Archived: Highbury Nursing Home

Updated 15 January 2020

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.

Inspection team

The inspection team consisted of one inspector, one assistant inspector and one specialist advisor (who was a qualified nurse).

Service and service type

Highbury Nursing 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 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 clinical commissioning group who work with this 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 seven people who used the service and four relatives about their experience of the care provided. We spoke with ten members of staff including the nominated individual, registered manager, nurses, carers, chef and maintenance manager. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included seven people’s care records and multiple medication records. We looked at two staff files in relation to recruitment. A variety of records relating to the management of the service were reviewed.

Updated 15 January 2020

About the service

Highbury Nursing Home is a care home providing personal and nursing care to 38 people aged 65 and over some of whom are living with dementia. At the time of inspection 34 people lived at the service. The accommodation is organised into three floors with communal areas on the ground floor.

People’s experience of using this service and what we found

Risks were not consistently reviewed following incidents. Whilst safeguarding referrals were usually made to an external body we found one instance when this had not occurred. Staff had been recruited safely and there were enough staff to meet people’s needs. Medication was administered safely and personal protective equipment used when required.

Not all staff felt they could approach the registered manager with concerns. The provider carried out regular audits of the service, however, further improvements were required to make them more robust. People and relatives told us they felt able to raise concerns with the management team.

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 did not always support this practice. Staff received training and worked with relevant healthcare professionals when appropriate.

Some improvement was needed to the decoration of the building and to ensure it was appropriate for people living with dementia, the registered manager told us plans were underway.

There were activities for people to take part in individually or as a group if they wished. The provider had a complaint process which people were aware of to share any concerns. End of life wishes were discussed and recorded.

Rating at last inspection

The last rating for this service was Good (published 27 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to regulation 12 safe care and treatment and regulation 17, good governance.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk