Longmead Court Nursing Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s needs were met through good organisation and delivery.

This service scored 64 (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 did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs

Although care plans were in place, people and their relatives were not consistently involved in care planning and reviews, which limited the person-centred approach. Feedback from relatives was mixed, with some reporting they were involved in assessing and reviewing needs, while others said they did not have access to care plans or opportunities to contribute. Daily records contained contradictory entries, making it difficult to determine whether people consistently received personalised care and support. For example, one record stated a person had been supported to shower while also recording that they were asleep. Daily notes also showed staff respected people's right to refuse care interventions, such as personal care and oral hygiene, however, recording did not consistently demonstrate that staff reoffered support. Leaders told us they were still in the process of learning how to utilise the digital system to its full capacity to resolve recording issues. Care plans included information about people's preferences, communication needs, goals, and desired outcomes. For example, one communication plan detailed how a person's sense of humour influenced their communication style. Plans also recorded preferred names and nicknames, although feedback indicated staff did not always use these consistently. Staff made reasonable adjustments to meet individual needs, including facilitating a move to a larger bedroom for a person with sensory needs. Their room was personalised with décor, sensory items, and equipment that reflected their preferences and supported their wellbeing.

he provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People received continuity of care from familiar staff who knew and understood them. We received feedback that although agency staff were used, these were generally regular staff members who were familiar to people. Leaders had good oversight of people’s individual funding and commissioning arrangements and organisations, and we did not receive any concerns regarding the provision of commissioned hours during our inspection. Where people were also supported by unpaid carers, we received feedback that staff worked in coordination with them for continuity of care whilst allowing them to continue important relationships, a relative said, “I can say to them [care staff] ‘can I have a hand’ if I’m going for a walk with [Person], and they get someone to go with us. They do it straight away.”

Leaders had taken some steps to improve staff understanding of the potential barriers faced by the specific service user group they supported, for example, by arranging a group supervision to enhance staff knowledge around the link between dementia and weight loss. However, the gaps in training relating to people’s specific needs, for example in diabetes and positive behaviour support, meant we could not be assured that all staff were fully trained to meet the needs of the service user group they were supporting. Leaders told us about future plans to complete ‘bitesize’ training sessions on a variety of topics to build on fundamental training.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People’s specific communication needs and preferences were captured as part of the care planning process. People’s vision, hearing and communication were assessed and care plans updated accordingly, including information about any aids used, for example, hearing aids or glasses. An accessible information ‘hub’ had been created, so people could receive important information in a way they could understand. This contained policies and procedures in a variety of formats, for example, easy read safeguarding protocols and falls prevention information. This also supported two-way information sharing, by providing thoughtfully designed resources to support open conversations, for example there were flash cards for helping people to express how they feel, and to let staff know what they would like to eat or drink. A person told us how staff had recently used an innovative approach to support their communication, they said, “I have a bad ear infection, the activity lady bought me this board in so people can write on it what they want to say to me”.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. However, staff did not always involve people in decisions about their care or tell them what had changed as a result.

Resident meetings were held, and people were given the opportunity to share their feedback in relation to the service. We saw action plans were created following these meetings in a ‘you said, we did’ format to demonstrate how the feedback had been used to improve the service. Despite this, we saw that some important feedback had been overlooked in the process and no follow up action had been taken to address people’s concerns and requests. For example, a person had expressed their desire to have their bedroom door closed overnight, however no actions had been recorded and there had still not been any resolution to this at the time of our inspection. Where another resident had provided feedback in relation to staff’s approach, an action plan was created which stated it would be addressed at a staff meeting, however, when we reviewed the staff meeting minutes it had not been discussed. Relatives also told us communication was not always effective when providing feedback, with 1 relative telling us it had taken a long time to receive a response and resolution to a query they had raised.

The provider made sure that people could access the care, support and treatment they needed when they needed it. The home was accessible for people’s mobility needs, promoting equity of access. Physical barriers in the environment had been considered, for example carpets were being replaced with vinyl flooring and nostalgic items were displayed in communal areas. We saw dementia friendly adaptations to support people, including photos on bedroom doors and activity walls with resources of varying textures and items to interact with. Other professionals told us they did not face any difficulties when contacting the service, they said, “We are able to contact Longmead Court Nursing home via phone call, email and face to face”.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff had received training in equality and diversity, to support them in identifying and addressing potential discrimination faced by the people they supported, both in the home and in the community. During the inspection we did not identify any concerns in relation to inequality or discrimination.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Although end of life care plans were in place to capture people’s preferences so their wishes could be respected, and appropriate care provided at the end of their lives, they were completed inconsistently across the service. Where they had been completed, they generally included a focus on symptom control, comfort, and dignity. However, some people’s end of life care plans did not include any personalised information relating to their plans and/or wishes or an indication of whether a discussion had been held with the person or their representatives. End of life plans for 2 people stated ‘no’ to a prompt regarding a discussion with the person or their representative, with no justification recorded. They did not always evidence person centred conversations had taken place around the topic to ensure people’s wishes were fully considered. We saw 1 person’s plan included a blanket statement about their inability to express or discuss their end of life preferences due to their condition, with no further information about how the topic had been explored, for example by involving relatives or engaging in discussion using the person’s alternative communication methods. Where people had expressed a choice not to be resuscitated in the event of cardiac or respiratory arrest, via a ‘do not attempt cardiopulmonary resuscitation’ (DNACPR) decision, this was clearly recorded in people’s records.