Highborder Lodge

Updated 27 September 2022

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

Two Inspectors carried out the inspection.

Service and service type

Highborder Lodge 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. Highborder Lodge is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Highborder Lodge is also registered to provide care and support to people living in their own homes. However at this inspection, no one was receiving this service.

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

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 considered the feedback from the local authority and professionals who work with the service. We used the information the provider sent us in September 2021 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 used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with six people who lived at Highborder Lodge. We spoke with two people’s relatives and one professional about their experience of the care and support provided by the service.

We spoke with eight staff including two assistant managers, a laundry assistant, a housekeeper and four care. Following our visit we spoke with the registered manager.

We reviewed a range of records. This included six people's care records. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 27 September 2022

About the service

Highborder Lodge is a residential care home providing accommodation and personal care to up to 40 people. The service provides support to older people and people living with Dementia. At the time of our inspection there were 32 people using the service.

The service is also registered to provide care and support to people living in their own homes. However, at the time of our inspection, this service was not being provided. Everyone living at Highborder Lodge had access to en-suite facilities, communal living and dining spaces and garden.

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

People were not always protected from avoidable harm. People’s care plans and associated records were not always current, accurate and did not provide staff with the correct information they required to safely meet people’s needs.

People did not always receive care and support which fully respected their wishes. Immediate action was taken by the management to address these concerns.

Monitoring systems were not always effective as the records supporting the management of the service were not always reliable. These systems had not always identified or addressed concerns found during our inspection, including concerns in relation to people’s care records, cleanliness of the home, people’s person centred care and medicine management.

People’s medicines were not always stored in accordance with manufacturers guidance and provider’s policies. The management took immediate action to address this concern.

People told us they felt safe. They told us the staff were tolerant, patient and friendly. Although there had been challenges in recruiting staff, there were enough staff to ensure people’s care needs were met.

There were a range of activities and events for people to enjoy. However, some people who were not mobile, or were living with dementia were not always supported to access or enjoy these activities. Additionally, while we observed there were enough staff to meet people’s needs, staff did not always take the opportunity to engage with people and promote their wellbeing.

The provider, registered manager and staff had learnt from incidents and used this to inform their actions.

People and their relatives felt the registered manager was approachable. The registered manager had sought feedback from healthcare professional which was positive.

Staff told us they felt supported and enjoyed working at Highborder Lodge. Staff had received training to meet people’s needs.

We were assured the service were working in accordance with current government COVID-19 guidance

Staff supported people in the least restrictive way possible and in their best interests. Where people were living under Deprivation of Liberty Safeguards; staff understood the support they required.

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.

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 December 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service. This included information of concern about people’s care and support.

As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Highborder Lodge on our website at www.cqc.org.uk.

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.