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Archived: Longley Meadows Requires improvement

Reports


Inspection carried out on 16 February 2016

During a routine inspection

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 carried out on 17 and 20 November 2014

During a routine inspection

An unannounced inspection visit to Longley Meadows took place on 17 November 2014.

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 is has nine registered beds.

The service was last inspected by the Care Quality Commission (CQC) in November 2013 and was found to be meeting regulations relating to respecting and involving people who use services, care and welfare of people who use services, safeguarding, staffing and assessing and monitoring the quality of service provision.

During our inspection we spoke with people and undertook a number of informal observations in order to see how staff interacted with people and see how care was provided. This was because some people accessing the service had communication difficulties and were not always able to verbally communicate their experience of the service to us. We also telephoned the relatives of three people on 20 November 2014 in order to gain their views about the service.

During our inspection visit we spoke with the registered manager, deputy manager and two support workers. 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.

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.

Our review care plans highlighted some gaps and inconsistencies about records at Longley Meadows. Our findings made it difficult to establish whether some plans were current and accurately reflected people’s needs. Whilst there was no evidence to suggest that these shortfalls had negatively impacted upon people, the lack of information, review and recording within some key documents meant that people may not be protected against the risks of receiving inappropriate care and treatment.

Whilst detailed checks took place in relation to health and safety and the premises, we identified that audits relating to key areas of practice did not take place. For example, the shortfalls identified during our inspection in relation to medicines, equipment and records had not been identified or highlighted by an internal auditing system.

Observations throughout our inspection demonstrated that people were supported safely by staff who knew their individual needs and preferences. Conversations with staff and our observations showed us that staff offered and involved people in a range of day to day decisions. People were treated with dignity and respect throughout our inspection. Staff were aware of people’s differing cultural and religious needs.

Relatives contacted following our inspection were confident that their family members were safe when staying at Longley Meadows. Our conversations with staff and our review of records demonstrated that staff identified safeguarding issues and followed local procedures in order to safeguard people. .

Staff were appropriately vetted to ensure they were suitable people to work with vulnerable adults before starting work. There were enough staff to safely meet people’s needs in a timely manner. Staff had appropriate qualifications, knowledge and skills to perform their roles and there were systems and opportunities for staff to develop their skills and discuss good practice.

People were appropriately supported to make decisions in accordance with the Mental Capacity Act, 2005 (MCA). Staff demonstrated a good understanding of these pieces of legislation and how they applied in practice.

Our observations of a meal time and our review of records evidenced that people’s nutritional needs were met. 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 who used the service, their relatives and staff.

Our inspection identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we have asked the provider to take at the back of the full version of this report.

Inspection carried out on 14 October 2013

During a routine inspection

We talked with four family members of people who used the service by telephone and one visiting parent in person. Family members told us �[We have] very good working relationships with staff�, �On the whole very pleased with the standard of care�, �Great service�, �Staff always helpful and cooperative�, �Staff keep you well informed�, �[It�s] great here� and �Staff are lovely.�

During our inspection we conducted a tour of the premises and found it was clean, tidy and free of any unpleasant odours. There were systems in place to reduce the risk and spread of infection.

We found people�s needs had been met by sufficient numbers of appropriate staff.

We found there were effective systems to regularly assess and monitor the quality of service that patients receive.

We found there was an effective complaints process in place.