We carried out a review of the data available to us about Highfield House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Highfield House, you can give feedback on this service.
We found the following examples of good practice.
There were procedures in place to support safe visiting, including appointments. Staff undertook basic screening of all visitors including temperature checks and a questionnaire to determine risks posed by visitors. Visitors were provided with Personal Protective Equipment (PPE) and guided to its safe use. Individual risk assessments had been completed for each person to determine the risks versus benefits for them to continue to receive designated family visitors.
The provider routinely tested people and staff for COVID-19. Staff had regular testing with rapid response lateral flow tests (LFT) as well as standard Polymerase Chain Reaction (PCR) tests weekly. LFT tests were available for use prior to visitors entering the home.
New admissions to the service were supported in line with best practice guidance. Admissions were expected to provide recent COVID-19 test results, were further tested by the service following admission and isolated upon arrival for 14 days to minimise the risk of potential infection to people already living at the service. These procedures would also be used for people returning to the home following a hospital stay.
Staff had been trained in infection control practices and individual risk assessments had been completed for each staff member.
The home was kept clean. Staff kept detailed records of their cleaning schedules, which included a rolling programme of continuously cleaning high touch surfaces, such as light switches, grab rails and door handles.
The service had an adequate supply of (PPE) to meet current and future demand. Staff were using this correctly and in accordance with current guidance and disposal was safe at the time of this inspection.
Highfield House is a care home registered to provide accommodation for up to 20 people. The service provides specialist care to people living with varying degrees of cognitive impairment. Some of the people at Highfield House had complex and sometimes challenging needs. The home also provides day care for people living in the community. Care was provided in a safe and dementia friendly environment. At the time of our inspection there were 20 people living in the home and six people being supported for day care.
People’s experience of using this service:
People at Highfield House received outstanding care and were supported by a staff team that were committed, passionate and knowledgeable. People were treated with exceptional kindness and had positive outcomes.
The service was especially responsive to the needs of people at the home, with a wide range of person-centred activities. Arrangements for social activities were innovative, met people's individual needs, and followed best practice guidance so people could live as full a life as possible. There were good community links and people accessed the community regularly.
The service went the extra mile to provide a family orientated and homely environment for people. Staff had developed strong relationships with people and knew them exceptionally well. People, their relatives and external health and social care professionals overwhelmingly told us that the staff made them feel included and part of a large family. One relative said, “It’s like a big family. They [staff] support us and make us laugh.”
Staff knew people exceptionally well and delivered care and support in a way that met those needs and promoted equality. People and their families were involved in planning their lives, and the service ensured that care was always personalised to meet the needs of each individual living there.
People received their medicines safely and as prescribed. Appropriate arrangements were in place for obtaining, recording, administering and disposing of prescribed medicines.
Staff used positive communication techniques with people so that they felt listened to and valued according to their individual needs. People’s unique communication styles were understood and respected by staff.
Staff were motivated by and proud of the home. Continuous learning was embedded in the home's culture.
People were supported by staff who were highly skilled, and knowledgeable in caring for people with complex needs. There were enough staff to meet people's needs and they supported people with a calm approach, that demonstrated their skills and confidence.
Appropriate recruitment procedures were in place to help ensure only suitable staff were employed.
The service ensured that care delivery was safe, with risks to people continually assessed to ensure both their home environment, and outings in the community were safe. Premises were well maintained.
Rating at last inspection:
The service was rated as Outstanding at the last full comprehensive inspection, the report for which was published on 01 December 2016. The service continues to be Outstanding.
Why we inspected:
This was a planned inspection based on the previous inspection rating.
Follow up:
There is no required follow up to this inspection. However, we will continue to monitor the service and will inspect the service again based on the information we receive.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Highfield House is a care home registered to provide accommodation for up to 20 people. At the time of our inspection there were 20 people living in the home. The service provides specialist care to people living with varying degrees of cognitive impairment. Some of the people at Highfield House had complex and sometimes challenging needs. Care was provided in a safe and dementia friendly environment.
There was a registered manager in place at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the home. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the home is run.
People received exceptionally person centred care from staff who knew each person well, about their life and what mattered to them. The people living at the home experienced a level of care and support that promoted their health and wellbeing and enhanced their quality of life. The service focussed on the individual needs of the people and their families. People, families and professionals all described Highfield House as a “Home from home” and praised the high quality person-centred approach to care provided by the staff.
People were supported by enough staff who were highly skilled and knowledgeable in caring for people with cognitive impairments. People and their relatives said or expressed that they felt safe in the service. Staff were clear about their safeguarding responsibilities and knew how to recognise signs of potential abuse and how to report it.
Staff carried out their roles and responsibilities effectively. Staff had an excellent understanding of managing risks and supported people to reach their full potential through inventiveness and personalised care. The attitude of the staff and their knowledge of the people clearly had a positive impact on the people and their families. Staff were skilled in helping people to express their views and communicated with them in ways they could understand.
People were treated with dignity and the greatest of respect at all times. Staff demonstrated caring and positive relationships with people and was sensitive to their individual choices. Staff focused on people's wishes and preferences and people were supported to remain active and independent.
The registered manager, provider and staff were highly responsive to the needs of the people and their families. Staff thought creatively about how people’s needs could be met and demonstrated a commitment to ensuring the service was tailor made and flexible to each individual. People and relatives and visiting professionals described the staff as ‘going out of their way’ to meet the needs of the people.
Staff worked tirelessly to meet the social, emotional and physical needs of the people they cared for. People’s lives were enhanced by being encouraged and aided to take part in activities they enjoyed and that were meaningful to them. Staff continually encouraged and supported people to remain active and independent.
People benefitted from an exceptionally well-managed and organised service and the provider and registered manager led by example. People were placed at the heart of the service though the providers clear vision and values that underpinned practice. The staff all recognised the on going importance of ensuring the vision and values were understood and implemented, without exception.
The registered manager was very approachable and well supported by the provider. There were comprehensive quality assurance processes in place using formal audits and regular contact with people, relatives, professionals and staff. Family members told us they were given the opportunity to provide feedback about the culture and development of the home and all said they were extremely happy with the service provided. The provider were responsive to new ideas and had developed links with external organisations and professionals to enhance the staff's and their own knowledge of best practice and drive forward improvements.
The provider, registered manager and staff all strived to improve the lives of the people using the service but also took an active role to increase the understanding of dementia and improve the quality of care provided to people living with dementia and their families in the wider community.
The management team and staff protected people’s rights to make their own decisions. Where people did not have the capacity to consent to care, legislation designed to protect people’s legal rights was followed correctly and confidently by staff. Staff demonstrated a clear knowledge and understanding of when Deprivation of Liberty Safeguards (DoLS) should be used and applications were made appropriately. DoLS provides a process by which a person can be deprived of their liberty when they do not have the capacity to make certain decisions and there is no other way to look after the person safely.
We spoke with three people using the service. One person told us 'they make me feel like it's my home.' Another said 'They look after me well'. A relative who was visiting that day said 'It's a lovely, lovely home. We are very lucky.'
We spoke with the manager, three senior carers, three carers, the administrator who also maintained the accounts and the chef. One senior carer told us 'The clients always come first. Cost doesn't matter, time doesn't matter.'
We reviewed care records for two people using the service. We found that people who lived at the home experienced safe and effective care because their needs were assessed and reviewed, and care plans updated to reflect a person's current needs.
People had a varied diet and were given the support and encouragement they needed to eat and drink.
People were protected from the risk of the unsafe management of medication because staff were trained and followed clear procedures.
There were effective systems in place to ensure people were safe because staff were subject to rigorous recruitment procedures and a thorough induction.
We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk to us. This helped us observe particular people and activities over a set period of time. This showed that there was a high level of staff initiated interactions with people and that these interactions were positive. Staff had a good knowledge of people.
We spoke with four health professionals involved in the care of people. They were complimentary about the way the service met people's needs. We were told that the home contacted them appropriately and followed guidance and suggestions. We observed that staff were courteous and respectful of people's views and opinions and that dignity was respected.