We carried out a review of the data available to us about Highlea Care Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Highlea Care Limited, you can give feedback on this service.
Highlea Care Limited is a domiciliary care agency proving personal care and support to people living in their own homes across County Durham. We visited four of the five locations where people receive personal care. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help and with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of our inspection 29 people were receiving personal care.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for young people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
People told us staff were kind and caring. We saw outcomes for people had improved since our last inspection. Staff supported people to remain independent and promoted their dignity. People's privacy was respected and their personal information was kept securely.
People were supported to take their medicines safely. Staff understood their responsibilities about keeping people safe. Risks were identified and managed well. Staff understood their responsibilities to prevent the spread of infection whilst working in people's homes. We saw people were now actively involved in the recruitment process for their staff.
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.
Staff had completed training in key areas and were supported to carry out their roles. Training was now person specific and people were involved in supporting the delivery of training to new staff. People had confidence in staff and were content with the care they received. People were supported to access health services if needed. People's dietary needs were assessed and, where required, people were supported with their meals.
People's support plans were up to date about their individual needs and preferences. People received support that met their needs. People and their relatives knew how to complain, although none we spoke with had any complaints. People's rights to make their own decisions were respected.
The registered manager, nominated individual and service managers had worked hard to improve the service since our last inspection. They had looked at opportunities to improve every aspect of the service and were committed to improving the service further. There were quality checks in place to ensure the service delivered a good standard of care and support.
The outcomes for young people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to develop, learn new skills and become independent.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published January 2019) 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.
Why we inspected
This was a planned inspection based on the rating at the last inspection.
Follow up
We will monitor all intelligence received about the service to inform the assessment of the risk profile of the service and to ensure the next planned inspection is scheduled accordingly.
This service provides care and support to people living in 12 'supported living' settings, so that they can live in their own home as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people's personal care and support.
People who use the service have learning disabilities, autism spectrum disorders or physical disabilities. People who use the service are supported with personal care, medicines, cooking, shopping, activities and other day to day tasks. At the time of our inspection 71 people were using the service. The service provides support to people living in County Durham.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
This service was previously registered at a different address. We last inspected this service in February 2016 when we gave the service an overall rating of good. During this inspection we found the service had deteriorated and have awarded an overall rating of requires improvement. This is the first time the service has been rated requires improvement.
The service had a registered manager. The registered manager joined the service as a service manager in May 2018 and took up the post of registered manager in July 2018. 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.
During this inspection we found breaches of Regulations 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, which relate to good governance and staffing. This was because ‘when required’ medicines (such as pain relief) and topical medicines (such as creams or ointments) were not always managed effectively as records were incomplete. Support plans did not always contain enough information about people's specific needs and were not always up to date. Records relating to people's finances and procedures for handling people's finances were not robust. Staff had not completed up to date training to enable them to perform their job role effectively.
Although we found several areas for improvement during this inspection, the provider’s quality assurance system had recently identified most areas for improvement within the service. The provider had not always acted on areas for improvement in a timely manner. The registered manager, who had only been in post since July 2018, was keen to address all of the areas for improvement found during this inspection, which were already in progress.
Staff understood their safeguarding responsibilities and told us they would have no hesitation in reporting any concerns about the safety or care of people. Staff said they felt confident the operations manager would deal with safeguarding concerns appropriately.
Accidents and incidents were recorded and dealt with appropriately,
Personal emergency evacuation plans (PEEPs) were in place which contained details about people’s individual needs, should they need to be evacuated from the building in an emergency. These had been completed with people’s involvement.
A thorough recruitment and selection process was in place which ensured staff had the right skills and experience to support people who used the service. Identity and background checks had been completed which included references from previous employers and a Disclosure and Barring Service (DBS) check.
People spoke positively about staff. Staff supported people to be independent and to do the things they enjoyed. People were at ease in the presence of staff.
People had maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People were supported to maintain a balanced diet and to have enough to eat and drink People were involved in decisions about menus and shopping.
Staff treated people with dignity and respect and promoted people’s independence wherever possible.
People told us they knew how to complain, although everyone we spoke with was happy with the care and support provided.
The registered manager was clear that the aim of the service was the wellbeing of the people they supported, and they were keen to address all of the areas for improvement found during this inspection, most of which were already in progress. The registered manager and provider's representative spoke to us openly during the inspection and were receptive to working collaboratively with other professionals to make the necessary improvements.
Highlea Care Limited is a domiciliary care service which provides support to people with a learning disability, physical disability and mental health needs. On the day of our inspection there were 58 people using the service.
The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
Highlea Care Limited was last inspected by CQC on 27 February 2014, when the location was registered as The Grange, and was compliant with the regulations in force at that time.
Accidents and incidents were appropriately recorded and investigated. Risk assessments were in place for people who used the service and staff and described potential risks and the safeguards in place. Staff had been trained in how to manage behaviour that challenged and in safeguarding vulnerable adults. Medicines were stored safely and securely, and procedures were in place to ensure people received medicines as prescribed.
The homes we visited were clean, spacious and suitable for the people who used the service and appropriate health and safety checks had been carried out.
There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. Staff were suitably trained and received regular supervisions and appraisals.
The provider was working within the principles of the Mental Capacity Act 2005 (MCA).
People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of visits to and from external health care specialists.
People who used the service, and family members, were complimentary about the standard of care provided by Highlea Care Limited. Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.
People had been involved in planning their care and care records were written in a person centred way.
Highlea Care Limited had a full programme of activities in place for people who used the service.
The provider had an effective complaints policy and procedure in place and people knew how to make a complaint.
The service had links with community services and other local organisations. The service had a positive culture that was person-centred, open and inclusive. The provider had a robust quality assurance system in place. People who used the service, family members and staff were regularly consulted about the quality of the service.