Longmead House

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 inadequate. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

The provider was previously in breach of legal regulations in relation to safe care and treatment, and fit and proper persons employed. Improvements were found at this assessment and the provider was no longer in breach of these regulations.

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 manager had developed a proactive and positive culture of safety, based on openness and honesty. People who lived at the home, relatives and staff were able to raise concerns without fear of repercussions.

Accidents and incidents were appropriately recorded and investigated. Lessons were learned from investigations, and these were shared with staff, which helped improve and embed good practice.

People received good continuity of care when they moved between different services. The manager and staff worked with other professionals to establish and maintain systems of care in which safety was managed well.

Care and support was planned and organised in ways that ensured continuity. People’s views about their care were listened to and taken into account. People told us they had received good support to settle into the home when they moved in. They said the staff team had ensured they felt welcome and comfortable.

The manager worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff focused on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect.

Staff attended safeguarding training in their induction and refresher training thereafter. Staff were able to describe the potential signs of abuse and how they would report any concerns they had.

The manager worked with the local authority and other agencies to investigate when safeguarding concerns were raised. This included contributing to safeguarding enquiries and providing information when requested.

Applications for Deprivation of Liberty Safeguards (DoLS) authorisations had been submitted where people were subject to restrictions for their own safety, such as being unable to leave the home unaccompanied. DoLS is a legal framework designed to protect people who lack mental capacity in care homes or hospitals from being deprived of their liberty without proper authorisation.These safeguards ensure that any restrictions on a person's freedom are necessary, proportionate, and in their best interests.

The manager worked with people to understand and manage any risks in their care. Staff provided care that was safe, supportive and enabled people to do the things that mattered to them.

Relatives said staff understood any risks involved in their family member’s care and managed these well. One relative told us, “[Family member] cannot walk and tries to get out of his chair; they keep an eye on him and make sure he is safe.” Another relative said, “There is always someone sitting with [family member] making sure he is safe.”

The manager had carried out risk assessments to identify any risks in people’s care and developed guidance to mitigate these for staff to follow. We observed during our visits that staff supported people to stay safe, for example, when transferring or mobilising.

The manager detected and controlled potential risks in the environment. They made sure equipment and facilities supported the delivery of safe care.

People told us the environment in which they lived had improved greatly since our last inspection. One person said, "[Manager] has had it painted, most people have new carpets, he pushed for the lift to be replaced. He has given the staff a staff room and their own toilet. It is all down to [manager]."

Relatives also reported that the environment had improved significantly since the manager took up their post. One relative said, “The staff were always very nice, but the environment left a lot to be desired. It is very different now, much improved.”

We saw evidence of much refurbishment work since the last inspection. All rooms looked freshly painted and most communal rooms and bedrooms had new flooring. The installation of a new lift was being completed at the time of our assessment. People told us this was a welcome development, as the previous lift had frequently broken down.

Action had also been taken to improve fire safety, including making sure all fire doors met applicable standards, and obtaining a quotation for improvement work to the external fire escape.

There were enough qualified, skilled and experienced staff available to meet people’s needs, who received effective support, supervision and development. Staff worked together well to provide safe care that met people’s individual needs.

People told us staff were available when they needed them and our observations confirmed this. One person said, "We always have enough staff. You are never without staff here."

Relatives told us staffing levels had improved since our last inspection, which had improved their family members’ experience of care. One relative said, “They are better staffed now than they were a while back. Now there are always plenty of staff around when I visit, and they are attentive.”

The manager used a dependency tool to calculate the number of staff needed on each shift based on people’s needs. The manager reviewed the dependency tool regularly, including when people’s needs changed or a new admission was made.

Staff were recruited safely. All staff had an induction when they started work and had access to the training they needed to carry out their roles. A member of staff who had recently joined the team told us they were working towards the Care Certificate, a nationally-recognised set of standards, knowledge, skills, and behaviours for care workers.The manager had introduced one-to-one staff supervision sessions, which provided staff with opportunities to discuss their performance, development and further training needs.

The manager effectively assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared any concerns with appropriate agencies when necessary.

Staff received training in the prevention and control of infection and told us they had access to personal protective equipment (PPE) when they needed it.

Relatives told us standards of cleanliness and hygiene had improved since our last inspection. One relative said, “The home is very clean, and so is [family member’s] room.”

Another relative told us, “The cleanliness of the home has improved loads.” Our observations supported this view. The home had a new housekeeper, who told us they completed daily cleaning checklists to ensure all parts of the property were cleaned regularly. We observed that all parts of the home were clean and hygienic.

The manager 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.

There were appropriate arrangements for the ordering, administration, recording, and disposal of medicines. The medicines administration records we checked were accurate and up to date. The manager had put in place guidelines for medicines prescribed ‘as and when required’ (PRN), which were not in place at our last inspection.

The manager had introduced electronic medicines administration records (eMAR), which they told us had led to a reduction in medicines errors. Staff said they found the eMAR system easy to use and felt it reduced the likelihood of errors occurring.

The cupboard used for medicines storage was not ideal for the purpose due to its size and location. The manager had identified this and planned to identify a more suitable site for medicines storage.