-in carers within about an hour of Suffolk
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 £1,020 to £1,260 a week. 17 can care for a couple. 7 years' experience on average.
“Not only was she professional, polite and efficient but she bought a lovely smile and laughter to my parents home.”
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.