CQC report explained · a nursing home
What the CQC found at The Highgate Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, December 2022
The Highgate Care Home was rated Good; inspectors found safe, effective and well-managed care, with improvements after concerns about choking risks.
This was an unannounced inspection over three visits in August 2022. Inspectors spoke with people living at the home, a relative, staff and health and social care professionals. They observed care and reviewed care plans, staff records, medicines records and management checks.
The home was rated Good overall, and Good for Safe, Effective and Well-led. Inspectors found that risks were assessed, medicines were managed safely, staff were suitably recruited and trained, and people received support from health professionals.
The inspection followed information about a death from choking two years earlier. The report says it did not examine the circumstances of that death, but it did examine choking risks. The home had improved training and checks for soft and pureed food.
The overall rating improved from Requires Improvement to Good because the previous ratings for areas not examined during this inspection were also used. Caring and Responsive were not assessed in this inspection, so their previous ratings carried over.
Care planning
Care plans and risk assessments were person-centred and updated when people's needs changed.
“People had person centred care plans and risk assessments.” from the report
Food safety
The home improved its support for people on soft or pureed diets. Staff were trained and checked food taste and texture before serving it.
“A process for staff to check all soft and pureed foods for taste and texture had been put in place.” from the report
Medicines
Medicines were stored and given safely. Records had no gaps, including records for medicines given through feeding tubes.
“People's medicines administration records (MARs) were completed appropriately with no gaps.” from the report
Staffing and training
Inspectors found safe recruitment, relevant training and enough staff to meet people's assessed needs.
“Staff were recruited safely. Checks had been carried out to ensure that they were suitable for their roles.” from the report
Management checks
The provider and managers carried out regular audits and unannounced visits, including at night.
“The provider and management team carried out regular unannounced monitoring of care practice at the home.” from the report
Health support
Staff worked with health and social care professionals, and a local GP visited twice a week.
“The local GP visited the home twice weekly.” from the report
Lift not yet finished
needs fixingA new lift for people using larger specialist wheelchairs and stretchers was being installed, but the work had previously been delayed and was not complete at the time of the report.
“At the time of this report, work had commenced on installing the lift.” from the report
Communication records
needs fixingInspectors found inconsistent wording in two care plans for people who did not communicate verbally. Some records said they could not communicate, despite referring to body language and facial expressions.
“However, we found inconsistencies in the care plans of two people who did not communicate verbally.” from the report
Some decoration needed updating
minorSome areas of the home needed redecorating. The manager said further work would follow the lift installation.
“We observed that some of the home's decoration required updating.” from the report
- 01Has the new lift now been completed, and can it accommodate stretchers and larger specialist wheelchairs?
- 02How do you check the taste and texture of soft and pureed food before it is served?
- 03How do you make sure staff follow each person's swallowing and choking risk plan?
- 04What action was taken to correct the inconsistent communication records for people who do not communicate verbally?
- 05What ratings did Caring and Responsive receive at the previous comprehensive inspection?
This was an unannounced focused inspection of Safe, Effective and Well-led; Caring and Responsive were not assessed and their previous ratings carried over. This explanation was written from the published report of 16 December 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.
What inspectors found, May 2021
Rated Good overall; inspectors found safe, person-centred care, but accessibility and some effectiveness arrangements still needed improvement.
This was an unannounced focused inspection on 11 and 16 February 2021. Inspectors spoke with people, relatives and staff, observed care, and checked care plans, medicines, recruitment files, training records and quality checks.
The home was rated Good overall. Safe, Responsive and Well-led were rated Good. Inspectors found that care plans, risk assessments, medicines records, infection control and quality monitoring had improved since the previous inspection.
Effective remained Requires Improvement. The planned larger lift had not been installed, so some people with complex physical needs still used a lift in an adjoining service. End of life care plans also varied in detail.
The previous overall rating was Requires Improvement, published in November 2019. This focused inspection found enough improvement to raise the overall rating to Good, but it did not look at the Caring question.
Updated risk assessments
Risk assessments were regularly reviewed and updated when people's needs changed. They gave staff guidance on managing individual risks.
“People's risk assessments were person centred. They included guidance for staff on managing risks associated with, for example, mobility, moving and handling, personal care, behaviour and nutrition.” from the report
Safe medicines practice
Medicines were stored and given safely. Administration records had no gaps, including records for medicines given through feeding tubes.
“People's medicines were safely stored and administered in accordance with their individual prescriptions.” from the report
Person-centred care plans
Care plans included people's histories, preferences, communication needs and medical needs. They were updated when people's needs changed.
“People's care plans were person centred. They included detailed guidance for staff on how care should be delivered in accordance with people's needs and wishes.” from the report
Infection control
Inspectors were assured that the home had suitable arrangements for preventing and managing infection during the COVID-19 pandemic.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Family involvement
Families were kept informed and were involved in care reviews where appropriate. Safe visiting and video calls were available during the pandemic.
“People and family members told us they were involved in reviews of care.” from the report
Accessibility of the lift
needs fixingThe promised larger lift had not been installed. Some people with complex physical needs continued to use a lift in an adjoining service, which inspectors said could create an infection risk.
“During this inspection we found that there had been no further action to provide a new lift.” from the report
End of life plans varied
needs fixingSome end of life plans were detailed, but others contained little or no information. The home said some people and families had not wanted to discuss their preferences.
“People had end of life plans but the quality of these was variable.” from the report
Reduced group activities
minorGroup activities had reduced during the pandemic and while a new activities co-ordinator was starting. Care staff provided day-to-day activities and one-to-one activities were recorded.
“The client engagement manager told us that this had led to a reduction in some group activities, but that care staff were providing day-to-day activities according to people's interests.” from the report
- 01Has the larger, more accessible lift now been installed, and what arrangements are in place for people using specialist wheelchairs or stretchers?
- 02How do you reduce infection risks when people need to use the lift in the adjoining service?
- 03How will you make sure every person's end of life plan records their wishes and preferences?
- 04What activities are now available for people who cannot attend group activities?
- 05What improvements have been made since this focused inspection, particularly in the area rated Requires Improvement?
This was a focused inspection covering Safe, Effective, Responsive and Well-led; Caring was not inspected and its previous rating was used in calculating the overall rating. This explanation was written from the published report of 6 May 2021 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 The Highgate Care Home
6 rated inspections over 7 years: the service has held its Good rating throughout.
- December 2022Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2021Goodup from Requires improvementSafe: GoodEffective: Requires improvementWell-led: Good
- November 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 21 March 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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