Highview Lodge

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

There was some learning culture in the service, however this was not consistent. People felt the move into the service had gone well. Most people felt safe, and staff knew how to raise concerns. However unexplained injuries such as bruises and skin tears were not always reported and investigated. People felt staffing was meeting their needs most of the time. Staff received training and supervision. Infection control systems were in place. The environment was managed safely. However, the provider needed to ensure needed repairs were reported and resolved more swiftly. People’s risks were managed. Staff knowledge of people needed more development to help minimise risks. Work was in progress to help staff familiarise themselves with the care planning system. Most people received their medicines as the provider instructed. However, some improvements to ensure consistent safe practice was needed.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People did not share any views on the learning culture in the home. Our observations showed there had been some learning since our previous inspection, but this was not yet fully embedded throughout the home or the staff team.

We spoke with members of the management team who advised us with what action was taken following our visit and feedback on the day. They advised of lifestyle framework and training that had been provided and inspection feedback given to staff.

The management team had taken some action to address many of the issues from the previous inspection. They had been working to share learning and embed the practice. However, this had not been consistent. Some issues around mealtimes and issues the provider had at another of their homes regarding injuries, learning had not been taken on board.

People felt the move into the service had been good. Relatives felt at times communication could be improved.

Staff told us there were handover systems in place to share important information. The management team told us of people's involvement in the assessment process.

Healthcare professionals told us the team worked with them. However, some training in different areas may be beneficial and they would support with this.

People received a preadmission assessment prior to moving in. Records were held on file and information was to be shared with healthcare professionals as needed.

Most people told us they felt safe. A person said, “Oh yes I could speak up if I was worried.” However, 1 person did tell us at times staff could be rough when assisting them and they did not feel they could speak up. We shared this with the registered manager and the management team to follow up.

We received limited feedback from staff but those we had contact with knew how to recognise, and respond to, abuse. We discussed the unexplained injuries with the management team and asked they reviewed the records to ascertain if there was an explanation and if they should have been investigated and reported. The management team confirmed there were unexplained injuries that required reporting, investigating and they would send reports retrospectively.

Information about safeguarding people from abuse was displayed. We saw staff working safely and noted that people were relaxed and happy in staff presence.

We reviewed records relating to skin tears and bruises and found where these had happened, there was not always an explanation, investigation and not reported appropriately. A staff meeting held in May 2024 raised awareness of unexplained injuries. However, did not state the need to report them to ensure any required actions could be followed.

Most people told us they felt staff supported them safely.

Staff were familiar with people’s individual risks and able to tell us how they worked to reduce these risks. However, some staff did not know people’s surnames which could potentially increase risk in some situations. A member of the management team advised that all staff have a handheld device which provides a safety net for staff not being familiar with people. The registered manager advised that a trainer for the system had been in the home weekly since our visit.

We saw staff working in accordance with assessed risks.

People had individual risk assessments and reviewed regularly.

People told us they felt safe and comfortable living at the service.

We received limited feedback from staff. Those we had contact with were aware of hazards and how to reduce these. Staff had attended fire drills.

The environment was free from hazards and fire safety equipment was in place. People had access to call bells, and sensor mats where needed, and the home was well maintained. However, 1 person’s bed and bedrail had been broken for some time. We raised this with the management team on our visit who replaced them the same day.

There was a maintenance schedule in place to carry out the required checks.

People gave mixed views about if there were enough staff to meet their needs. A person said, “Staff are nice to me, but I think they are short staffed.” Others told us staff came when they needed them. Relatives shared their views on staff training. A relative said, “The staff all seem very competent but, as I said before, they are kind and considerate which, to me, is far more important.” Another relative said, “I sometimes get the impression that some of the staff don’t understand dementia.”

We received limited feedback from staff. Those we had contact with told us they felt there was not always enough of them to meet people’s needs in a timely way. A staff member said, “There have been times where the home has been left vulnerable due to the lack of staff and in turn this leads to care actions being missed and I sometimes feel people’s needs aren’t being met.” Staff told us they felt they had enough training for their role. A staff member said, “In regard to my training I feel like I’ve had enough but I do feel regular refreshers should happen.”

Most of the time staff were visible and prompt when people requested support. We asked staff to assist 4 people on different units who told us they were cold as they were busy carrying out other tasks. While staff were happy to help someone when we shared their need for support, when support was not happening, there was no engagement between people and staff.

We reviewed the training matrix and saw most training was completed. There was also a record of regular supervision. The provider had a recruitment policy in place which they followed.

People’s bedrooms and communal areas were kept clean for people. However, we did note 1 bedroom had a strong odour.

We received limited feedback from staff. Those we had contact with knew how to practice good infection prevention and control (IPC). The registered manager told us following our visit the bedroom with the odour had received a deep clean, along with other carpets in the home.

Staff were practicing good IPC in their tasks. We observed correct handwashing and use of personal protective equipment (PPE).

There were audits of infection prevention control in the home.

Most people received their medicines in accordance with their needs and as the prescriber intended. However, 1 person told us they were in pain but when they tell staff, staff tell them they have had their medicines. We reviewed this person’s medicines chart and found they had not received their pain relief in the past 3 days. We spoke to a senior staff member, responsible for medicines, who told us the person had refused any pain relief. We asked the staff member to administer this and for communication between care staff and those administering medicines be clearer so if a person’s need for medicines changes, this is responded to.

Staff responsible for managing medicines were aware of safe practice.

We checked quantities of medicines against records held and found these to be correct in most cases. A box of paracetamol indicated a dose had been missed when checked against the records, we shared this with staff. Overall plans for as needed medicines were in place, we noted 1 was not completed, we shared this with staff. We also noted that not all medicines boxes were dated when opening. This is good practice to help monitor medicine stocks.