Archived: Longhill House - Care Home

Updated 14 January 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the registered provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 17 and 18 November 2016 and was unannounced. The inspection team consisted of one adult social care inspector over the two days.

The registered provider had completed a Provider Information Return (PIR). This is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make. We also checked our systems for any notifications that had been sent in as these would tell us how the registered provider managed incidents and accidents that affected the welfare of people who used the service.

Prior to the inspection we spoke with local authority contracts and commissioning teams and safeguarding team about their views of the service.

During the inspection we observed how staff interacted with people who used the service throughout the days and at mealtimes. We spoke with two people who used the service and five people who were visiting their relatives. We spoke with the registered manager, two senior care workers, seven care workers and the cook. We also spoke with a health care professional and a chiropodist.

We looked at five care files which belonged to people who used the service. We also looked at other important documentation relating to people who used the service such as all their medication administration records (MARs) and monitoring charts for food and fluid intake, weights and pressure relief. We looked at how the service used the Mental Capacity Act 2005 to ensure that when people were assessed as lacking capacity to make their own decisions, best interest meetings were held in order to make important decisions on their behalf.

We looked at a selection of documentation relating to the management and running of the service. These included training records, the staff rota, minutes of meetings with staff and people who used the service or their relatives, quality assurance audits, complaints management and maintenance of equipment records.

We completed a tour of the environment.

Updated 14 January 2017

Longhill House is situated in a residential area. It is registered to provide personal care for up to 41 people who may be living with dementia. Bedrooms and bathrooms are located over two floors which are accessed by a passenger lift. All bedrooms are for single occupancy and most have an en suite toilet. There are two sitting rooms and a large dining room on the ground floor, which has access to an enclosed garden. There is a reminiscence room on the first floor.

The service had a registered manager in post as required by a condition of registration. 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.

We undertook this unannounced inspection on the 17 and 18 November 2016. At the time of the inspection there were 38 people living in Longhill House.

At the last inspection on 14 September 2015, we had concerns about infection prevention and control and how the quality of the service provided to people was monitored. The registered provider sent us an action plan which stated the measures they were to take to improve and when they would be compliant in these areas. We found there have been improvements in both these areas at this inspection. For example, we found the service was clean, tidy and smelled fresh. Some minor issues were attended to on the day of inspection. Staff had appropriate personal and protective equipment to use when required and there were sufficient supplies of cleaning products.

The registered manager was carrying out more audits and checks on the quality of the service and asking people their views in surveys and meetings. We saw some areas required review to continue the improvement achieved so far, especially in relation to records. We have made a recommendation about this in the well-led section.

During this inspection, we found people had not always received their medicines as prescribed. You can see what action we have asked the registered provider to take at the back of the full version of this report.

Staff knew how to keep people safe from the risk of harm and abuse; they had received relevant safeguarding training and knew how to report issues of concern. Staff completed risk assessments for people who used the service to help them minimise risk and keep people safe. The registered manager had looked at accidents and incidents so staffing levels could be adjusted at specific times of the day in order to reduce the number of incidents.

We found people’s health care needs were met. Staff had developed good relationships with health care professionals and they made referrals to them when required.

People’s nutritional needs were met. There were choices available for them on the menus and alternatives if they didn’t like what was on offer. Nutritional risk was assessed and people were weighed in accordance with risk and their diet adjusted when required.

People’s needs were assessed prior to admission and this was kept under review and updated when there was any significant change. People had care plans which provided staff with guidance in how to look after them. Some care plans were very detailed but others lacked some information which could be relevant to their care. However, in discussions it was clear that staff were very knowledgeable about people’s individual needs and how each person preferred to be cared for. The registered manager confirmed the minor issues with care plans were to be addressed straight away.

We found the staff approach was kind, patient and caring; there were positive comments about staff approach from people who used the service, relatives and visiting professionals. Staff respected people’s dignity and privacy and we saw them encourage people to be as independent as possible and to make their own decisions when they were able to. When people were assessed as lacking capacity, staff acted within the principles of the Mental Capacity Act 2005 and ensured important decisions were made within best interest meetings with relevant people attending.

We saw confidentiality was maintained and personal data protected and stored securely.

Staff had access to training which helped them to feel skilled and confident when supporting people who used the service. The training was monitored and refresher courses made available; there was an expectation that staff completed training in a timely way. There was an induction which covered training considered as essential and which gave new staff basic skills on which to build on. Staff received supervision, appraisal and support.

We found the registered manager was approachable and people who used the service and their relatives were listened to. There was a complaints procedure on display and people felt able to complain.

At the last inspection in September 2015, staff had been recruited safely and all employment checks had been carried out before they started work in the service. The recruitment process had not changed in the interim so we did not feel it necessary to check this again. Recruitment processes will be checked at the next inspection to ensure the robust processes continue to be maintained.