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Archived: Longley Meadows Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 11 May 2016

We carried out an announced comprehensive inspection of this service on 17 and 20 November 2014 where we identified breaches of legal requirements. This was because people were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place for the safe administration and recording of medicines. There was also a breach because the provider did not have an effective system to regularly assess and monitor the quality of service that people’ received. Nor did they have an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. We undertook a comprehensive inspection on the 16 and 24 February 2016 to check that they had followed their plan and to confirm that they now met all of the legal requirements. 24 hours’ notice of the inspection was given because the service is small and we needed to be sure that someone would be in.

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

Longley Meadows is in the grounds of the Northern General Hospital and provides short stay respite accommodation for adults with learning difficulties. Many of the people accessing the service have profound and multiple learning difficulties, including multiple health needs and physical disabilities. The service can provide care for up to nine people at any one time. 39 people use the service in total.

The service did not have a registered manager. 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 and associated Regulations about how the service is run. There was an acting manager in post at the time of the inspection however she had only worked at the service for two weeks.

The requirements of the Mental Capacity Act 2005 were in place to protect people who may not have the capacity to make decisions for themselves. However, we found there was not sufficient detail recorded about how consent and best interest decisions were achieved for the use of assistive technology in people’s bedrooms.

Our check of medication records identified that medicines were not always safely managed and recorded. This meant that people accessing the service may not be protected against the risks associated with the unsafe management of medication.

The support plans were centred on people’s individual needs and contained information about their preferences, backgrounds and interests. People were treated with dignity and respect throughout our inspection. Staff were aware of people’s differing cultural and religious needs.

There were enough skilled and experienced staff and there was a programme of training, supervision and appraisal to support staff to meet people’s needs. Procedures in relation to

recruitment and retention of staff were robust and ensured only suitable people were employed in the service.

Our observations, together with our conversations with relatives of people who used the service provided evidence that the service was caring. The staff we spoke with had a clear understanding of the differing needs of people staying at the home and we saw they responded to people in a caring, sensitive, patient and understanding professional manner.

People’s physical health needs were monitored and referrals were made when needed to health

professionals. People were supported to access existing day time and evening activities during respite stays at Longley Meadows. The service had an open and transparent culture that actively encouraged feedback from people wh

Inspection areas

Safe

Requires improvement

Updated 11 May 2016

The service was not always safe.

People�s medicines were not always safely managed and recorded. The lack of a consistent method of checking medicines received and returned increased the risk of medicines not being administered safely.

People were safeguarded from the risk of abuse; staff knew how to identify and report abuse.

An effective recruitment process was in place. There were enough staff on duty to ensure people were safely supported. Staffing numbers were matched to the number and needs of people receiving respite care at the service.

Effective

Requires improvement

Updated 11 May 2016

The service was not always effective.

Most staff had received training on the Mental Capacity Act which helps to protect people if they are unable to make important decisions for themselves. We found evidence that some decisions for people had been made without a formal best interest meeting taking place.

Each member of staff had a programme of training and were trained to care and support people who used the service safely and to a good standard.

People�s nutritional needs were met. The food we saw, provided variety and choice and ensured a well-balanced diet for people staying in the home. We observed people being given choices of what to eat and what time to eat.

Support plans contained detailed information about people�s healthcare needs. These were reviewed and updated before each respite stay in order to ensure that they were accurate.

Caring

Good

Updated 11 May 2016

The service was caring.

Most people had been involved in deciding how they wanted their care to be given and they told us they discussed this before they stayed at the home.

We saw staff had a warm rapport with the people they cared for. Relatives spoke positively about the staff at all levels and were happy with the care.

People were treated well by caring staff who respected their privacy and dignity. Staff were aware of people�s differing cultural and religious needs.

Staff interacted well with people and provided them with them support they needed.

Responsive

Good

Updated 11 May 2016

The service was responsive.

We found that peoples� needs were thoroughly assessed prior to them staying at the service. A relative told us they had been consulted about the care of their relative before their stay and again after they had returned home.

Relatives told us the staff at all levels were approachable and would respond to any questions they had about their relatives care and treatment.

Communication with relatives was mainly good. The service had a complaints procedure that was accessible to people who used the service and their relatives. People told us they had no reason to complain as the service was very good.

Well-led

Requires improvement

Updated 11 May 2016

The service was not always well led.

People who used the service and their relatives had opportunities to give feedback or raise issues through meetings and one to one discussions with staff.

The service worked closely with the families of people who used the respite service, to ensure they were informed of any changes to their care needs.

The systems and audits to monitor and improve the quality of the service were not always effective. We found in some audits we looked at, areas for improvement had been identified however these had not been addressed in a timely manner.

Staff told us they felt supported and felt able to have open discussions with the manager and nurses through one-to-one meetings and staff meetings. However uncertainties around the future of the service caused some anxieties for staff.