The inspection visit at The Highcroft was undertaken on 14 November 2018 and was unannounced.

The Highcroft Care Home is situated in a residential area of Blackpool. Accommodation is provided in mainly single rooms. There are communal lounge areas, dining room and garden areas to the rear of the premises. Parking facilities are at the front of the home. The home is registered to provide care for up to 31 people. At the time of the inspection visit there were 28 people who lived at the home.

A registered manager was 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.

The Highcroft is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

At the last inspection in November 2017 we rated the service as ‘Requires Improvement’. This was because breaches of legal requirements were found. These related to medication issues. Furthermore, the management team failed to properly assess the quality assurance of the service provided. We made a recommendation to improve quality assurance systems.

During this inspection, we found the provider had made improvements to ensure they met legal requirements in recording and administering medication. In addition, they had addressed the recommendations from the previous inspection. There now were systems in place to undertake quality audits in a timely manner to ensure the service continued to be monitored and improvements made where required.

We observed staff administered medication with a skilled and secure approach, which the registered manager strengthened through training, a new medication system and regular audits. They now had good oversight of relevant procedures through daily and weekly auditing to ensure people who lived at the home remained safe.

The registered manager had now completed a range of quality audits to ensure a safe environment and monitor the service they provided. These for example included, medication, the building, care planning and DoLS processes. Documentation highlighted examples of where the registered manager took action to address identified issues.

Care records included an assessment of the level of risk and actions to guide staff to manage people’s safety. The registered manager retained an accident book and analysed patterns to assess control measures reduced the risk of incidents.

We saw staff supported people with their meals sensitively and respected their privacy. Staff checked they had enough to eat and comments were positive in relation to quality of meals. One person who lived at the home said, “We are lucky we have cooks who are really good.”

People were supported to have 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.

Staff had been recruited safely, appropriately trained and supported. They had skills and experience required to support people with their care and social needs.

Care planning followed a person-centred approach and people told us they were involved in this process.

Comments we received about the attitude and caring nature of staff were positive and included, “Lovely people they are so kind and helpful.” Another person said, “Everybody has been so good with me. They all are a very caring bunch.”

People who lived at the home told us they enjoyed a variety of activities and regular outside entertainers which were organised for their enjoyment. One person said, “We had a singer recently, absolutely

The inspection visit at The Highcroft Care Home took place on 04 October 2017 and was unannounced.

The Highcroft Care Home is situated in a residential area of Blackpool. Accommodation is provided in single rooms. There are two communal lounge, dining room and garden areas to the rear of the premises. Parking facilities are at the front of the home. The service is registered to provide care for people without nursing needs. At the time of the visit, 23 people lived at the home.

The service had a registered manager in place. 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.

At the last inspection on 04 February 2016, we found the provider was meeting the requirements of the regulations that were inspected.

At this inspection, staff responsible for assisting people with their medicines had received training to ensure they were competent and had the skills required. However, there had been occasions when staff had failed to sign medication administration recording forms to indicate medicines had been administered. Protocols related to the management of medicine stock were safe but not consistently followed.

This was a breach of Regulation 12 of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Safe Care and Treatment. You can see what action we told the provider to take at the back of the full version of the report.

Care plans were organised and identified the care and support people required. We found they were informative about care people had received. They had been kept under review and updated when necessary to reflect people’s changing needs. However, we observed two occasions when staff did not follow documented instructions on how to support people safely.

We have made a recommendation the service ensure staff knowledge on how to meet people’s care and support needs is accurate.

During this inspection, we noted the provider had systems that ensured people who lived at the home were safe. We found staff were knowledgeable about support needs of people in their care. They were aware of what help people needed to manage risks and remain safe.

Records we looked at indicated staff had received safeguarding training related to the identification and prevention of abusive practices. They understood their responsibilities to report any unsafe care or abusive practices related to safeguarding of adults who could be vulnerable.

Staff received further training related to their role and were knowledgeable about their responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs. One person who lived at The Highcroft Care Home, “I feel as safe as houses.”

The provider had recruitment and selection procedures to minimise the risk of inappropriate employees working with people who may be vulnerable. Checks had been completed prior to any staff commencing work at the service. This was confirmed from discussions with staff and records we looked at.

We found staffing levels were suitable with an appropriate skill mix to meet the needs of people who lived at the home. The deployment of staff was organised directing staff with their allocated tasks.

Family members told us they were involved in their relatives care and had discussed and consented to their care. We found staff had an understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

Relatives told us and observations indicated people were happy with the variety and choice of meals available to them. We saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration. One person commented, “The food is very good we

We carried out an unannounced focussed inspection of the service on 04 February 2016. The purpose was to check staffing levels were sufficient to meet the needs of people who lived at the home. Also people were not at risk of receiving unsafe care due to insufficient staff. We had received anonymous concerns about how the home was staffed and the management of the service.

This report covers our findings in relation to those concerns brought to our attention. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Highcroft Care Home on our website at www.cqc.org.uk.

The Highcroft Care Home is situated in a residential area of Blackpool. Accommodation is provided in single rooms. There are two communal lounge, dining room and garden areas to the rear of the premises. Parking facilities are at the front of the home. The service is registered to provide care for people without nursing needs. At the time of the visit there were 25 people who lived at the home.

A registered manager was 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.

At the last comprehensive inspection on 25 August 2015 we found the overall rating for the service was ‘good’.

During this inspection visit we reviewed staffing rotas and found they sufficiently met people’s needs and we noted Highcroft was well resourced. We reviewed staffing rotas and found they sufficiently met people’s needs and we noted Highcroft was well resourced. For example on the day of our visit the activity co-ordinator employed by the service was on duty in the afternoon.

The inspection visit took place on 25 August 2015 and was unannounced.

The Highcroft Care Home is situated in a residential area of Blackpool. Accommodation is provided in single rooms. There are two communal lounge, dining room and garden areas to the rear of the premises. Parking facilities are at the front of the home. The service is registered to provide care for people without nursing needs. At the time of the visit there were 27 who people who lived at the home.

There was a registered manager in place. 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.

At the last inspection 22 January 2014, we found the provider was meeting all the requirements of the regulations inspected.

During this inspection, people who lived at the home and their relatives told us they felt safe. We observed staff were respectful and caring towards individuals and had a good understanding of how to protect them against abuse. One staff member said, “I understand the different types of abuse and the process to follow should I witness something untoward.”

There were sufficient staff on duty to meet people’s needs. However, not all new staff had been recruited in-line with national guidelines. For example the application form for employment at the service did not request any gaps in people’s employment to be explained.

We have made a recommendation about the appropriate recruitment of employees.

People who lived at the home were given a full menu choice at all meal times and could have refreshments whenever they wished. We observed this happened during the day of our inspection visit. One person who lived at the home said about the quality of food, “The food is good.”

We checked how medicines were administered to people. This was done in a safe and appropriate manner. There was a clear audit trail of medicines received and administered.

People who lived at the home were encouraged and supported to maintain relationships with their friends and family members. Relatives and visitors we spoke with told us they were always made welcome when they visited their relatives.

The care plans we looked at were centred on people’s personal needs and wishes. Daily events that were important to people were detailed, so that staff could provide care to meet their needs and wishes. Activities were organised daily and trips out to the local community had taken place.

We found a number of audits were in place to monitor quality assurance. The manager and provider had systems in place to obtain the views of people who lived at the home and their relatives.

We spoke individually with the provider, manager and four staff at the Highcroft. We also discussed standards of care with four people living at the home and four relatives. We observed staff interactions with people in their care. We checked the home’s practices in relation to infection control and nutrition. We reviewed policies and procedures, care records and staff files, as well as various audit processes.

We observed staff interacting with people in a compassionate, dignified and supportive manner. One person told us, “I’m so glad I have come here because the staff are wonderful”. Care provided matched service user’s related care plans. Care records were person-centred and reviewed regularly. We found evidence that people’s nutritional needs were maintained to a high standard.

People were cared for in a clean and safe environment. The Highcroft had effective procedures in place to maintain infection prevention and control. We additionally observed that staff were appropriately trained and supervised to undertake their duties. Suitable systems were in place to monitor the quality of the service provided.

Before people came to stay at the home they had their needs assessed and their care was discussed with them. They told us staff were respectful to them and treated them with kindness. Staff were described as “Very good, lovely”. “I’m happy with them. They always help”. “We’re lucky really with the staff, always helpful and smiling”. One person told us, “They are very good, they do their job properly”. Other people told us “They help you in anyway they can. I need some help with dressing. I’m not left waiting for long”. We found staff were recruited safely and trained to do their job properly.

People told us they were satisfied with the service they received. They commented “Well satisfied and no grumbles. I have a nice room, good bed, good food, excellent service. Whatever I want they would get for me”. “You can ask for anything. If I don’t like what’s on the menu they will get me something else. I like Mulligatawny soup, it’s nice and spicy. They get it for me and sometimes they make me a curry as most of the other people don’t like it. It’s lovely”.

Relatives commented “All the staff are very patient and kind”. And “I’m made to feel welcome”.

People told us their health care needs were met. They had visits from their doctor when needed.

We were told activities were provided. Preparations were ongoing in readiness for Christmas. Staff supported people to be involved such as sending season’s greeting cards to relatives and friends.