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Inspection Summary


Overall summary & rating

Good

Updated 16 July 2019

About the service

Longfield House is a residential care home providing personal care to up to nine people with a diagnosis of learning disability and other complex behaviours.. There were nine people living at the home at the time of our inspection.

Longfield House accommodates five people in one building, and four others in self-contained flats in the adjacent Coach House.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

We had concerns which we expressed to the registered manager about the recruitment process and also the retention of staff. Although we did not find sustained impact on people, staff were concerned about how fragile the balance of staffing was at times in terms of numbers and skill mix. We have made a recommendation about the robustness of the recruitment process.

People looked happy and comfortable with staff and told us they felt safe. Safeguarding concerns were dealt with robustly and staff knew how to report such concerns. Risks assessments reflected people’s specific needs and provided guidance for staff which they spoke to us about. People with more complex behavioural needs were supported by staff trained in appropriate use of restraint and the service had worked hard to reduce incidents.

We found medicines were managed safely and all staff understood the importance of effective infection control practice. Staff had received supervision and training and understood the importance of ensuring people attended health and other appointments as necessary. Staff evidenced good communication around people’s changing needs.

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people promoted choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Staff displayed kindness and reassurance for people and respected their privacy and dignity. Care documentation was detailed and provided evidence of how well staff knew people. There needed to be more evidence of written reviews although staff were very knowledgeable about people’s individual circumstances and were happy to share ideas about how best to support someone.

The registered manager was a strong advocate of person-centred practice and was working hard towards embedding this approach in the service.

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 this service was Good (report published 2 September 2017).

Why we inspected

The inspection was prompted in part due to concerns received about staffing, service provision and management. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe and well led sections of this full report.

Follow up

We will continue to monitor information

Inspection areas

Safe

Requires improvement

Updated 16 July 2019

The service was not always safe.

Details are in our safe findings below.

Effective

Good

Updated 16 July 2019

The service was effective.

Details are in our effective findings below.

Caring

Good

Updated 16 July 2019

The service was caring.

Details are in our caring findings below.

Responsive

Good

Updated 16 July 2019

The service was responsive.

Details are in our responsive findings below.

Well-led

Good

Updated 16 July 2019

The service was well-led.

Details are in our well-Led findings below.