Highview Lodge

Updated 11 January 2024

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 Care Act 2014.

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

This inspection was carried out by 2 inspectors.

Service and service type

Highview Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager who had applied to be registered with the Care Quality Commission. Being a registered manager 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.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with 10 people who used the service and 5 relatives and friends about their experience of the care provided. We spoke with, and received feedback from, 15 members of staff including the registered manager, deputy manager, care workers and ancillary staff. 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 reviewed a range of records. This included 5 people’s care records and multiple medication records. We looked at a variety of records relating to the management of the service, including policies and procedures.

Updated 11 January 2024

About the service

Highview Lodge is a residential care home providing personal and nursing care to 53 people at the time of the inspection. The service can support up to 77 people in 1 purpose built building.

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

At the last inspection we found the provider did not have robust governance systems to monitor the service and address shortfalls in the home. There had not been enough improvement made at this inspection and the provider remained in breach of regulation. Well led had been rated requires improvement at the last 3 inspections.

At this inspection we found there had not been enough improvement and it had remained in a negative rating. Ineffectiveness of governance systems was a concern at the last inspection and the provider submitted an action plan stating how they would make the required improvements. This had not happened. The registered manager had left since the last inspection. There had been an additional 3 managers, including the manager at the time of this inspection who had only been in post 3 weeks prior to the inspection. Feedback from people, relatives, most staff and professionals was that the management had been inconsistent and communication needed to be improved but the provider had not yet made any positive changes.

At our last inspection we found that people’s safety was not always promoted. There had not been enough improvement at this inspection, and we found shortfalls in relation to medicines management, individual risks such as pressure care, falls and pressure care.

People were not always supported by sufficient numbers of staff. We found people had care missed or delayed as staff were often busy. This also impacted on mealtimes as there was not enough time elapsing between meals.

People and relatives told us that staff were kind. We saw staff were kind and caring. However, due to demands on their time, tasks were at times missed. Staff worked hard to try and minimise the impact of this. Staff felt they had enough training, which was up to date in most cases.

Care plans were in place but at times this included inconsistent information which made it unclear about how people needed their needs met. Due to staffing issues, care was not always personalised, for example, the time people went to bed, the gender of staff supporting them and how they spent their day.

Some people and relatives told us they would like there to be more to do to help prevent social isolation. There were some activities in place but these did not reach everyone as some people were cared for in their rooms and some were eating at the time.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

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 requires improvement (published 14 October 2022).

Why we inspected

The inspection was prompted in part due to concerns received about management, poor care and staffing. 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 all sections of this full report.

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 coronavirus and other infection outbreaks effectively.

The overall rating for the service remains requires improvement. This is based on the findings at this inspection.

Enforcement and recommendations

We have identified breaches in relation to safe care and treatment, person centred care, staffing and governance. You can see what action we have asked the provider to take at the end of this full report.

We have made a recommendation about the improving communication aids.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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

Follow up

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.