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Longhill House Care Home Requires improvement

The provider of this service changed - see old profile

Reports


Inspection carried out on 29 September 2020

During an inspection looking at part of the service

About the service

Longhill House Care Home is a care home which is registered to provide accommodation and personal care to 41 older people, some of whom may be living with dementia. At the time of our inspection, 37 people lived at the service. Accommodation is provided on one adapted building and has a mixture of smaller and larger communal areas for people to use.

People’s experience of using this service and what we found

People were at risk of their human rights being breached as one person was subject to a high level of restriction for a short time. The provider’s governance systems had not identified shortfalls with capacity assessment and best interest decision records which had contributed to the restriction. People were mostly 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. However, the policies and systems in the service did not support this practice. We have made a recommendation about mental capacity assessments and recording decisions.

Processes were in place for reporting safeguarding concerns, though on one occasion this was not done promptly. Accidents and incidents were monitored and investigated, though records did not always evidence what was learnt. Governance systems had failed to identify the shortfalls we found, which placed people at risk or receiving a poor-quality service.

People’s medicines were administered safely, and care plans contained appropriate guidance. The service was clean and appropriate processes were in place to prevent the spread of infections.

The provider’s recruitment processes helped ensure only suitable staff were employed. Staffing levels were safe. Staff were patient and supported people with their individual routines.

Staff had the relevant skills and knowledge to support people. People were offered a healthy, varied diet which met people’s preferences and dietary requirements. Staff supported people to access healthcare services and followed professional advice.

People were included in the development of the service and the provider was improving the environment. The management team supported staff and worked closely with relevant professionals.

For more details, please see the full report which is on the Care Quality Commission’s (CQC) website at www.cqc.org.uk.

Rating at last inspection

The last rating for this service was good (published 22 November 2018).

Why we inspected

We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received in relation to the Mental Capacity Act 2005 and restrictions on people’s liberty. A decision was made for us to inspect and examine those risks.

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 coronavirus and other infection outbreaks effectively.

We inspected and found there was a concern with safeguarding and governance systems, so we widened the scope of the inspection to become a focused inspection which included the key questions of Safe, Effective and Well-led. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvement. Please see the Safe, Effective and Well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection

Inspection carried out on 17 October 2018

During a routine inspection

This comprehensive rated inspection took place on 17 and 18 October 2018 and was unannounced. It was the first rated inspection of the service under the provider National Care Consortium Ltd, which registered Longhill House Care Home as a new location in November 2017.

Longhill House Care Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Longhill House Care Home accommodates 41 people on two floors in one adapted building. It provides a service to older people and those who may be living with dementia. At the time of this inspection there were 39 people using the service.

The provider is required to have a registered manager in post. At this inspection there was a manager that had been registered and in post for the past year. A registered manager is a person who has registered with the CQC 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.

People were protected from the risk of harm because the provider had systems in place to detect, monitor and report potential or actual safeguarding concerns. Staff were appropriately trained in safeguarding adults from abuse and understood their responsibilities in these matters. Risks were also managed and reduced so that people avoided injury or harm.

The premises were safely maintained and there was evidence in the form of maintenance certificates, contracts and records to show this. Staffing numbers were sufficient to meet people’s needs and we saw that rosters accurately reflected the staff that were on duty. Recruitment policies, procedures and practices were carefully followed to ensure staff were suitable to care for and support vulnerable people. We found that the management of medication and risk of infection were safely carried out. The staff learned from accidents and incidents to avoid these being repeated.

People were cared for and supported by qualified staff that were regularly supervised and appraised regarding their personal performance. Communication was effective, people’s mental capacity was appropriately assessed and their rights were protected. Employees of the service had knowledge and understanding of their roles and responsibilities in respect of the Mental Capacity Act (MCA) 2005 and they understood the importance of people being supported to make decisions for themselves. The registered manager explained how the service worked with other health and social care professionals and family members to ensure decisions were made in people’s best interests where they lacked capacity. People received adequate nutrition and hydration to maintain their health and wellbeing. The premises were suitable for providing care to older people and those living with dementia.

We found that people received compassionate care from kind staff and that staff knew about people’s needs and preferences. People were supplied with the information they needed at the right time, were involved in all aspects of their care and were always asked for their consent before staff undertook care and support tasks. People’s wellbeing, privacy, dignity and independence were monitored and respected.

People were supported according to person-centred care plans, which reflected their needs well. These were regularly reviewed. People had the opportunity to engage in pastimes and activities if they wished to in order maintain mobility and conversation skills. Activities stimulated the brain and kept people’s skills going. People had very good family connections and support networks. An effective complaint procedure was in place and people’s complaints