Background to this inspection
Updated
23 July 2021
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 one inspector.
Service and service type
Higham House Nursing Home 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 registered with the Care Quality Commission. 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.
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 sought feedback from the local authority and professionals who work with the service.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We used all of this information to plan our inspection.
During the inspection
We spoke with three relatives of people who use the service about their experience of the care provided. We spoke with eight members of staff including the registered manager, nurses, care and support workers and a cook.
We reviewed a range of records. This included three people's care records, care delivery records and medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were also reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data, staff rotas and provider oversight.
Updated
23 July 2021
About the service
Higham House Nursing Home is a care home providing personal and nursing care to seven people aged 65 and over at the time of the inspection. The service can support up to 30 people in one adapted building.
People’s experience of using this service and what we found
Systems to monitor the quality and safety of the service were in place to ensure people received safe and person-centred care. However, this required time to be embedded into the service to ensure they were sustained, and improvements continued.
Mealtime experiences for people had improved, however, this needed to be maintained and monitored to build on the improvement.
Risks to people’s care were identified and plans to mitigate the risk were in place. There were sufficient staff deployed to meet people’s needs and people could be assured staff had been recruited safely.
Staff understood how to protect people from harm and followed good hygiene practices to prevent and control infection. Medicines were safely administered and stored.
People's needs were assessed, and care plans guided staff how to meet those needs. Further improvements were needed to care plans to ensure they detailed the support people required for their social and emotional well-being. People had access to activities, but more opportunities were needed so people could undertake activities geared towards their interests.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Refurbishment plans were in place and improvements to the environment had been made. This needed to be sustained and improvements continued.
Based on our review of Safe, Effective and Well-led
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update: The last rating for this service was requires improvement (published 11 February 2021) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
The service remains rated requires improvement. This service has been rated requires improvement for the last four consecutive inspections.
Why we inspected
We carried out an announced focused inspection of this service on 12 January 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, person- centred care and good governance.
We undertook this unannounced focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.
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.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Higham House Nursing Home on our website at www.cqc.org.uk.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.