Long Lea Residential Home

Updated 28 October 2023

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Three inspectors and an Expert by Experience completed this inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Long Lea Residential Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Long Lea Residential Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

The first day of our inspection was unannounced. We informed the provider we would return on the second day to complete our inspection.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We sought feedback from Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 5 people and 5 relatives about their experience of the care provided. 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 spoke with 13 members of staff including the registered manager, 2 regional managers, the operations director, a team leader, a senior care assistant, 2 care assistants, 2 members of kitchen staff, 2 members of the housekeeping team and the activities co-ordinator. We also spoke with 5 external healthcare professionals.

We reviewed a range of records. This included 4 people's care records in full and specific aspects of 1 other care plan. We looked at 3 people’s medicine records and 2 staff files in relation to recruitment. A variety of records relating to the management of the service were also reviewed.

Updated 28 October 2023

About the service

Long Lea Residential Home is a care home providing personal care and accommodation for up to 35 adults living with dementia or mental health needs, physical disabilities and sensory loss. The care home is a 2-storey building with en-suite bedrooms and communal facilities. At the time of our inspection visit there were 28 people receiving care.

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

There had been frequent changes in management and senior staff at Long Lea Residential Home which had impacted on the provider’s ability to maintain consistency in care standards. The service has not achieved an overall rating of good for the last 4 inspections dating back to January 2021.

The provider carried out a range of quality checks and audits. These had driven improvements in some areas and maintained standards in the key questions of effective, caring and responsive. However, systems to monitor people’s health and wellbeing required more day-to-day scrutiny. Important records were not always detailed enough to demonstrate people received the right levels of care and safe practices were followed. Training needed to become embedded in the everyday practice of staff to ensure risks were consistently mitigated.

There were enough staff on duty to support people with their care needs. Staff understood their responsibility to report any concerns of abuse or discrimination. Where potential safeguarding incidents had occurred, appropriate action had been taken. Medicines were ordered and stored safely, and people generally received medicines as prescribed. However, some improvements were required in the recording of medicines administration to ensure safe medicines practices were consistently followed.

Managers and staff liaised with other agencies and health professionals to meet people's specific needs. Staff told us changes to people's health and well-being were communicated effectively. Catering staff demonstrated a good knowledge and understanding of their responsibility to provide food and drinks that met people's nutritional needs and preferences. Changes in the layout of communal areas had improved people’s mealtime experiences.

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.

People were positive about the relationships they had built with the staff and relatives told us staff demonstrated a kind and caring approach. Staff understood people’s right to be treated with dignity and respect and encouraged people to let them know how they wanted their care to be provided.

People’s care plans reflected their histories, care needs and preferences. People were supported to engage in a range of interesting things which helped keep them active and gave them opportunities to socialise with other people living at the home. People’s wishes for how they wished to be cared for in their final days had been explored and plans developed with input from their family members.

Staff told us the culture in the home had improved and the provider was working proactively to promote staff well-being. Staff felt supported and listened to and good practice was recognised.

The provider sought advice and guidance from other organisations to improve outcomes for people. They worked closely with commissioners of their service including the local authority and infection control teams, to make improvements to the service.

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

Rating at last inspection and update

The last rating for this service was Requires Improvement (published 13 December 2022) and there a breach of a regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

Why we inspected

We carried out an unannounced focussed inspection of this service on 1 November 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

We undertook this inspection to check they had followed their action plan and to confirm they now met legal requirements. In addition, we had received further concerns in relation to poor-quality care.

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.

The overall rating for the service has remained as Requires Improvement based on the findings of this inspection. We found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We have identified breaches in relation to governance and safe care and treatment at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.