1 November 2022
During a routine inspection
Highwood Mill is an extra care housing setting where staff provide personal care and support to people living in their own flats within one large purpose-built building. People are supported with a range of needs including learning disabilities, age related frailties, physical disabilities, dementia, and Parkinson's disease. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our inspection, 46 people who were using the service received a regulated activity.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it. At the time of the inspection one person was living at the service who had a learning disability. We spoke with the person, who told us they were pleased with the care and support they received.
People’s experience of using this service and what we found
Right Support
Known risks associated with people's care were not always well-managed. Some people's risk assessments did not provide staff with the information they needed to keep people safe. Some people’s medicines were not always managed safely.
The model of care and settings maximised people's choice and independence, people had their own apartments which were adapted to suit their needs and taste. People were supported by staff to pursue interests and hobbies, staff supported people to achieve their aspirations and goals.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Right Care
People received kind and compassionate care by staff who knew them well. Staff respected people's privacy and dignity and, promoted their independence. There were enough skilled and trained staff to meet people's needs. People received consistent care as understood their individual communication needs.
Right Culture
Systems to monitor the quality and safety of the service and to drive improvement were not always effective. The service had a registered manager who had recently resigned, a new manager was overseeing the management of the service with the support of the regional manager. The management team recognised improvements were needed at the service and showed a willingness to improve. People and staff told us there had been an improvement in communication and morale since the appointment of the new manager.
People led inclusive lives and felt in control of their support. Staff knew and understood people well and supported their aspirations to live a quality life. Staff and management encouraged, listened to and acted upon people's views and wishes.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 5 April 2022 and this is the first inspection.
Why we inspected
The inspection was prompted in part due to concerns received about medicine management and the management of risks. A decision was made for us to inspect and examine those risks.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
The provider responded to our concerns throughout the inspection and immediately put measures in place to improve medicine management, the management of risks and quality assurance processes.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to safe care and treatment and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.