You are here

Inspection Summary


Overall summary & rating

Good

Updated 6 June 2018

Longmead House is a care home providing personal care and support for a maximum of 23 older people. Accommodation is set over three floors all of which have access via stairs or a lift. On the day of our inspection there were 17 people living in the home, 12 of whom were living with dementia.

The inspection took place on 12 April 2018 and it was unannounced.

People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

There was a registered manager at the service 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.

At our last inspection in April 2016, we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to make improvements to the care records they held on people, some of which were out of date or giving contradictory information about people’s needs. Following the inspection, the registered manager told us they would introduce a new care plan format and review people’s care records. We found that this had been implemented and saw some good examples of care records on this visit. The registered manager has recruited a deputy manager to support them with the record keeping and auditing the quality of care.

However, we found care planning and risk assessments needed to be more consistent and fully completed for all people. Other improvements that were needed at the last inspection had also not been fully implemented. The recording of mental capacity assessments were not always completed correctly in relation to the Mental Capacity Act 2005. People who had 'as required' (PRN) medicines still did not have a protocol in place. During and following our inspection the registered manager took steps to demonstrate to us they would put these things right. We will monitor this and check the improvements have been embedded into practice and sustained at our next inspection.

There were very good relationships between staff and people living at the home. Care was provided in an inclusive, person- centred way by staff, who were appropriately trained and supervised by a manager. There were sufficient numbers of trained staff to meet people’s needs safely. The provider had carried out appropriate checks on staff to ensure that they were suitable for their roles.

Staff were able to tell us of the risks to people and what they did to keep people safe. Staff understood their responsibilities under safeguarding and how to prevent and report abuse. People’s medicines were stored safely at correct temperatures in locked cabinets, and the management of people’s medicines was safe.

People were protected from infection and staff were practicing good hygiene. There were systems and checks in place to ensure cleanliness and to reduce the risk of infection.

The manager was working with staff to make changes in practice, using the learning from recent incidents.

People were receiving good and effective care. Each person had an assessment and care plan in place, and they were involved in deciding how their needs should be met. People were looked after by staff who had been well trained, and with the skills they needed to carry out their role.

People were supported to remain as healthy as possible. Staff enabled people to get specialist healthcare when it was required. There was evidence of good relationships with local health care professionals. The needs of people living with dementia were taken into account.

The building had been adapted to meet the needs of people living there whilst retaining

Inspection areas

Safe

Good

Updated 6 June 2018

The service was safe.

People�s risks were known, recorded and acted upon.

The staff understood their role in relation to safeguarding.

People were cared for by a sufficient number of trained staff.

People received the medicines they required and medicines were

stored correctly and safely.

Environmental and hygiene checks were in place daily and there was an evacuation plan in place.

Learning from accidents and incidents was happening.

Effective

Good

Updated 6 June 2018

The service was effective.

Staff applied the principals of the Mental Capacity Act and people were asked for their consent.

The recording of decisions made on a person�s behalf was being improved.

Staff were trained to ensure they could deliver care based on best practice.

People were provided with food and drink which supported them to maintain a healthy diet.

People received effective care had access to external healthcare professionals when they needed it.

The premises were adapted to meet the needs of people living there whilst retaining a homely environment

Caring

Good

Updated 6 June 2018

The service was caring.

People were treated with kindness and care, respect and dignity.

People were supported to maintain relationships with people close to them.

Staff encouraged people to make decisions for themselves and they were given help when requested.

Responsive

Good

Updated 6 June 2018

The service was responsive.

Staff knew people well and ensured their choices, interests and activities were provided for.

People�s care plans reflected personal history and interests and were holistic.

People were involved in making their own decisions about their care.

People knew how to raise their concerns or a complaint. These were responded to immediately.

People were encouraged to discuss their end of life care wishes.

Well-led

Requires improvement

Updated 6 June 2018

The service was not always consistently well led.

Improvements were needed in relation to the governance of people�s mental capacity assessments.

Positive changes to care plans and the reporting of outcomes from incidents needed to be embedded and sustained within the practice of the service.

Staff felt supported by the registered manager and there was a culture of open communication.

Staff and people were given a say in the running of the home.

The leadership was person-centred.