Longacre Care Home Limited

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 good. At this assessment the rating has remained unchanged. This meant people were safe and protected from avoidable harm.

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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

We reviewed the provider`s governance systems. These were detailed and focused on continuous learning and improvement. Investigations following complaints or incidents, were conducted in a timely manner, and outcomes were shared in line with their duty of candour policy. There was evidence of lessons learned from incidents and complaints. For example, concerns raised by people or their relatives were followed up promptly by the management team, with appropriate responses provided and reassurance and at times apologies offered. Actions were taken where needed and key learning was shared with staff to support ongoing improvement in practice. People told us that they were confident that concerns were dealt with appropriately.

One person told us, “I would talk to [name].She’s very good, she listens and she gives you a proper explanation”.

The provider worked collaboratively with people and healthcare partners to design, establish and maintain safe systems of care where safety was consistently well maintained and monitored. They ensured continuity of care during transitions between services.

Effective planning was in place with tools such as detailed hospital passports used to capture key information about people's needs and preferences. This supported other healthcare professionals to understand people`s needs; reduced the risk of miscommunication and promoted safe consistent and person-centred care across settings. This enabled timely and safe hospital discharges into the service and promoted better outcomes and experiences for people.

One person told us, “I came quickly from hospital. I could have been cared for at home, but I decided to stay here”.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that.

The provider fostered an environment where people felt safe and supported by staff who knew them well. A relative told us, “When I`m approaching his room you can hear them laughing with him. I’ve never felt a tinge of concern”.

Some people had Deprivation of liberty safeguards (DoLS). [DoLS is a legal protection order used when a person`s freedom needs to be restricted to keep them safe, for example in a care home setting].Records showed that arrangements were in place including specific conditions that were consistently followed. This helped to ensure that any restrictions were proportionate, lawful and applied in the person`s best interest.

People, staff and relatives understood how to raise concerns and told us they felt able to do so. Staff attended safeguarding training and demonstrated understanding of safeguarding principles. The provider showed a commitment to protect people from harm and abuse including keeping their personal information safe.

The provider worked with people to understand and manage risks in a holistic way, supporting them to remain safe while continuing to do the things that matter to them. The provider responded appropriately to incidents that posed risks to people`s wellbeing.

Staff consistently followed care plans and were proactive in identifying and responding to risks by applying safe practices. For example, during a recent emergency situation involving a person, staff responded promptly ensuring the person received the support they needed and arranged timely hospital treatment. Following this, the provider reviewed their emergency preparedness arrangements and identified opportunities to further strengthen their response, including plans to introduce additional resuscitation equipment to enhance their ability to manage medical emergencies.

People and their relatives felt reassured and confident that risks were being managed appropriately. A relative told us, “I've never had to worry about her care”.

The provider identified and managed risks within the care environment and ensured equipment and facilities supported safe care. Maintenance issues were addressed promptly by a designated staff member and improvements to the environment, such as replacing bedroom carpets with vinyl flooring were ongoing. In addition, the provider arranged for rooms to be repainted following each discharge, so that new people moving into the service had a clean and freshly prepared environment. This meant the environment was continuously maintained to support people`s safety and comfort.

Equipment was clean, well maintained and regularly serviced. Safety measures were in place, including appropriate management of oxygen and secure clinical storage. Staff were trained in health and safety and demonstrated a good understanding of maintaining a safe environment. Fire safety systems were robust with regular testing, clear evacuation plans and routine drills.

Staff understood what constituted a safe environment, with the provider taking continuous action through training; regular environmental safety checks and audits to ensure safety and cleanliness was upheld for people using the service.

A person told us, “Yes. It’s a nice home. It’s the general atmosphere.”

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Staffing levels and skill mix were assessed using a dependency tool to determine appropriate staffing to meet people`s needs. Recent increase in daytime nursing supported care delivery and agency staff were used when required, to maintain continuity .A person told us. “I’ve never felt there’s not enough. There’s plenty if you need them. You only have to press the buzzer once.”

Recruitment processes were safe and included all necessary checks. Staff received training, supervision and appraisal, with a clear induction process in place. This supported staff to have the skills and knowledge needed to carry out their roles effectively.

There were currently no staff vacancies or planned levers reflecting a stable and committed workforce.

The provider had systems to prevent and control infection. Staff followed infection prevention and control (IPC) procedures consistently, including correct use of personal protective equipment which was readily available throughout the service.

We observed that the environment was clean and well maintained throughout the service. Cleaning schedules were in place and adhered to, and equipment was cleaned between use. Laundry, waste management and clinical equipment procedures were effective, reducing the risk of cross contamination. Staff had received IPC training and demonstrated an awareness of best practice that supported safe care. The provider responded promptly to infection risks and undertook regular audits of IPC practices. A person told us, “I think it’s very clean and well maintained”, and another person said, “The lady who normally does it is unbelievable. It’s all wiped down and she gets down and does under the bed. The building is a bit old, but there’s no smell."

The provider ensured that medicines were managed safely and met people's needs and preferences. Systems and processes were in place to monitor medicines, and storage was secure with limited access.

There was evidence of partnership working with external professionals to support safe practice through regular audits and reviews. Changes to medicines were discussed with people wherever possible and relatives were involved when appropriate, alongside oversight from the GP. A person told us, “There’s been a couple of changes and they’ve been discussed with me. I sometimes ask about what a tablet’s for.” This meant staff had a good understanding of their medicines.

Where people were assessed as not having capacity to consent to treatment, decisions about their medicines were made in their best interests, with relatives involved, where possible.

We observed a nurse administering lunchtime medicines safely and respectfully. People received their medicines in a person-centred way with their preferences respected, including their right to refuse.