• Care Home
  • Care home

Archived: Highgrove Care Home

Overall: Requires improvement read more about inspection ratings

West Road, Mexborough, South Yorkshire, S64 9NL (01709) 578889

Provided and run by:
H G M MEXBOROUGH LLP

Important: The provider of this service changed. See old profile
Important: The provider of this service changed - see old profile
Important: We are carrying out a review of quality at Highgrove Care Home. We will publish a report when our review is complete. Find out more about our inspection reports.

All Inspections

21 September 2016

During a routine inspection

The inspection took place over two days; 21 September and 23 September 2016, and was unannounced. We last inspected the service in February 2016, where concerns were identified in relation to how the provider ensured people were cared for safely; how the provider ensured they were acting in accordance with the legal requirements around consent; and the provider’s arrangements for ensuring it provided an effective and well managed service. At that inspection we rated the service as Requires Improvement.

Highgrove Care Home is a 78 bed nursing home, providing care to older adults with a range of support and care needs. At the time of the inspection there were 31 people living at the home. The home is divided into four discrete units, although the provider had stopped using two of the units and therefore only two were in use at the time of the inspection.

Highgrove Care Home is located in Mexborough, a small town in Doncaster, South Yorkshire. The home is known locally as Highgrove Manor. It is in its own grounds in a quiet, residential area, but close to public transport links.

At the time of the inspection, the service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

Staff interacted with people warmly and with respect. People’s privacy and dignity was upheld when staff were carrying out care tasks. Care plans were devised in such a way as to ensure that good care was supported effectively. Where people’s health needs changed, the provider responded promptly, engaging external healthcare professionals and altering the way people were cared for, as required.

There were effective systems in place to reduce the risk of abuse and to assess and monitor potential risks to individual people. Recruitment processes were safe and we saw there were sufficient staff on duty to meet people’s needs.

The provider had appropriate arrangements to make sure people received their medications safely, although some improvements were required. We also noted that some staff needed to make improvements to their hygiene practices.

People told us they enjoyed their meals at the home, and our observations corroborated this. People’s nutrition and hydration were closely monitored to ensure they maintained good health.

The provider had appropriate arrangements in place to ensure that it adhered to the requirements of the Mental Capacity Act 2005

There was a comprehensive programme of activities, both in the home and within the community.

There were thorough systems in place for auditing the service, to ensure that people received care which was safe and of a good quality.

Staff told us they felt well supported to undertake their roles, although the provider’s formal supervision programme was not yet fully embedded.

9 February 2016

During a routine inspection

The inspection was unannounced, and took place on 9 February 2016. The home was last rated in February 2015 where it was given an over all rating of inadequate. Further, non-ratings, inspections took place in June and July 2015. Breaches of regulations were identified during these inspections, and we are currently taking action against the provider in relation to this. We will report on this action at a later date.

Highgrove Care Home is a 78 bed nursing home, providing care to older adults with a range of support and care needs. At the time of the inspection there were 37 people living at the home. The home is divided into four discrete units, although the provider has stopped using one of the units and therefore only three were in use at the time of the inspection.

Highgrove Care Home is located in Mexborough, a small town in Doncaster, South Yorkshire. The home is known locally as Highgrove Manor. It is in its own grounds in a quiet, residential area, but close to public transport links.

At the time of the inspection, the service did not have a registered manager. However, the home’s manager had applied to the Care Quality Commission to become registered and her registration interview took place during the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

We found that staff had a caring and patient approach when supporting and caring for people. They took steps to uphold people’s privacy and dignity, and treated people with respect and kindness. Staff had a good knowledge of people’s needs, and there were plentiful activities within the home.

Safeguarding arrangements in the home were effective; staff were knowledgeable and trained in this area, and appropriate procedures had been followed when abuse or suspected abuse had occurred.

Care records were not always fit for purpose. Some lacked detail or were out of date or contradictory. When care records were reviewed, the reviews did not always result in relevant changes being made to people’s care plans or risk assessments. We identified instances where care was not being provided in accordance with people’s assessed needs.

People’s nutrition and hydration needs were not always met. This was due to a combination of poor or absent recording, inaccurate recording, and care plans and risk assessments not being followed.

The arrangements in place for obtaining and acting in accordance with people’s consent, and decision making when people did not have the capacity to consent, did not meet legal requirements. Although staff were trained in this area, we identified occurrences where best interest decisions had not been appropriately made.

Medicines were well managed, and where there had been recent, untoward incidents in relation to medication, the provider had taken appropriate steps to address this. However, the arrangements for auditing medicines were not robust.

The systems and processes in place to ensure compliance with relevant regulations were not effective. Although the provider told us that new systems were in the process of being introduced, the Commission had informed the provider 18 months earlier that their existing systems of quality monitoring were inadequate, and the provider had failed to address this in a robust or timely manner.

20 July 2015

During an inspection looking at part of the service

The inspection took place on 20 July 2015, and was unannounced. We carried out this, focused, inspection in response to concerning information we had received about the home from the local authority’s safeguarding procedures, and from a notification that the provider had submitted to us. The home was previously inspected in February 2015, and June 2015. Breaches of regulations were identified during these inspections, and we are currently taking action against the provider in relation to this. We will report on this action at a later date.

Highgrove Care Home is a 78 bed nursing home, providing care to older adults with a range of support and care needs. At the time of the inspection there were 47 people living at the home.The home is divided into four discrete units.

Highgrove Care Home is located in Mexborough, a small town in Doncaster, South Yorkshire. The home is known locally as Highgrove Manor. It is in its own grounds in a quiet, residential area, but close to public transport links.

At the time of the inspection, the service did not have a registered manager, although it was required to do so. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

The home had received a comprehensive inspection in February 2015, and was rated at that inspection. A follow up inspection took place in June 2015. This inspection, of July 2015, took place to look at the fire safety arrangements and the way that people experienced care. The ratings referred to in this inspection are those awarded in February 2015.

During the inspection, we found that staff did not always interact well with people, although we noted that staff ensured they were present with people as much as possible. We observed that staff understood people’s needs well, although did not always meet these needs.

We checked the arrangements for fire safety in the home, and found that the provider had engaged an external agency to give formal advice on fire safety. However, the external agency’s written advice had only just been received at the time of the inspection and therefore plans to address shortfalls were only just being introduced. Staff gave us positive feedback about the fire safety training they had received, but we noted that good practice was not always being adhered to.

18 June 2015

During an inspection looking at part of the service

We last carried out a full inspection of this service on 3 and 5 February 2015, during which we found a number of breaches of regulation. We gave the location an overall rating of inadequate following that inspection. The inspection of 18 June 2015 took place to look at whether any improvements had been made since the previous inspection.

This report only covers our findings in relation to this topic. You can read the report from our last inspection by selecting the 'all reports' link for Highgrove Care Home on our website at www.cqc.org.uk

We undertook this focused inspection to determine people experienced a service which was well led and effective.

Highgrove Care Home is located in the Doncaster suburb of Mexborough. It is known locally as Highgrove Manor. The home is purpose built and set in its own grounds with parking facilities. The home is divided into four separate units, although at the time of the inspection one of the units was not in use.

The home had not had a registered manager in post for over a year, despite one being required. There was a new manager in post, but they had not yet applied to be registered with the Care Quality Commission. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law, as does the provider.

At this inspection we identified a number of concerns. We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in that people did not receive care which met their needs, and the systems in place to monitor and assess the quality of the service were not always effective.

We found that the arrangements in place for obtaining consent, and acting in accordance with people’s consent, were poor, and the provider had failed to take the steps they were legally required to take in relation to this.

The provider had developed a range of audit tools, and appointed an external consultant to assist them in improving the service. However, we identified that the audits were not always effective, or were not carried out at their intended frequency. The provider had failed to have regard to concerns identified by the external consultant some months earlier.

Staff we spoke with told us that staffing numbers had recently increased, and they felt they were better supported to do their job and provide care. However, we found that some staff had not received training in key areas, including consent and mental capacity, and safeguarding of vulnerable adults.

We saw that the provider had made some environmental improvements and was undertaking a refurbishment programme, although this had not yet been completed, and some bathrooms were still in a poor condition.

We are taking action against the provider, and will report on this at a later date.

3 and 5 February 2015

During a routine inspection

The inspection took place on 3 February and 5 February 2015, and was unannounced. The home was previously inspected on 5 August 2014, where the provider was found to be in breach of regulations 9 (care and welfare), 11 (safeguarding) , 21 (requirements relating to workers) and 10 (assessing and monitoring the quality of service) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. We issued compliance actions in response to these breaches.

In addition, two compliance actions had been issued at the inspection prior to this, on 21 May 2014. These were in relation to breaches of regulations 17 (respecting and involving people who use services) and 22 (staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. Part of this inspection looked at whether improvements had been made in relation to these six breaches of regulations.

Highgrove Care Home is a 78 bed nursing home, providing care to older adults with a range of support and care needs. At the time of the inspection there were 47 people living at the home.The home is divided into four discrete units.

Highgrove Care Home is located in Mexborough, a small town in Doncaster, South Yorkshire. The home is known locally as Highgrove Manor. It is in its own grounds in a quiet, residential area, but close to public transport links.

At the time of the inspection, the service did not have a registered manager, although it was required to do so. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

During the inspection people told us, or indicated, that they didn’t always enjoy life at the home. Staff were observed to be very task-oriented and did not have time to spend with people beyond carrying out care tasks. There were limited activities taking place, and often peope were not interacted with.

We found that monitoring and quality assessment arrangements were insufficient to ensure people were cared for safely or in accordance with their needs. This included the management of people’s care and their medication. Where changes to people’s needs were apparent, they were not always appropriately acted upon.

Where people lacked the mental capacity to make decisions about their care and welfare, the correct legal procedures were not followed. Where there was a risk that people were being deprived of their liberty, appropriate assessments were not being made.

We found the provider did not have effective systems in place to ensure people’s safety. Risk assessments were lacking in detail or didn’t cover all areas of risk that people were vulnerable to. Restraint was not always practised legally, and we identified incidents during the inspection that we notified to the local authority’s safeguarding adults team.

We are taking enforcement action against the provider, and will report on this when it is completed.

5, 7 August 2014

During an inspection looking at part of the service

Our inspection looked at our five questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, speaking with the staff supporting them and looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We found that the provider had appropriate arrangements for handling and administering medicines safely but did not have appropriate arrangements on place for recognising possible abuse. People did not always receive care in a safe manner. We have asked the provider to tell us how they will make improvements and meet the requirements of law in relation to keeping people safe.

Is the service effective?

People's care plans did not always support effective, safe care and care was not always delivered in the way people had been assessed as needing. We have asked the provider to tell us how they will make improvements and meet the requirements of law in relation to ensuring the service is effective.

Is the service caring?

We observed staff failing to meet people's needs, and staff did not always provide engagement and stimulation to people. We have asked the provider to tell us how they will make improvements and meet the requirements of law in relation to ensuring people's care needs are met.

Is the service responsive?

Risks were not always appropriately assessed or responded to, and we found that the provider did not have appropriate arrangements in place for recognising the risk of abuse. We have asked the provider to tell us how they will make improvements and meet the requirements of law in relation to assessing risks and managing the risk of abuse.

Is the service well-led?

The provider had recently recruited a new manager who demonstrated a good understanding of the measures needed to improve the care provided, however, this had not yet been embedded into care practice. The systems in place for monitoring and auditing the quality of care were not effective. We have asked the provider to tell us how they will make improvements and meet the requirements of law in relation to monitoring and auditing the quality of care.

21 May 2014

During a routine inspection

Our inspection looked at our five questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, speaking with the staff supporting them and looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We found that the provider did not have appropriate arrangements for handling or administering medicines safely, or for responding to allegations of abuse. People did not always receive care in a safe manner. We have told the provider they must take steps to achieve regulatory compliance in relation to safeguarding and medication.

Is the service effective?

People did not always receive the care they were assessed as needing. We have told the provider they must take steps to achieve regulatory compliance in relation to people's care and welfare.

Is the service caring?

Staff told us they wanted to spend more time engaging with people, but were unable to do so. We observed staff failing to respect people's dignity or privacy. We have asked the provider to tell us how they will make improvements in relation to people's dignity being respected.

Is the service responsive?

Risks were not always appropriately assessed or responded to, and we found that the provider did not take all required steps when dealing with allegations of abuse. We have told the provider they must take steps to achieve regulatory compliance in relation to people's care and welfare, and safeguarding.

Is the service well-led?

The manager named in this report as the registered manager was no longer in post at the time of the inspection, however, the provider had not formally notified CQC of this, which is a legal requirement. The manager at the time of the inspection was not registered with CQC. We found the provider had failed to make a number of legally required notifications to the commission.

23 January 2014

During a routine inspection

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

During our inspection we spoke with ten people who used the service and three relatives. We also observed care interactions in the communal lounge and dining areas and in people's bedrooms on all three floors. All of the people we spoke with said they were happy with the care provided. Comments included, "This is a lovely place to live. If it wasn't any good I'd be straight out the door." "I get such help with everything. I think it's a marvellous place" and "I'm a happy lady. I've got everything I need here." The relatives we spoke with also said they were happy with the standard of care being provided. One relative said, "I know X is well cared for here. She's happy and I'm happy." Another relative told us, "It's a friendly home and people are looked after. I've no complaints at all."

We observed staff interactions with people who used the service in communal areas and in people's rooms. We found staff were polite, friendly and caring. People seemed relaxed and comfortable in the company of staff.

Our review of the management of medicines showed not all people were protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines. This was in relation to the recording and safe administration of medicines.

There were enough qualified, skilled and experienced staff to meet people's needs. People we spoke with were complimentary about the staff. They told us they thought there were enough staff to meet their needs.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. People who used the service felt the staff were trained to deal with their needs.

The provider had an effective system to regularly assess and monitor the quality of service that people received.

4 March 2013

During an inspection looking at part of the service

During our inspection we spoke with one person who used the service. We also observed how medicines were being given, spoke to staff and looked at medication records. We found medicines were administered safely and at the right times. One person who used the service told us the nurses gave them their medicines at the correct times each day.

Medicines were prescribed and given to people appropriately. There was guidance on how and when medicines prescribed 'when required' should be used. Appropriate arrangements were also in place in relation to the recording of medicine. We looked at medicine charts for people who used the service and saw the receipt and administration of medicines was recorded correctly. We found medicines were kept safely and stored appropriately.

19 November 2012

During an inspection looking at part of the service

We spoke with two people who used the service and one relative. We gathered evidence by observing people who were unable to speak with us. People told us they liked living at the home. We observed people in the dementia and nursing units. We found good interactions between staff and people who used the service. One person told us: "The meals are good I always have a choice, I didn't like the meal choice today so I had a cold meat salad which was lovely. Staff look after me, I like it here."

We found people experienced care, treatment and support that met their needs or protected their rights. People's care and treatment was being planned and delivered in line with their individual care plans. Assessments had been regularly evaluated and action taken where required.

We looked at the management of medicines. Evidence showed improvements had been made since our last inspection in September 2012. However not all people were protected against the risks associated with the management of medication because the provider did not have appropriate arrangements in place to manage obtaining, recording, handling, administration and use of medicines safely.

Evidence showed there were enough qualified, skilled and experienced staff to meet people's needs. One relative we spoke with told us there was always enough staff on duty when they visited. We found staff received appropriate training and professional development.

10 September 2012

During an inspection looking at part of the service

We spoke with five people who used the service. We gathered evidence by observing people who were unable to speak with us. People told us they liked living at the home and they felt safe. One relative said: "My mum is well looked after." We observed people being given their morning medicines. The nurse carried out the task safely and spoke to people in a kind and respectful way. We observed people in the lounge on the dementia unit. We found staff were task orientated. This meant the planning of people's social and welfare needs did not consider all aspects of their individual circumstances, their preferences and diversity.

We found people experienced care, treatment and support that did not met their needs or protected their rights. People's care and treatment was not always being planned and delivered in line with their individual care plans.

Evidence showed improvements had been made since our last inspection in August 2012 however not all people were protected against the risks associated with the management of medication because the provider did not have appropriate arrangements in place to manage medicines.

Although we found people were cared for, or supported by, suitably qualified, skilled and experienced staff appropriate staffing levels in the nursing unit were yet to be determined. Evidence showed not all staff were receiving appropriate training, supervision and appraisal.

The provider had a system in place to monitor the quality of the service.

20 August 2012

During an inspection in response to concerns

We spoke with a small number of people who use the service. A large number of people were unable to speak to us due to their medical conditions. Those we spoke with spoke positively about the care and support they received. They told us staff gave them their medication as they preferred.

15 May 2012

During an inspection looking at part of the service

As part of our inspection we spoke with a number of people who use the service. They spoke positively about the care and support they received. They told us they liked living in the home and confirmed they were well supported to make choices and decisions about their care. We received comments such as: "Nice home, plenty of choices, staff are really good and respect my privacy and dignity' 'Very nice staff' and 'Good care.'

People living in the home confirmed they felt safe and said they liked the staff. One person told us: "Yes it's very safe and very good staff." Another person said, "Staff will sort out any concerns I have."

Relatives we spoke with were complimentary about the home. They told us staff were pleasant and nothing was too much trouble. They felt their relatives were well cared for and were safe. One relative told us, 'Staff are very helpful if we have any concerns they always deal with them quickly.'

23 March and 26 April 2012

During an inspection in response to concerns

People we spoke with told us they were happy living at Highgrove Care Home and staff were good and looked after them.

One person told us, 'There is not much going on so I spent a lot of time in my room'. However other people told us they liked sitting in the entrance area as there was always something going on and people to talk to.

Some people at Highgrove lacked capacity due to their medical conditions, we therefore spoke with some relatives. They told us that on many occasions when they visited, their relative did not have their false teeth in, their glasses on or were not dressed appropriately.