Highdowns Residential Home

Updated 27 April 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Highdowns is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Highdowns is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We visited the service and spoke with the registered manager and 6 other members of staff. We met with 5 people and 1 visiting professional. We looked at 4 care plans, 2 staff recruitment records, 2 people’s financial records and a selection of Medication Administration Records. We reviewed the training records and other records in relation to the management of the service. Following the site visit we spoke with 8 relatives and a further 3 professionals with experience of the service.

Updated 27 April 2023

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.

About the service

Highdowns Residential Home is a residential care home providing personal care for up to 14 people with learning disabilities or autistic people. At the time of the inspection 14 people were living at the service. The accommodation is spread across several buildings and situated on farmland. At the time of the inspection 5 people were living in the main house, 4 people lived in an adjoining cottage and the remaining 5 people all had their own separate accommodation.

People’s experience of using this service and what we found

Right Support

Staff supported people to have choice and control and be independent.

People were supported by staff to pursue their interests.

Areas of the service were in need of updating to help ensure people’s surroundings were pleasant and supported their comfort and well-being. There were plans to make the necessary improvements in the near future.

Staff enabled people to access specialist health and social care support in the community.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.

The policies and systems in the service had not consistently ensured staff supported people in the least restrictive way possible and in their best interests. Staff had not consistently recorded when restrictions had been put in place to keep people safe. This meant opportunities to learn from those incidents and how they might be impacting on everyone living at the service were lost.

Right Care

Staff promoted equality and diversity in their support for people. They understood people’s diverse needs and provided appropriate support.

Staff had training on how to recognise and report abuse and they knew how to apply it.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.

Right Culture

People led meaningful lives because of the ethos, values, attitudes and behaviours of the management and staff.

Training for staff to help ensure they were able to provide good quality care and support had not been refreshed regularly in line with the organisations policies.

The management team were supportive and knew people well.

Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 4 October 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

We have identified breaches in relation to restrictive practices and staff training. Please see the action we have told the provider to take at the end of this report.

We have made recommendations about recording information in relation to risks and support for management when new systems are introduced.

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.