Long Lea Residential Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s needs were assessed before they moved to the home so their care could be planned based on their needs and choices. Care records were personalised and provided staff with a good level of detail to ensure they had the information needed to provide safe and effective care. Care records had been regularly updated to reflect any changes in people’s needs and recommendations made by visiting health care professionals.

Changes in people’s assessed needs were communicated to staff. One senior member of staff told us, “Each senior has a number of residents allocated and we are responsible for reviewing their care records. We look at them all the time and update them. When there is a change, we share it at the flash meeting, and we add it to the electronic records system so staff not on duty get told.”

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People were positive about the food provided. Comments included: “The food is great”, “They ask us what we want to eat in the morning, there is a choice. I have salad most of the time, I prefer that” and “The food is excellent. I get a choice mid-morning. They will do an omelette for me instead if I ask.”

Most people chose to eat their meals together in the dining room. However, we found improved organisation around the lunch time experience would ensure staff had more time to support and encourage some people to eat and drink well.

Evidence based assessment tools were used for monitoring people’s care such as their weight and nutritional needs. Care plans clearly recorded people’s needs and what support they required to maintain a good nutritional intake. Where people had risks related to eating or drinking, staff supported them in line with their care plan.

Catering staff told us they were kept informed about people’s individual nutritional needs and how they needed their food to be prepared. They explained how they added extra calories to meals for those people who were at risk of losing weight and prepared sugar free options for diabetic people. One member of catering staff told us, “Communication is very good. At the daily flash meeting I am informed if anything has changed, and I get an updated copy for my records. If something changes in-between, the managers come and tell me.”

Catering staff completed training in the International Dysphagia Diet Standardisation Initiative (IDDSI). IDDSI is a standard for describing food textures and drink thicknesses for people with swallowing difficulties. A member of catering staff told us, “The IDDIS training is very good. You learn all about how to achieve the correct consistencies and what each one means.”

Where people had been identified as losing weight or experiencing swallowing difficulties, they had been referred to external health care professionals. Advice from healthcare professionals was recorded in people’s nutritional care plans and known by staff.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The registered manager had worked with external healthcare professionals to build better relationships and ensure effective information sharing across services. The GP had a weekly ‘ward round’ at the home and processes were in place to ensure information about people was shared prior to their visit. The registered manager explained, “Every Tuesday we fill out a GP list of concerns we have about residents and it is all scanned over to the GP so they have the notes.” Staff supported healthcare professionals’ visits so their advice was known and recorded. One member of staff explained, “The GP does a weekly round, and we always go with him. We have a good relationship with the district nurse. This benefits the residents. We know our residents so we can share all the information to help the professional make their decisions.”

The registered manager and staff described the processes in place to ensure important information was shared. This included a handover between shifts and a daily ‘flash’ meeting between staff to discuss any risks within the service. One staff member told us, “Teamwork is really good. We help each other. We get allocated tasks at handover. This works well and avoids confusion, but we would still help in other areas if needed.” Another staff member explained, “At the start and end of a shift we have a full handover and there is the flash meeting in between. This makes sure information is shared.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People were supported to attend healthcare appointments to promote their continued health. Care plans included information about people’s health conditions so staff could recognise any signs or symptoms which may indicate a deterioration in their condition.Where a need was identified, people were referred to other specialist healthcare professionals to keep them well. For example, dieticians and speech and language therapists. One member of staff explained, “We know the residents so if we think something is not right, we call for the GP, or the district nurse or the dentist. Whatever we think they need to help them.”

Staff recognised the importance of supporting people’s emotional health by promoting their independence and encouraging people to recognise their own skills and abilities. A staff member commented, “For me, independence is a right. If you encourage them (people) it’s good for them. I do little things like showing them how to cut their food. Even if they cut 2 little bits it’s good. You know yourself, if you do something you feel good about it.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Records were completed to demonstrate safe practice and enable effective monitoring to take place. This included people who were at risk of sustaining skin damage or who were at risk of not eating and drinking enough. Overall, monitoring records were completed accurately and demonstrated people were receiving the care set out in their care plans. The registered manager explained the oversight they maintained to ensure accuracy in recording to promote positive outcomes for people.

Staff explained how they shared monitoring records with other healthcare professionals to support their clinical decision making. For example, 1 person was being reviewed by speech and language therapists due to increased risks of choking. One staff member explained, “SALT and the dietitian have been out more than once, but they didn’t see what we see, so we have made another referral and telephoned them to explain. We only want the best for the residents.” Another staff member told us, “If the GP has prescribed antibiotics, we keep an eye on the resident to make sure they are working. At the next weekly GP ward round we say how the resident has been and if they are getting better. In-between, if there was a problem we would ring the surgery.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People told us they were supported to make daily decisions such as what time they got up and where they spent their time. One person told, “I get up when I like, I dress myself and I go to bed when I feel like it.” Another person said, “They prefer you to get up in the morning, but I could stay in bed. I go to bed at 9.00pm, that’s my time.”

Staff understood the importance of listening to people’s wishes and respecting these. During our inspection we saw staff sought people’s consent before providing assistance and respected people’s choices. One staff member told us if a person declined support with personal care, they would talk to the person and offer the care later. Another member of staff explained, “We always ask consent, its automatic. I explain to the new staff, even if a resident can’t tell you because they don’t have capacity, you still ask. It’s their body, their life and their right to choose. You’ve got to have the right approach to our work.”

Managers and senior staff understood how and when to formally assess whether people had the capacity to make decisions about their care and treatment. Capacity assessments contained information about how people had been supported to understand the decision to be made so they had the best chance possible of making their own decision.