Highview Lodge

We found 3 breaches of regulation relating to risk management, person-centred care and governance.

At the last inspection the service was rated overall as ‘Requires Improvement’. The rating at this assessment remains ‘Requires Improvement.’

During this assessment we found the provider did not ensure all risks to people’s safety and wellbeing were identified or provided enough detail as to how these should be mitigated. Not all care plans were accurate or accurately reflected all of a person’s care and support needs. Records where people could be distressed and anxious provided insufficient information relating to staffs’ interventions and people’s outcomes. Fluid intake information for individuals demonstrated fluid targets were not always maintained and there was a lack of evidence to show what was being done to monitor this. Assessments relating to people’s capacity were not routinely recorded and completed. Capacity assessments are important to understand a person’s ability to make decisions.

Lessons were not always learnt to identify and embed good practice. Although people and those acting on their behalf considered themselves and family members to be safe, improvements were required to ensure safeguarding investigations were sufficiently detailed. Not all staff had received formal supervision and where issues were raised about a member of staff’s performance, there was a lack of information as to how this was to be addressed and monitored.

Whilst people and those acting on their behalf were mostly happy with the care and support provided, not all care and support observed was person centred to meet people’s needs. Observations of staff practice did not always provide assurance staff were skilled and competent to effectively apply their learning in their everyday practice to support people safely, specifically safe moving and handling practices. Staff interactions on occasions were minimal, task focused and did not consistently ensure people were able to participate in meaningful social activities.

Governance arrangements at the service were not effective, as they did not ensure proactive action was taken to make the required changes and improvements. However, following our assessment the provider has provided the Care Quality Commission with a Service Improvement Plan. The purpose of a Service Improvement Plan is to proactively identify and monitor performance, address weaknesses in service delivery and recognise areas for improvement. Progress of the actions taken by the provider to achieve compliance has been regularly communicated to us via their updated Service Improvement Plan demonstrating progress and action taken to address identified shortfalls and to achieve compliance with regulatory requirements.

People’s needs were assessed prior to their admission to the service and people confirmed they had been involved in the process. The premises were clean and odour free. Medicine arrangements at the service were safe. The dining experience was positive across the service and people were complimentary regarding the meals provided. The service worked well with external healthcare professionals and services to ensure people’s ongoing healthcare needs were met.

We will ask the provider for an action plan to tell us how and by when they will meet the breaches of regulations identified at this assessment.