Longmead Court Nursing Home

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• 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

We identified 1 breach of the legal regulations. The provider’s governance processes were not effective in identifying and addressing concerns in the quality and safety of people’s care. There was a poor culture of learning and staff did not always feel listened to.

This service scored 57 (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.

Staff told us the management team were knowledgeable and were a visible presence within the service, spending time each day in different areas of the service checking on people and staff. However, we received mixed feedback about the culture of the service and the effectiveness of management in addressing issues promptly. Most staff we spoke with felt this was improving; however, positive changes were taking time to embed.

At the time of the assessment, the new management team were establishing roles and responsibilities and prioritising actions to address to make improvements. However, we found managers were not always fully aware of the issues in the service and this meant some areas of concern had not been addressed appropriately. The management team told us they were continuing to improve communication within the service to ensure openness, improve the culture and identify issues more promptly. This included arranging regular staff meetings, 1:1 support and group supervisions.

Staff told us they had not always felt listened to or able to speak up easily; however, most staff we spoke with felt this was starting to improve. Staff were able to identify members of the management team who they felt comfortable approaching if they had any concerns. The management team told us they were making improvements to ensure staff felt comfortable talking to them and knew their availability. An ‘open door’ policy was now in place where knew they could drop in to the office at any time to discuss issues or raise concerns.

The provider had a whistleblowing policy and process in place for staff to follow. Information was available to staff about how and where to raise concerns anonymously if required.

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.

The management team were open in acknowledging improvements were needed in their governance processes. At the time of the assessment, a new management team had recently come into post and were in the process of reviewing what was in place and implementing a service development plan to identify and address shortfalls. Staff we spoke with confirmed the new management team had started to make positive changes. However, improvements were not embedded and we found significant concerns which the management team were not aware of and had not identified prior to the assessment. Managers told us it was taking time to establish governance processes due to the number of changes required and the need to respond to immediate concerns first.

The provider's governance processes were not robust and they did not effectively monitor the safety and quality of the service or promote good outcomes for people using the service. We identified significant concerns with the provider's oversight of risks to people’s health and safety. There was a lack of oversight of care planning and risk assessment documentation. We identified a number of concerns with the management of safeguardings, accidents and incidents. The provider did not have effective oversight of staff knowledge and competence and a lack of robust processes were in place to determine what staffing levels were required to meet people's individual needs and preferences.

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

The management team were not always able to demonstrate how people, relatives and staff were involved in making decisions about improvements in the service. We received mixed feedback from staff about how well they were supported to learn and develop. The management team were not able to evidence a clear strategy for addressing shortfalls and driving improvement. Following the assessment, the operations director confirmed they were reviewing their service development plan to ensure it included all relevant areas and more clearly evidenced priorities for improvement.

The provider's processes were not effective in driving continuous improvements and learning. For example, where safeguarding and complaint investigations had identified concerns with poor care, poor record keeping and care plans which were not reflective of people’s needs, it was unclear whether there had been any follow up action taken to ensure improvements were made and sustained. During our assessment, we identified a number of concerns which had been raised previously. This demonstrated a poor culture of learning and improvement in the service.