Highgrove House Residential Care Home

Updated 14 April 2021

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 CQC's response to the coronavirus pandemic we are looking at the preparedness of care homes in relation to infection prevention and control. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.

This inspection took place on 26 February 2021 and was announced.

Updated 14 April 2021

Highgrove House Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home can accommodate 19 people and at the time of the inspection it was full. People within the home had a variety of needs and the home cared for older people with a range physical disabilities and mental health issues, including dementia. Care was provided over two floors and there were large communal areas, including a large dining room, conservatory, separate lounges and communal gardens.

We inspected Highgrove House Residential Home on 11 and 12 July 2018. This was an unannounced inspection. The home had previously been owned by a different provider and this was the first inspection since the home had been managed by Highgrove House Care Home Limited.

At the time of the inspection a registered manager was not in post. 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 2008 and associated Regulations about how the service is run. However, there was a new manager in post and it was their intention to become the registered manager. They had submitted their registered manager application to the Care Quality Commission (CQC) which was currently being processed. The owner of the home was also actively involved in the running of the home and present on the day of the inspection.

The home was accepting more people with dementia. This was impacting on the level of care people required. At the time of the inspection there were sufficient staff on duty and people told us that staff responded to their needs quickly. However, staff expressed some concerns about the impact of their increasing workload. This was discussed with the manager, who assured us they regularly reviewed people's dependency needs and staffing levels were kept under review.

There was a recruitment system in place and appropriate checks had been made to ensure new staff were suitable to work within a care setting. However, some of the details were stored in a different folder and the recruitment files did not always state the reason for any breaks in employment. This was discussed with the management team and they we taking appropriate action to improve the documentation. Staff received regular training to ensure they had the relevant knowledge and skills to care for the people in the home. There was also a programme of supervision and appraisals, which provided staff with support and guidance.

People told us they felt safe and well cared for. There was a safe-guarding procedure in place and staff could discuss the actions they would take, to ensure the continued safety of people under their care. Medicines were administered appropriately and there was a clear method for ordering and disposing of medicines. Medicines were stored according to current recommendations. The home was clean and staff followed procedures to maintain infection control. Environmental and personal risks were assessed and kept under review. There was a system in place to ensure equipment was maintained and the environment was safe. The environment had been adapted to suit the needs of the people, with an accessible garden, a lift and railings for ease of access.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the home supported this practice. People were cared for in a kind and compassionate manner. They spoke highly of the staff and the staff were proud of the care they provided. We observed staff gaining consent from people and offering choices. Staff were aware of requirements in relation to equality and diversity. We observed staff treating everyone with respect. The staff also worked in ways that promoted people’s privacy and dignity.

People’s care needs were identified and documented in care plans. These were reviewed and updated regularly. People were involved in this process and relatives were also kept informed of changes, according to the wishes of the person. People’s communication needs were considered and the home had details of the Accessible Information Standard (AIS). People were referred to health care services as required and staff had good relationships with health care professionals. The home provided end of life and we saw positive comments received from bereaved relatives, about the care provided at this time.

People told us they were happy with the food. People’s nutritional needs were assessed and there were systems in place to ensure people’s hydration needs were met.

There was an activity programme in place. This included music, poetry and flower arranging. The activity programme was under review and staff hours had been adjusted to enable more activities during the day. The manager was also exploring ways to enable more visits and activities, outside of the home and had organised a trip to the local pier.

There was a complaints procedure and people told us they felt able and supported to raise any concerns with the staff. There was also a system in place for monitoring any accidents or incidents within the home. These were reviewed, to determine if any actions were required, to prevent future incidents. Relatives were informed of any incidents and any actions taken, in compliance with the Duty of Candour. The Duty of Candour is a regulation that all providers must adhere to. Under the Duty of Candour providers must be open and transparent and it sets out specific guidelines providers must follow if things go wrong with care and treatment.

There was a comprehensive system of policies and procedures. There was also a range of audits which were completed regularly. There was a quality assurance system in place, which aimed to ensure high standards of care were maintained.

There was a positive culture within the home and people felt able to approach the management with any concerns. There were regular resident and staff meetings, which were well attended. The care team worked well together and felt able to discuss any concerns with the management.