Long Close Retirement Home

Long Close Retirement Home is a residential care home registered to provide care and support to up to 16 people. The service provides support to older people some of whom were living with dementia. At the time of our inspection there were 11 people living at the home.

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

People and their relatives told us Long Close Retirement Home was a happy place, care was provided to a high standard. Staff described working at the home as, ‘just being with family.’ People told us they felt safe living at Long Close.

Utilities checks were not always carried out as planned, the provider and registered manager took immediate action and booked in the necessary checks. We received assurances the environment was safe. The registered manager was in the process of reorganising the documentation and office at the home. Risks people faced day to day had been identified and assessed, there were clear instructions for staff for safe ways of working. Staff told us they had enough information to enable them to provide safe care. Recruitment procedures were in place and all necessary checks had been taken to ensure staff were suitable to work with people.

People received their medicines as prescribed. The home was clean and free from clutter, people told us they liked the décor and homely feel of the environment. The provider told us there was a continual redecoration plan for the home. People’s bedrooms were spacious, lounges were well lit and there were various places people could spend their time in the home, as well as access to the gardens and grounds.

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 understood the importance of asking people how they wished to receive their care.

Audits were used to monitor the standard of care within the home, the registered manager told us they were making changes to the programme of audits to use them for continual improvements. Action points from audits were carried out and the registered manager and provider continued to work through improvements. Long Close Retirement Home actively sought feedback on the service it provides. Annual surveys and regular meetings with people and their relatives meant they were involved in how the home operated.

Staff felt appreciated by the provider and registered manager and were complimentary about their colleagues. They told us they were proud to work at the home. Long Close Retirement home worked well with external professionals and we received extremely positive feedback about how the home worked together with health services to ensure people received the best care.

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 good (published 25 January 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained good.

The service met all of the fundamental standards.

The service worked safely. Risks to people were assessed and managed so that people were supported to remain safe with the fewest possible restrictions on their freedom. People were safeguarded from abuse. Medicines were stored securely and managed properly. Infection prevention and control measures were in place. The premises underwent regular maintenance, were kept clean and smelt fresh. Equipment was regularly serviced. Accidents and incidents did not happen often, but there were systems for learning from them and bringing about improvement. There were checks on new staff before they started work to ensure they were suitable to work in a care setting.

There were sufficient staff on duty to ensure people remained safe and had the support they needed. Staff had the skills and knowledge to provide effective care and people spoke highly of them. They were supported through training, supervision and appraisal.

The service looked and felt very homely. There were adaptations in the house and garden for people with impaired mobility.

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. People were as involved in decisions about their care as they wished to be. Their views were listened to and their preferences were respected.

People were treated with kindness, respect and compassion. Their privacy, dignity and independence were respected and promoted. They were encouraged to feel they mattered and staff got to know them well, understanding what mattered to them and how they liked their care to be delivered. People valued the family feel of the service. Visitors were welcome at any time.

People’s care promoted a good quality of life and was in line with current legislation and good practice. People and, where appropriate, their relatives were involved in planning and reviewing care. People’s care was personalised and was responsive to their needs. Staff had a good understanding of the care people needed. Organised activities were provided for people if they wanted these. Community links had developed and, where possible, people were encouraged to use facilities outside the home. Staff liaised with GPs and district nurses as people approached the end of their lives, to help ensure a dignified and comfortable death.

People had enough to eat and drink and were supported to maintain a balanced diet. Food was freshly prepared and was appetising. Dietary needs and preferences were catered for. People were also supported to manage their health and had access to the healthcare services they needed. Staff communicated effectively with other organisations so that people received effective care and treatment.

There was a complaints process, although no formal complaints had been received since 2011. People’s concerns were taken seriously and acted upon. People and relatives felt the registered manager and provider were approachable.

The service was well led. There was a culture of person-centredness, valuing people and staff, and open communication. The registered manager was well established, understood her responsibilities and met her legal responsibilities. There were organised systems of delegation between the registered manager, deputy manager and provider that kept the home running smoothly and ensured a high standard of care. This was reflected in good staff morale and strong team work. The registered manager and provider maintained oversight of the service and regularly monitored its quality. There was work in partnership with other agencies, such as commissioners, to support the provision of care.

Further information is in the detailed findings below.

The service is registered to accommodate and provide personal care for up to 17 people. At the time of the inspection there were 15 people living at the home.

There was a registered manager at the time of the inspection. 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.

Overall, people were very positive and complimentary about the staff team and the way they cared for and supported people.

People felt safe living at the home and there were established monitoring and auditing systems to make sure that the environment and the way people were looked after were safe. Risk assessments had been completed to make sure that care was delivered safely with action taken to minimise identified hazards. The premises had also been risk assessed to make sure the environment was safe for people.

Staff had been trained in safeguarding adults and were knowledgeable about the types of abuse and how to take action if they had concerns.

Accidents and incidents were monitored to look for any trends where action could be taken to reduce likelihood of their recurrence.

Sufficient staff were employed at the home to meet the needs of people accommodated.

Recruitment procedures were being followed to make sure that suitable, qualified staff were employed at the home.

Medicines were managed safely and administered by trained staff.

The staff team were both knowledgeable and informed about people’s care and support needs. There were good communication systems in place to make sure that staff were kept up to date with any changes in people’s routines or care requirements.

Staff were well-supported through supervision sessions with a line manager, an annual performance review and also direct supervision.

Staff and the registered manager were aware of the requirements of the Mental Capacity Act 2005 and acted in people’s best interest where people lacked capacity to make specific decisions. The majority of people accommodated had capacity to make their own decisions for all aspects of their lives. They were consulted and gave consent to the care and support they received.

The home was compliant with the Deprivation of Liberty Safeguards with appropriate referrals being made to the local authority.

People were provided with a good standard of food and their nutritional needs met.

People’s care needs had been thoroughly assessed and care plans put in place to inform staff of how to care for people. The plans were person centred, covered all areas of people’s needs and were up to date and accurate.

People and staff were very positive about the standards of care provided at the home. People were treated compassionately as individuals with staff knowing people’s needs.

Communal and individual activities were arranged to keep people meaningfully occupied.

There were complaint systems in place and people were aware of how to make a complaint.

Should people need to transfer to another service, systems were in place to make sure that important information would be passed on so that people could experience continuity of care.

The home was well-led. There was a very positive, open culture in the home with staff proud of how they supported people.

There were systems in place to audit and monitor the quality of service provided to people.

We spoke with one person who was visiting their family member. They told us their relative had 'nothing but the best of care and the staff are so kind and obliging.'

We spoke with the proprietor and the trainee proprietor, the registered manager, the deputy manager, two senior carers and one carer. Staff told us 'It's like a family here.' Another said 'The training is very good.'

We reviewed care records for four people using the service. We found that people who lived at the home experienced safe and effective care because their needs were assessed and reviewed, and care plans kept current.

People could choose from a varied menu and had the support they needed to help them eat and drink.

People using the service benefited from a staff team who were well trained and supported to do their job.

People received safe care, treatment and support because effective systems were in place to regularly assess the quality of the service provided.

People told us the staff were 'very good and they help you'. They commented that the staff were kind and respectful when providing care. We observed the staff were friendly, respectful and courteous when speaking with people. The care plans contained adequate information and reflected people's needs. People were supported to make choices about meals and relatives were involved in assisting with people's care plans as needed. People were complimentary about the meals and told us they were offered a varied diet and balanced meals that met their needs.

Appropriate arrangements were in place for the management of people's medicines. People had access to healthcare professionals and treatment. There was a recruitment process that was followed. Information was available on how to raise concerns.