Longview

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At the last inspection this key question was rated good. At this inspection this key question has changed to requires improvement. This meant the service management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care. During our assessment of this key question, we found concerns around the provider's systems and processes. . This was a breach of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 17 – Good Governance.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Capable, compassionate and inclusive leaders during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Not all staff spoken with felt supported and valued by the management. Some members of staff told us they were wary about raising concerns with management as they did not feel these would be addressed effectively. Some staff were positive about working at the service and promoting good outcomes for people. Staff told us, "The manager is very supportive and approachable, and we all work well together. I like my job and I enjoy supporting people.'' However, some staff told us, ''There has been too much change. We need some stability. Information doesn’t always get shared with us so we don’t know why changes are constantly being made.'' A health professional told us, “The communication could have been better and effective.”

The manager told us they had a ‘whistleblowing’ and safeguarding policy for staff to follow and discussed concerns in meetings. The manager promoted an open culture to encourage staff to speak up about concerns and also to share positive ideas they may have about the running of the service. However, not all staff we spoke to felt involved and informed and did not feel confident about raising concerns. Staff meetings were held. We reviewed minutes and saw they included information about the service as well as reminders about training. However, there were no action plans completed to evidence how issues raised were to be addressed, dates to be achieved and if actions had been resolved or remained outstanding.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Staff told us they had supervisions but these were not completed regularly. A staff member told us, “I can’t remember the last time I had one but I have had a supervision. It would be useful to regularly meet with seniors to discuss any concerns we have on a one to one basis.” Staff told us they had an induction when they first started. A staff told us, “There was always a clear divide between the management and staff working at the home but that is changing now. The manager is really trying to work alongside us and is introducing new changes to make things work better for us.”

The quality assurance and governance arrangements in place were not always effective in identifying shortfalls at the service. Risks to people’s safety and wellbeing were not always being recorded, monitored and managed effectively. Although the register manager had completed a monthly audit of care plans and risk assessments, these were not robust and did not identify the shortfalls found during this assessment. This meant robust processes were not in place to monitor the quality of the service, risks to people’s safety and maintain complete, up-to-date records in respect of the decisions taken about each person’s care and treatment. We found no evidence that people had been harmed however, effective systems to monitor and improve the quality of the service were not in place. This was a breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The management have been working closely alongside the local authority. Feedback from a health professional stated, “I can confirm that the provider is working with us to make improvements. However, there are still concerns in relation to care plans, risk assessments and the number of falls in the care home.”

The management have been working with the local authority to aid improvements at the service. This process is on-going and full engagement is required from the provider to ensure improvements are made. The manager had developed good relationships with the local GP, district nurses and mental health professionals. Staff were aware of the importance of working alongside other agencies to meet people's needs and liaised with other healthcare professionals such as the GP and pharmacy when required.

The manager and staff shared the same goal to provide positive outcomes for people. The manager encourages staff to discuss and share ideas for improvement and innovation. The manager is passionate about making improvements in the service and told us, “I want to keep staff involved throughout this process. Its important to involve them and keep them included in discussions. We can all work together to make improvements and we are learning from each other everyday.”

The management had a clear vision for the direction of the service which demonstrated ambition and a desire for people to achieve the best outcomes possible. The service worked closely alongside a quality team in order to drive continuous learning and improvement in the service. The manager worked closely with the local authority to investigate any concerns and implement any learning from these. However, a health professional told us, “Whilst we have noticed some improvement, we are still seeing very little progress, there continues to be a significant number of adults having serious falls and adults are still losing weight. Food and fluids are still not being monitored sufficiently. Families and people are not well communicated with. Investigational reports and learning outcomes and very poor, if completed at all.” The provider worked in partnership with different healthcare professionals to support people's needs. A representative from the GP was at the home on the day of the assessment discussing people’s needs with staff.