The self assessment is publicly accessible via the company’s website –
Highfield is proud of its staff and the service we provide though we are clear there is always room to improve and strive to do so. External audits, questionnaires and now self assessment allow us to identify any area of improvement from different viewpoints and action these.
Management have reviewed the Driving Up Quality documents, attended workshops and met to discuss the various aspects of the code and its five principles and what this means for Highfield as a support provider.
Highfield are committed to adhering to the principles of the code and will be developing our self assessment with the people we support, their families, staff, management and external partners.
Highfield’s management team can already identify some aspects of good practice within the 5 areas -
1.Support is focused on the person
‘R has support built around his needs and wishes. R recently moved into his own home after originally coming to live within a shared house also supported by Highfield. R liked some of his existing members of staff and asked for them to continue with his support. We developed a rota which enabled them to do this and provide R with support around key times of the day – avoiding mornings as R often enjoys a lie in. Occasionally R uses his support flexibly to allow him to attend special events or days out. R has shown some behavioural issues which are centred around his learning disability. Staff have received training and management support to help them support R better. R also has contact with his parents on a regular basis, his mother has close contact with the care team and management which helps to improve R’s support network.
We know R is happy as he can tell us so and is showing signs of responsibility and increased independence with his new living arrangement.’
Highfield has often provided a service above and beyond – though it is difficult to determine which people we have and have not gone the extra mile for in the past. Highfield continue to offer ‘above’ support in this way – offering our service users a feel of security, emotional support, flexible care and management input during times of need, as and when necessary.
Highfield has often provided support for service users to attend family events and even short breaks, provided additional support during hospital stays which funding has not covered, provided transport so families can visit their loved ones in our care, moved rotas around to accommodate special occasions or appointments (sometimes at very short notice), supported service users to organise, plan for and attend holidays of a lifetime, shows, concerts and one off activities which enrich their lives.
Highfield identifies service user wishes in PCPs, timetable planning meetings, family input and on a day to day basis. Outcomes can be measured by the service user’s enjoyment, participation, behaviours and in a more tangible manner by completing the annual questionnaires or providing direct feedback at review meetings.
During times when support has been difficult, input from families, social workers and community nurses is sought. Experience, ongoing knowledge of behaviour patterns, consistent staff and key workers, diaries and tried and tested reports help staff and management learn what works for the different service users in our care.
Most of our service users have suffered large cuts to their support packages. We have had to adapt to being more flexible with the limited number of hours now available, making hours go further by exploring options such as sharing support with people attending the same activities or taking advantage of family or social connections to deliver informal support. We have also had to be transparent with staff and try to change their working ethos – operating at the same level but with fewer hours mean staff need to adapt to working harder and being more flexible to accommodate appointments or changes to rotas etc.
What we could do better –
Highfield are looking to incorporate more evidence of consent within all documentation. This will help ensure support is delivered in a service user focused way and one which they are happy with and consent to.
2. The person is supported to have an ordinary and meaningful life
‘J & P were both living within Highfield, J at a shared home and P in his own flat receiving support at key times in the day. J & P had been in a long term relationship for a number of years and though have spoke about marriage but dismissed this idea due to the associated costs, decided they would like to take the next step and move in together.
We involved the appropriate socialworkers and held meetings with J & P, sought input from their families and consulted with local housing landlords.
Funding was agreed, a house sourced and plans were in place for them to move in together. Staff both J & P were familiar with and liked were included within the new rota.
J & P have now cohabited for two years and receive support for key times of the day. J has more support needs than P and P had some health needs which originally required 24 hour monitoring from staff. Since they have lived together, work has been done to help them support each other so they are less reliant upon staff. J now knows to keep calm and ring on-call should anything happen with P’s health. P helps to support J at home and though it was identified J could not go out without staff support due to limited safety awareness, work around positive risk is being done to allow P to provide J with support to access local shops and community venues.
Both J & P continue to do their individual activities and visit friends and family regularly. Both J & P volunteer at fundraisers. This helps to provide them both with a varied and meaningful life and maintain their happiness.’
Highfield is ambitious for its service users. Highfield strives to encourage independence and build skills and confidence as much as possible, having the ethos that staff support service users to do things rather than doing things for the service user. This is often reiterated to the more able service users we support in regards to their household tasks and chores.
During PCP and timetable reviews, were interests or wishes for educational, vocational training, voluntary or paid work are identified, plans are made between the service user, care team, manager and possibly family to try and source appropriate opportunities.
As such, a number of our service users have voluntary jobs in libraries, charity shops, local arts projects, horse riding centres and residential homes for the elderly and one young man is in paid work. A number of volunteering jobs within the kitchen at the day centre ran by Highfield are offered, providing kitchen and food hygiene experience. Other service users are accessing various college courses and one, a drama club at a performing arts facility. Where possible, service users are encouraged to attend ‘mainstream’ clubs (line dancing, drama, church groups) and social activities (artists at social clubs, bingo, community fairs etc).
Highfield has always had the ethos of ‘giving back’ and the Director is heavily involved in fundraising and community events – service users have often been giving the chance to help at such fundraising events and community projects such as bulb planting, litter picking etc.
Highfield promotes social contacts – friends and on occasion, relationships. By attending regular clubs, service users have the potential to meet new friends and acquaintances. When interest is shown, staff may encourage the service user to swap telephone numbers and organise a tea time visit or afternoon out to build friendships or relationships.
A number of people within the service are interested in similar things and when special events such as shows, wrestling, concerts are on, service users may be encouraged to attend together to build on these acquaintances.
Highfield offers flexible rotas (term time/non term time, changes to days/times etc), transport to attend and support (either transitional or ongoing) to allow people to undertake all of these opportunities.
What we could do better –
We could explore further positive risk taking and will have to should further cuts be enforced.
Generally, support has been agreed with social workers and/or via assessments and changing this to offer positive risks is often a grey area – what can/can’t we do, what are we/aren’t we liable for etc.
It is often difficult to judge levels of appropriate risks as professional advice is often offered reluctantly or varies from one opinion to the other. By further understanding initiatives such as mental capacity act and dols, getting further professional advice or input and having the appropriate recording systems in place we hope to review the company’s, service user’s and family’s attitudes to positive risk in the near future.
Our aim is to look into the MCA and DOLS via appropriate training and advice, set up proper recording systems and look at our risk assessment policies in the near future.
3. Care and support focuses on people being happy and having a good quality of life
‘K has mid-high support requirements and the shared home she lives in with three other service users, receives 24 hour support. K has a number of personal care requirements and health issues, with which she needs support to manage – attending appointments, giving medications, applying creams, monitoring health etc.
K’s mum indicated that only female staff should provide K with personal care to maintain K’s dignity and privacy.
K also enjoys a number of activities, including swimming which requires a female staff member confident in a pool.
K can sometimes be difficult to communicate with and show certain behaviours meaning it is important to her to have a consistent support team who understand her well. During staff absences, effort is put into moving rotas around to cover shifts from the pool of staff based at the house or using familiar bank staff which K and the other service users know.
To ensure that recruitment and staffing relates to K’s specific needs we ensure that appropriate people are employed and that rotas are balanced to ensure a female is on shift at all times and that competent swimmers are available when K is scheduled to go swimming.
All staff, including bank staff are provided an induction, allowing them to become familiar with K’s needs before they start.
K has epilepsy so staff are all provided with Epilepsy training along with a number of generalised training courses relating to care. K also has a number of ongoing health issues, staff who have attend the medical appointments record this in K’s file and cascade the information or instructions to others in the team, ensuring everyone can support K appropriately.’
Recruitment is based on the service users being supported, their individual as well as collective needs. Recruitment may be specific to cater to specific requirements or include questions relating to activities the service user wishes to do.
When planning rotas, consideration is given to - male/female ratios, drivers where necessary to attend activities or appointments, consistent staff to attend particular activities and/or staff confident within set activities.
On a number of occasions, service users have been directly involved with interviews and selection processes.
If issues arise between particular service users and staff, this may be cascaded up to management via a team leader and considered within supervisions and appraisals.
The initial application pack contains the company’s core principles, person specification and job description. These can also be found on our website. This allows potential employees the opportunity to see what is expected of them even before they apply for the job.
The company provides a 12 week induction process with input from colleagues and management. Two monthly supervisions and annual appraisals ensure management can relay what it is we expect them to achieve. Memo’s and regular care team meetings reiterate this.
Staff are able to make small day to day decisions individually or collectively within their teams on an ad-hoc basis or during care team meetings. Staff are heavily involved with PCP planning and support service users through decision making processes in relation to this and may decide upon trips, new activities to try, managing healthy diets and wellbeing etc. The company trust staff to make good decisions in line with company ethos and policies and procedures. Sometimes judgement may be wrong in which case management may advise to avoid future issues.
Management are very ‘hands on’ and visit their respective teams/service users at least a couple of times each week, allowing them to pick up on any dissatisfied service users very quickly. Families are welcome to visit the office or telephone a manager as and when necessary. The management team operate an open door policy and with the offices based at the day centre, service users have ample opportunity to come into contact with their own managers and/or the director and operations manager.
Highfield tailor support to people through times of distress depending on what the issue is. If the issue is family bereavement or a fall out with friends, staff may offer emotional reassurances, support to visit or transport etc. If the issue is with a particular member of staff or activity, service users may be offered an alternative. If the issue is a known behaviour, this may be dealt with by agreed responses or family/professional input.
Highfield has recently reviewed and implemented new interview questions. This, along with the applications form, 12 week induction and ongoing supervisions, provide us with the opportunity to gauge staff values and attitudes.
Highfield has recently brought in the ‘Bradford Scale’ which allows us to better monitor and manage staff absences and hopefully further deter staff from any unwarranted absence. Policies are currently being reviewed in regards to staff booking leave to maintain appropriate staffing levels within the houses at all times reducing the neccesity of using bank staff and maintaining the regular staff team where possible. We try to encourage other members of the team to cover shifts or use well known members of the bank team (who are all inducted within the houses they are to cover) to ensure minimum disruption during staff absence or sick leave.
What we could do better –
Highfield could formally request service user and family input upon completion of inductions and during appraisals.
The managers could encourage more service users (or their families) to take part in the recruitment process.
4. A good culture is important to the organisation
Highfield works within a set of core principles which the company's policies, procedures and working ethos are based around -
The management discuss issues, policies and procedures at their regular meetings; this is cascaded down to the team leader meetings, care team meetings and via internal memos. Issues may arise which are reviewed as and when necessary.
Highfield often implements change based on the input and feedback from staff in care team meetings or supervisions, from service users via their PCP or review meetings and from families via annual questionnaires. Changes on an organisational level are a combination of the feedback cascaded up to the management team.
Our organisation contributes to the local community and society; providing job opportunities, training and qualifications, fundraising for local and national causes, promoting independence and opportunities for the people we support and providing volunteering placements and experience for people wishing to enter the sector.
The management team also attend partnership board meetings and task groups on a regular basis and the company provides support so service users can attend service user group meetings. These meetings are important to shaping support policies and sharing good practice, and is a platform to voice any concerns or attempt to improve areas of concern.
The service users in our care receive funding for a set number of hours. Rotas are planned carefully to ensure these hours are met yet in a flexible and person centred way – dictated by the wants and wishes of the service users, not the needs of the company or its staff.
The company has made efficiencies to ensure its sustainability following funding cuts and increased business costs – management working hours were reviewed, efficiencies with stationery and personal protection items have been made to achieve best prices, efficiencies in regards to insurances have been made where possible and non mandatory training and refresher training has been minimised (but not compromised).
Having a structured recruitment and induction process to help us employ the right staff. The recruitment process is an investment of management time. The induction process is a financial investment (paying staff to shadow others and attend necessary training). Each home has a Team Leader enabling ongoing staff support in house and a Team Manager who is available to them for supervisions, appraisals, meetings and ad-hoc support.
The company make a large investment each year in providing ongoing training and accreditation – often paying for training above and beyond which is mandatory. This is to ensure staff are well trained, knowledgeable and able to do a good job.
Highfield feels that being able to offer opportunities for development, a good support network and giving staff the confidence and esteem that they are doing well and forging a good career, helps to retain quality staff.
By providing easy read and easy to understand communication tools during things such as meetings or during the interview process, we can actively involve service users in the decision making rather than them being there just as a token gesture – i.e. using photos to vote on new members of staff so service users can remember easier who they preferred.
What we could do better –
The company used to have regular service user group meetings in which service users could actively participate in decisions and discuss issues or air views. Due to funding cuts and restrictions to times when everyone is available these have not been kept up. Meetings should be scheduled at least 4 times yearly to give the service users more opportunity to actively participate in decision making and be better informed of changes to policy, procedures or organisational issues.
Highfield should adopt the plan-do-review process. Often things are planned and done but not always reviewed in a measurable or structured way.
Highfield should review its core principles each year and ensure that recruitment, training and organisational processes tie in with these wherever possible, making sure that the company’s culture and ethos is emphasised better.
5. Managers and board members lead and run the organisation well
A large proportion of management time is spent directly with staff and service users. The management visit the houses regularly and as stated earlier, managers operate an open door policy which ensures they are accessible to their care teams and people they support. Being hands on (and all the managers having worked within the houses), they are very aware of service user needs and communication which enable them to engage properly with people. Manager’s also attend care meetings which ensure that they can discuss matters with staff first hand and the operations manager and/or director attend when necessary to discuss policy or organisational changes.
A number of the service users attend the activities at The Base which is where the company offices are located. This allows all levels of management to interact and engage with visiting staff and service users.
Managers have all attended the internal safeguarding training but the operations manager or director have not as they don’t provide ‘hands on’ care or support.
The management team drives up quality by actively reviewing policies and procedures, attending partnership board meetings and cascading good practice, and by following external regulations from local government, CQC and Investors in People. The evidence can be found in the assessments from external agencies and the satisfaction questionnaires sent to service users each year.
The management team know that it’s achieving it's mission by the overall happiness and good standard of living of the service users in our care.
Good communications at all levels, regular supervisions, various monitoring charts, having an open door policy, hosting regular meetings and having a stringent complaints procedure in place all help to identify poor service or failings.
The management team discuss these issues and deals with specific failings in line with policy and procedures, informing relevant external agencies where necessary (raising safeguarding alerts, contacting social workers etc). Discussions between management, input from higher management and where necessary family or external agencies help to focus on the appropriate way to deal with queries and issues.
Policy changes may occur from lessons learnt from specific incidents, complaints or safeguarding issues. These are cascaded down to the team and further training or management input may be given to avoid reoccurrences.
The management team have all been promoted up from support workers and have been here for many years. As such, all are experienced within the care sector and employ the company's ethos. Having worked in specific houses they have been provided with a cross section of experience from low to high care needs and a variety of subsequent disabilities and health and behavioural issues.
As they have taken on the role of management, they have received appropriate training in management to supplement their training and experience in care. They have further developed skills and experience by being delegated tasks from the Director. Now we have a Training Manager, an Operations Manager who deals with HR and organisational issues, a Developments Manager and a Registered Manager. Each has key knowledge pertinent to their roles and complement each other as members of a team.
What we could do better –
The Director should visit the houses on a rotation basis to make
sure he remains visible to staff and service users, making sure staff and service users are happy and there are no pressing issues. The Director used to do this but with his semi retirement status,
the expansion of the company and the delegation of some of his workload maintaining a high level of visits are difficult – effort should be made to at least do this on an 8 weekly basis per
Though it is apparent that the management team believe in the ethos of the company and live to the values of the organisation, there is no formal demonstration of this. In the past we have had questionnaires staff completed in regards to their manager and formal management supervisions . Again with funding restraints and external pressures on management and higher management time, this has lapsed and should be reinstated at least once yearly.