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Longley Hall Limited

Overall: Requires improvement read more about inspection ratings

Longley Hall, Longley Lane, Sheffield, South Yorkshire, S5 7JF (0114) 242 3773

Provided and run by:
Longley Hall Limited

Latest inspection summary

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Background to this inspection

Updated 13 June 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 3 inspectors.

Service and service type

This service provides care and support to people living in 2 blocks of flats so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

This service is also a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with CQC to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

This inspection was announced on the first day and unannounced on the second day. We gave the service 24 hours’ notice of the first inspection day. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.

Inspection activity started on 19 April 2023 and ended on 5 May 2023. We visited the service on 19 April 2023 and 25 April 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We spoke to 8 people using the service and 3 relatives about their experience of the care provided. We spoke to 11 members of staff which included the nominated individual, operations manager, the manager, 3 team leaders and 9 support workers. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke to the local authority’s safeguarding and commissioning team for feedback. We received feedback from 3 people’s social care professionals allocated to their care. We reviewed a selection of people’s care records and medication records. We looked a selection of staff files in relation to recruitment, training and support staff received. We reviewed a variety of records relating to the management of the service, including incident records, audits, policies and procedures.

Overall inspection

Requires improvement

Updated 13 June 2023

About the service

Longley Hall Limited is a supported living and domiciliary care service which provide personal care to people with a learning disability or autistic people. The supported living service comprises of 2 blocks of flats and can cater for up to 17 people. People live in studio flats with an ensuite shower room and have access to a shared lounge, kitchen, bathroom and garden. There is one small self-contained flat and a manager office co-located on the premises. By supported living we mean schemes that provide personal care to people as part of the support that they need to live in their own homes. The personal care is provided under separate contractual arrangements to those for the person’s housing. CQC does not regulate premises used for supported living; this inspection looked at people's personal care and support. At the time of our inspection there were 10 people using the service who received personal care.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

Risks to people’s health and safety were not always effectively managed safely by the service. People’s risk assessment on how to support them safely often contained inaccurate or out of date information, which placed them at an increased risk of harm. Despite issues with people’s care records, most staff appeared to know people well and understood their support needs to effectively manage risk. The provider submitted an action plan to CQC to address the quality and safety issues in people’s care records.

The training and support staff received from managers needed to improve. Staff received the provider’s minimum training requirements to support people. However, not all staff completed training individualised to the needs of the people in the service to support their quality of life. For example, the service supported people with a learning disability and/ or autism, yet only half of the staff were trained in this area. The provider told us physical restraint was not taught or practiced at the service as they promoted less restrictive interventions, such as de-escalation and breakaway strategies with staff. We found approximately half of all staff were trained on how to manage challenging behaviour.

The provider used the Positive behaviour support (PBS) model, which is a person-centred framework for providing long-term support to people with a learning disability, and/or autism, including those with mental health conditions, who have, or may be at risk of developing behaviours that challenge. Where people had been assessed for PBS, plans provided detailed proactive and reactive strategies for staff to follow to prevent behaviour that challenges. However, we found people’s PBS plans were not consistently followed by staff.

Processes to manage incidents and safeguarding concerns had been historically poor, which placed people at increased risk of harm. The provider had recently taken action to re-establish processes to monitor and review incidents and concerns at the service for opportunities to address future risk.

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. We saw people were supported to access the community as and when they wished.

Right Care:

People's needs were assessed and developed into a support plan. Further work was underway to ensure support plans and risk assessments contained accurate information to enable people to receive appropriate care and support that was responsive to their needs. The manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards although records needed to be improved.

There were sufficient staff deployed to meet people's needs and wishes. Staffing levels were determined by people’s assessed needs and the commissioning bodies. The provider told us staffing had recently increased at the service, which they felt was safer. The provider told us there was also a business case under review to increase night-time staffing arrangements.

Right Culture:

Governance arrangements were not as effective or as reliable as they should be. Inconsistencies in leadership led to serious shortfalls in the provider’s quality assurance processes, which meant processes to identify risk and ensure the service was operating within the scope of regulations had not been effective. Relatives, staff and professionals linked to the service told us the recent change in leadership had been positive and the standard of care provided by the service was improving.

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

Rating at last inspection

The last rating for this service was good (published 19 May 2018).

Why we inspected

The inspection was prompted in part due to concerns received about people’s care, closed cultures and management of risk. A decision was made for us to inspect and examine those risks.

You can see what action we have asked the provider to take at the end of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. Please see the safe, effective and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Longley Hall Limited on our website at www.cqc.org.uk.

Enforcement

We have identified 3 breaches in relation to safe care and treatment, staff training/ support and the systems of governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.