We carried out a review of the data available to us about Longfield House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Longfield House, you can give feedback on this 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 we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Longfield House is a specialist residential care home for adults with learning disabilities and complex needs located in Clayton village. The service consists of Longfield House a five bedded home with one self-contained apartment and Longfield Coach House which has four self-contained apartments. There are communal areas within the complex for people to enjoy activities and social events. At the time of the inspection 9 people were living in the home.
A registered manager had been in post since May 2017. A registered manager is a person who has registered with the Care Quality Commission 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 supported safely by vigilant staff who knew them well. Risks to people’s health and safety were assessed and clear and detailed plans of care put in place which were subject to regular review. Incidents were recorded, investigated and analysed to look for any themes or trends. Safeguarding procedures were in place and we saw they had been followed to help keep people safe.
Medicines were safely managed and stored securely. People received their medicines as prescribed and clear records were kept.
The premises were well maintained and suitable for its intended purpose. People had access to a range of communal areas where they could spent time, either alone or with others who used the service. People were able to personalise their environment in line with their preferences.
There were sufficient staff deployed within the home to ensure people’s safety and welfare. Staff were highly visible and able to respond to people’s changes in behaviour or mood.
Staff received a range of training relevant to their role caring for people in the learning disabilities sector. Staff demonstrated a good knowledge of the people and topics we asked them about.
The service was acting within the legal framework of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). People’s consent was sought and people were given choice and control over their lives.
People’s healthcare needs were assessed and the service worked with a range of health professionals to ensure that people’s healthcare needs were met.
Staff treated people well with kindness and dignity. Staff had a good knowledge of people and demonstrated a commitment to ensure people’s lives were fulfilled and occupied.
People’s independence was promoted. The service helped people achieve independence increasing goals, for example around spending more time alone in the community or undertaking household tasks.
People’s care and support needs were assessed and detailed plans of care put in place. Some of these required updating but a plan was in place to address.
People had access to a range of activities and social opportunities in the local community. However we found some instances where people had not received their planned community support due to the way staffing hours had been organised.
We found an open and honest culture within the service and people, staff and relatives said they felt able to approach the management team with any concerns.
A range of checks and audits were undertaken and these were used to make continuous improvements to the service.
We inspected Longfield House on 8 October 2014 and the visit was unannounced. Our last inspection took place in July 2013 and at that time we found the home was meeting the regulations we looked at.
Longfield House is a specialist residential care home for adults with learning disabilities and complex needs located in Clayton village. The service consists of Longfield House a five bedded home and Longfield Coach House which has four self-contained apartments. There are communal areas within the complex for people to enjoy activities and social events.
There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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.
Not everyone who lived at the service was able to communicate verbally therefore we observed how staff interacted with people over short periods of time throughout the day to ensure we caused only minimal disruption to their daily life. Four people who were able told us they enjoyed living at the service and staff were friendly and supportive.
Everyone who lived at the service was supported on a one to one or two to one staff ratio whilst in the home during the day and two people were supported on a three to one staff ratio when they accessed community based activities. This was because their complex needs meant they could exhibit behaviour that challenged which might put either themselves or others at risk of harm.
The organisation’s staff recruitment and selection procedures were robust which helped to ensure people were cared for by staff suitable to work in the caring profession. In addition all the staff we spoke with were aware of signs and symptoms which may indicate people were possibly being abused and the action they needed to take.
The staff had access to a range of training courses relevant to their roles and responsibilities and were supported to carry out their roles effectively though a planned programme of training and supervision.
People’s care plans and risk assessments were person centred and the staff we spoke with were able to tell us how individuals preferred their care and support to be delivered. Care plans and risk assessments were reviewed on a regular basis to make sure they provided accurate and up to date information and were fit for purpose.
Staff received training in the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and were able to demonstrate a good understanding of when Best Interest Decisions need to be made to safeguard people.
People were encouraged to participate in a range of appropriate social, educational and leisure activities both within the service and the wider community and staff actively encouraged them to maintain and develop their daily living skills.
There was an effective quality assurance monitoring system in place which quickly identified any shortfalls in the service and there were systems in place for staff to learn from any accident, incidents or complaints received.
We found people who used the service and/or their representatives were involved in planning their care and the care plans in place were person centred and provided staff with accurate and up to date information about how to meet people's assessed needs.
We also found there were effective quality assurance systems in place and people who used the service and/or their representatives were able to express their views and opinions of the care and facilities provided.