Longfield Care Home

Longfield Care Home is a residential care home providing accommodation with personal care for up to 40 people. The service provides support to older people and people with dementia. At the time of our inspection there were 39 people using the service.

People’s experience of the service and what we found:

People and their family members were very complimentary about the service and told us they were happy with the care provided.

Risks to people's health and welfare were identified and assessed. Safeguarding processes were in place to protect them from abuse and harm. Lessons were learnt when things went wrong.

People’s support needs were met by enough staff who were recruited safely. Infection control was promoted, and medicines were managed well.

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 told us staff had the necessary skills to support them. Staff said they felt supported by the management team, enjoyed the training provided and were supported to develop their knowledge and qualifications.

People were supported to eat and drink well and able to choose how they spent their time. Care plans were written in a person-centred way showing dignity and respect to people. People could choose the gender of the staff who supported them.

The provider continually assessed the premises, and all health and safety checks were completed. People had access to ample communal and garden areas and their bedrooms were personalised.

Staff worked very collaboratively with health and social care professionals to support joined up working which benefitted people’s health and wellbeing.

People said staff were compassionate, kind, and caring, treated them as an individual and listened to their views and opinions. People’s end of life wishes and preferences were discussed, and staff were trained to support people in a dignified way.

Complaints were investigated promptly, and people and their family members told us they could speak up. There were meetings and frequent contact with people, their family members, and staff to get their views. Feedback was collated and shared and used to improve the service.

The management team were well thought of among staff and people who used the service. The registered manager monitored the quality of care in the service and the provider’s systems supported them to manage this effectively and to a high standard.

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 the service was Good published on (27 June 2017).

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.

We found the following examples of good practice.

People were encouraged to stay in regular contact with friends and relatives. Staff supported people to make regular telephone and video calls and the registered manager created individual weekly newsletters for people living in the service with photos and updates from their loved ones.

Staff were encouraged to take part in practical training scenarios in addition to their infection prevention and control training. These included practicing donning and doffing personal protective equipment (PPE) and talking through what actions staff would take if a person in the service tested positive for COVID-19.

The provider had increased the frequency of cleaning in the service and implemented hourly cleaning for high touch areas such as door handles and hand rails.

The provider had created a testing area where staff completed their regular COVID-19 testing. The room had seating and a screen, clear step by step guidance displayed on the wall, hand washing facilities and PPE supplies.

The registered manager completed regular hand hygiene audits with staff to ensure good practices were maintained.

We carried out an unannounced inspection of Longfield on 26 June 2017 to see if the provider had made the necessary improvements to the service. We saw that improvements had been made to ensure people were kept safe and staffing levels had improved. Safe was rated as 'Good'. The service received a rating of 'Good' overall.

The service provides accommodation with personal care to older people with a range of support needs. These included people with a physical disability and those living with dementia. At the time of the inspection, there were 40 people being supported by the service including two people on short stay visits.

There was a registered manager in post. 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.

The service had reviewed their staffing arrangements and made improvements to ensure people were kept safe. There were also systems in place to safeguard people from avoidable harm and staff knew who and how to report any concerns. The risk assessments undertaken provided staff with the necessary information and guidance on how risks to people could be minimised.

The provider had an effective recruitment process in place for the safe employment of staff. People’s medicines were managed safely and given as prescribed.

A very well organised programme of induction, training, supervision and appraisals for staff were in place and they had the knowledge and skills to care for people effectively. They understood their roles and responsibilities to seek people’s consent prior to care being provided.

Systems were in place to ensure that people’s rights were respected and protected under the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Where people did not have capacity to consent to their care or make decisions about their lives, this was managed in line with the requirements of the MCA.

The service had developed new initiative and schemes to share good practice with other organisations which had shown good outcomes for people.

People were supported by kind and caring staff who were respectful and polite to people. They were supported to make choices about how they lived their lives. People's meal time experience was fulfilling and meaningful. They had a balanced diet which was nutritious, home-made and tailored to their individual needs. This helped to maintain their health and wellbeing. People were also supported to access healthcare services when required.

People’s care plans were person centred and provided the necessary information about their assessed needs, preferences and choices. They were involved in reviewing their care plans. People engaged in a range of social and leisure activities both inside the service and in the local community.

The provider had a process in place for dealing with complaints and concerns. They encouraged feedback from people who used the service, their relatives, other professionals and staff, and they acted on the comments received to improve the quality of the service.

The registered manager provided leadership and promoted an open, inclusive and caring culture in the service. Audits and records were completed to assess and monitor the quality of the service. We have made a recommendation that the service considers how to effectively manage the deployment of staff across the service.

The service provides care and support to older people with a range of support needs including chronic health conditions, physical disabilities, and those living with dementia. At the time of the inspection, there were 34 people being supported by the service and one person was in hospital.

There was a registered manager in post. 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.

There were risk assessments in place that gave guidance to staff on how risks to people could be minimised. There were systems in place to safeguard people from avoidable harm. The provider had effective recruitment processes in place. However, the majority of people, relatives and some staff said that there was not sufficient numbers of staff to support people quickly. People were put at risk of harm when they had been left unsupervised when the only member of staff on each unit supported their colleagues on other units. People’s medicines were managed safely.

Staff had regular supervision and they had been trained to meet people’s individual needs. They understood their roles and responsibilities to seek people’s consent prior to care being provided. Where people did not have capacity to consent to their care or make decisions about some aspects of their care, this was managed in line with the requirements of the Mental Capacity Act 2005 (MCA).

People were supported by caring, friendly and respectful staff. They were supported to make choices about how they lived their lives. People had adequate food and drinks to maintain their health and wellbeing. They were also supported to access healthcare services when required.

People’s needs had been assessed, and care plans took account of their individual needs, preferences, and choices. They were involved in reviewing their care plans. People had been provided with enjoyable activities and some had been supported to pursue their hobbies and interests outside of the home. People were involved in the local community and took pride in their gardens that won a ‘Gold Award’ in a local gardening competition.

The provider had a formal process for handling complaints and concerns. They encouraged feedback from people who used the service, their relatives, other professionals and staff, and they acted on the comments received to improve the quality of the service.

Various audits were completed to assess and monitor the quality of the service. Staff said that the manager provided stable leadership and effective support, and they also promoted a caring culture within the service. However, they had not taken proactive action to ensure that people were constantly supervised in communal areas of the home.

The provider was not meeting one of the fundamental standards of care. You can see what action we told the provider to take at the back of the full version of this report.

We saw that people's care needs were assessed and planned for with any risks associated with their care being minimised as far as possible.

We found that people lived in a clean and comfortable home. They were protected from the risk of infection as there were good procedures in place and standards of hygiene were well maintained.

Staff said that they were well supported and had opportunities for training. We saw that staff were kept up to date with training in essential areas such as moving and handling. They also had opportunities to undertake training in other areas relevant to their work. Staff felt that communication and teamwork in the service was good. This helped to ensure that people receive a good and consistent service.

People were happy with the quality of the service and there were good systems in place to ensure that the quality and safety of the service was monitored and maintained.

Overall we found Longfield to be a safe, caring, responsive, effective and well led service.

People were treated with dignity and respect and were well cared for. Staff approached people and spoke with them in a kind and friendly manner. People's expressed wishes including end of life care were met.

We saw that people were provided with care and treatment that met their individual needs. We saw evidence that people had risk assessments completed and that their care plans were reviewed regularly.

We examined the roster for each of the five units in the service for the week of our inspection and found there were enough qualified, skilled and experienced staff to meet people's needs.

We saw that medication was administered safely and when required. Staff were trained to administer medication and recorded this by signing in the records. Medicines were stored securely.

People were aware of the complaints system in the service. Complaints and compliments information was clearly displayed in the public areas. People were encouraged to feedback about the service.