Highmarket House

Highmarket House has 2 registered providers meaning both legal entities are responsible for this service. The service was last inspected in May 2018, where it was rated Good. At this inspection, the overall rating has changed to requires improvement. The service was in breach of 3 legal regulations, safe care and treatment, good governance and staffing. The provider was required to send us an action plan telling us how they would improve and by when.

The provider’s systems and processes did not always identify the concerns we found during our inspection and therefore failed to drive improvement. The provider was very responsive during the inspection and put new systems and processes in place to mitigate the risks to people. Records of people’s needs and the support they were provided were not always accurate, complete. Risks were not always managed; risk assessments were not available for staff regarding use of hot food trolleys, although this was rectified, it had put people at risk.

The provider did not always assess or manage the risk of infection as there was a lack of sanitiser in the building and poor fridge and food management. People’s medicines were safely stored and administered and where people required external professional input into their care this was sought and provided.

The provider had a good learning culture and people could raise concerns. The registered manager and provider maintain good-quality care.

The provider had safeguarding processes in place and people could raise concerns. People felt safe. Before people came to live at the home, their care and support needs were assessed to ensure these could be met appropriately. Consent to care and treatment was gained lawfully.

The home was well maintained, clean and homely.

Governance systems had not identified or addressed areas for improvement.

People were supported to access input from healthcare professionals when they needed it. Managers and staff worked well with other professionals to achieve good outcomes for people.

Incidents were reported and managed well to protect people from harm. Recruitment systems were effective in ensuring new staff were suitable and safe to work in a care setting. There was mixed feedback regarding there being sufficient numbers of staff, a dependency tool was used to calculate the numbers of staff required, however some staff stated that there was a lack of staff sometimes meaning that peoples care was compromised. People and their relatives stated that they thought staff numbers were too low on occasions which has affected the ability of staff to provide care in a timely manner.

People were treated with kindness and compassion. Staff treated people with respect and maintained their dignity when providing care. People were able to choose how they spent their time, and their preferences were known and respected by staff. People’s friends and families were made welcome when they visited and encouraged to become involved in the life of the home. The home had a much appreciated full and varied activity schedule, individual preferences were also taken into account and personal wishes actioned by the home. People knew how to give feedback and were confident the provider took it seriously and acted on it. People received fair and equal care and treatment and were involved in planning their care. The service supported staff well-being.

We have asked the provider for an action plan in response to the concerns found at this assessment.