CQC report explained · a residential care home
What the CQC found at Highview Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Medicines were not safely managed, environmental risks were not always monitored, and accidents and incidents were not consistently reviewed. Staffing, safeguarding and infection control arrangements were positive.
- Effective?
- Requires improvement
- This question was not assessed during this focused inspection.
- Caring?
- Requires improvement
- This question was not assessed during this focused inspection.
- Responsive?
- Requires improvement
- Care plans and risk assessments did not always explain people's individual needs. People living with dementia were not always supported with information to help them choose, although activities were provided and staff generally knew people well.
- Well-led?
- Requires improvement
- Quality audits were incomplete or out of date, and management systems did not reliably identify risks or improve care. This was the third CQC inspection where a breach in governance was found.
What inspectors found, January 2023
Rated Requires Improvement; inspectors found risks in medicines, safety checks and management systems.
This was an unannounced focused inspection on 21 and 22 September 2022. Inspectors followed up earlier breaches and concerns about accidents, incidents and how the home was managed. They spoke with people, relatives, staff and professionals, and checked care plans, medicine records and management audits.
The home was not always safe. Medicine stocks did not match electronic records, safety checks were out of date and risks from the building were not always identified. Accidents and incidents were not consistently reviewed to prevent similar events happening again. The home also did not have a registered manager in place at the time.
There were positive findings. People said they felt safe, staffing levels were enough, and relatives felt their loved ones were well cared for. Staff generally knew people's likes and dislikes, daily activities were provided, and complaints were recorded and followed up. However, care plans did not always contain enough information, and people living with dementia were not always given information in a way they could understand.
The overall rating was Requires Improvement. Safe, Responsive and Well-led were all rated Requires Improvement. Effective and Caring were not assessed during this focused inspection. The home remained in breach of Regulations 12 and 17, although the earlier breach of Regulation 9 had been resolved.
Enough staff
Inspectors found enough staff available to meet people's needs, and requests for help were answered promptly.
“We saw there were adequate staff available to meet people's needs during our inspection.” from the report
Activities
People had daily individual and group activities. Inspectors saw activities taking place that appeared enjoyable.
“The provider had employed an activity coordinator at the service and people were supported with activities daily.” from the report
People felt safe
People told inspectors they felt safe, and safeguarding systems and staff training were in place.
“People told us they felt safe at Highview Home.” from the report
Complaints handled
The home had systems to record, respond to and learn from complaints.
“The provider had a system in place to record, respond to and review any learning from complaints received.” from the report
Medicines
seriousMedicine stocks did not match electronic records. This meant inspectors could not be sure that people had received medicines as prescribed.
“People's medicines were not safely managed.” from the report
Safety monitoring
seriousEnvironmental checks, including fire alarm and emergency lighting checks, were not up to date. Codes for secure doors had also been written on the doors.
“The safety of the environment was not always monitored.” from the report
Learning from incidents
needs fixingAccidents and incidents were only sometimes reviewed, so possible patterns and lessons could be missed.
“Systems were not effective in identifying trends following incidents, with a view to reducing the risk of further incidents in the future.” from the report
Dementia-friendly information
needs fixingSome people living with dementia had difficulty understanding meal choices. The provider planned to use pictures to help people choose.
“The service didn't always ensure communication was dementia friendly.” from the report
Weak governance
seriousAudits were not consistently completed or up to date. Management systems did not identify several of the problems found by inspectors.
“Systems and processes were not established to ensure service users received safe, quality care that meets their current needs.” from the report
- 01How do you now check that medicine stock matches the electronic records and that medicines are given as prescribed?
- 02How often are medicine competency checks, fire safety checks and other safety audits now completed?
- 03How do you review accidents and incidents for patterns, and what changes have you made as a result?
- 04How have care plans been updated to cover people's health needs, distress behaviours and medicines that affect their response to falls or injuries?
- 05How are people living with dementia now helped to understand meal choices and other important information?
This was a focused inspection of Safe, Responsive and Well-led only; Effective and Caring were not assessed during this visit. This explanation was written from the published report of 5 January 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, September 2022
Highview Home was rated Requires Improvement; inspectors found risks with care plans, medicines, activities and management systems.
Inspectors visited the home without notice on 3 and 4 November 2021. They spoke with people, relatives and staff, reviewed care and medicine records, checked staff files and observed how care was given.
People said they felt safe and that staff were kind and respectful. Infection control had improved since the previous inspection. However, some risks were not managed properly, including missed medicines, poor monitoring of fluid intake, choking risks and falls risks.
People did not always receive personalised care or enough activities. They were not consistently involved in care reviews or discussions about end of life wishes. The home had no registered manager at the time, and its systems had not found or fixed important problems. The overall rating and all three assessed areas remained Requires Improvement.
People felt safe
People told inspectors they felt safe. Staff understood how to recognise and report safeguarding concerns, and safeguarding incidents had been referred to the relevant agencies.
“Where a safeguarding incident had been identified, the relevant agencies had been notified and action had been taken by the service.” from the report
Improved infection control
Inspectors found improvements in infection control since the previous inspection. They were assured about the use of protective equipment, testing, hygiene and managing infection outbreaks.
“At this inspection we found the provider had taken action in response to our concerns and had made improvements.” from the report
Kind and respectful staff
People said staff were kind, caring and respectful. Inspectors also observed some examples of this.
“People told us staff were kind and caring and treated them with dignity and respect and we observed some of this.” from the report
Approachable new manager
People, relatives and staff knew who the newly appointed manager was and said they felt able to approach them. Staff felt the manager had started to make improvements.
“People and relatives told us they knew who the manager was and they were approachable.” from the report
Risk assessments were incomplete
seriousSome risk assessments did not explain what staff should do. Inspectors found gaps involving falls, choking, diabetes and injuries after accidents.
“Risk to people had not been appropriately managed.” from the report
Limited activities and involvement
needs fixingPeople spent long periods with little interaction or activity. Care plans did not always reflect individual interests, and people and relatives were not consistently involved in care reviews or end of life decisions.
“During the inspection we observed people sat for long periods with little interaction and no objects of interest or activities available to them.” from the report
Weak management checks
seriousThe home's audits and other checks had not identified repeated problems. There was no effective system to analyse accidents and incidents or use them to prevent a recurrence.
“There was no system in place to monitor accidents and incidents.” from the report
Missing training
needs fixingStaff did not have training in some areas needed for people's care, including diabetes and end of life care.
“The training matrix seen had no training in end of life care, diabetic care or enhanced training in Hoist use.” from the report
- 01How do you now make sure every person's medicine is in stock and given as prescribed?
- 02What has changed to make sure care plans and risk assessments give staff clear instructions about falls, choking, diabetes and fluid intake?
- 03How are people and relatives now involved in care reviews and decisions about end of life care?
- 04What regular checks now track accidents, incidents, medicines and care plan updates, and what action is taken when problems are found?
- 05What activities are now available, and how are they matched to each person's interests and abilities?
This inspection looked only at Safe, Responsive and Well-led; the report says the other two key questions were not inspected because no concerns had been identified about them. This explanation was written from the published report of 8 September 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 Highview Home
7 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- January 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2022Requires improvementstayed Requires improvementSafe: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2021Requires improvementSafe: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2020Inspected but not ratedSafe: Inspected but not rated
- December 2019Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2018Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2017Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2020
Registered with the Care Quality Commission on 17 April 2020.
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
At least 100 live-in carers within about an hour of Dudley
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 £1,230 a week. 88 can care for a couple. 10 years' experience on average.
“I have never met a person who is so kind and thinks about others before himself to such an extent as Chris Malagala.”
“Knowing Mum was in Corina's care made an enormous difference to us and we knew she was in safe hands.”
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.