Longley Health Care Limited

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a strong proactive and positive culture of safety, based on openness and honesty. Staff actively listened to concerns about safety and thoroughly investigated and reported safety events. Lessons were always learnt to continually identify and embed good practice. Opportunities for learning and reflective practice were actively sought throughout the service. There was clear system for reporting incidents which were individually reviewed with detailed feedback provided to staff through daily meetings to identify learning and how they could work together to keep people safe. There was a strong focus on using incidents as an opportunity to identify where people may have support needs that were not being met. There was detailed analysis of incidents to identify themes or trends and this information was then shared to develop staff practice within the service, and also within the other provider services in other regions.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Before people moved into the service there was an assessment of their needs to ensure they could be safely supported. Needs assessments were comprehensive and evidenced detailed conversations with people and their representatives. Information about the person, their relatives, friends and health conditions was recorded along with what support they needed with personal care, mobility, nutrition and other areas. Information was also gained on their religious beliefs, interests and social history. Organisations who worked with the service fed-back positively about how proactive they were at addressing concerns. One professional said, “The service is very responsive and proactive. I am often invited to attend the regular meetings, and all the required information is provided, with updates on actions.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. People told us they felt safe at the service, and staff were kind. Relatives echoed this telling us, “My relative has a 121 and there is always someone in the room with them. I have never seen any resident alone. Staff are always around so that people can get assistance if they need it”. And “I feel my relative is safe and cared for.” Staff were knowledgeable about safeguarding procedures and how to report any concerns effectively. Staff told us they felt confident raising issues about safety and felt these would be listened to and the appropriate action would be taken. People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In [care homes/hospitals], this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that the registered manager understood their responsibilities and the key principles of the MCA and DoLS, and we saw any conditions were being met. DoLS were being applied for appropriately and the manager tracked the progress of these. We found the documentation of people’s mental capacity and ability to make specific decisions was comprehensive and detailed.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Risk assessments were completed comprehensively and updated on a regular basis. We found people were not restricted unnecessarily, and where any restrictions were in place, these were carried out in people’s best interests, with the service adhering to relevant legislation and good practice guidance. There was a balanced approach to risk which supported people and their choices. For example, a person who liked to walk around the unit, was encouraged to do so, with the risk of any weight loss being closely monitored. Staff explained how they supported people to stay safe from known risks by reporting any changes in people’s presentation and referring to people’s care plans to assess risks. Systems in place ensured staff were trained and equipped with the skills and knowledge they needed to support people safely. Staff knew people well and they recognised triggers for anxiety and distress. Staff told us when they took prompt action it helped to reduce distress and prevented potential risk of incidents. We observed staff approach was calm, respectful and promoted people’s rights. Records showed staff worked closely with people, their family where appropriate and external partners to ensure risk management plans were robust.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Managers completed daily walk arounds of the home to ensure equipment was safe and any concerns were reported promptly. Maintenance staff were available to rectify any safety concerns promptly and the provider conducted regular checks and had risk assessments in place to ensure people’s safety.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. Some people in the service were assessed as requiring 1:1 support, or regular checks on their well-being. During the inspection, we observed staffing levels to be safe and found people to be in receipt of their assessed care. Staff were recruited safely, with appropriate pre-employment checks carried out before staff started working at the home, which included Disclosure and Barring Service (DBS) checks. Staff had received appropriate training to enable them to safely carry out their roles and staff received regular supervisions and appraisals. The service had also introduced a ‘buddy’ scheme where experienced staff could support new starters to transition into their roles with additional skill sharing and support.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. An Infection Prevention and Control (IPC) policy was in place, together with a cleaning schedule and the service’s domestic staff. The home had IPC champions and IPC audits took place. People and relatives told us all areas within the service were kept hygienic. One relative commented, “[Relatives’] room is always clean and tidy, and they [service] manage their [relatives] laundry well.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. Medicines were stored, administered and documented safely in line with best practice. Staff closely monitored people’s medicines to ensure they were effective in managing their mental and physical health needs and proactively arranged medication reviews with health service if they were not working as intended. For individuals prescribed antipsychotic medications, the service was closely monitoring any side effects and working in partnership with professionals to ensure these remained necessary and the least restrictive option. The service ensured the use of antipsychotic medications was as a last resort in line with relevant best practice guidance.