4 July 2023
During a routine inspection
Long Lea Residential Home is a care home providing personal care and accommodation for up to 35 adults living with dementia or mental health needs, physical disabilities and sensory loss. The care home is a 2-storey building with en-suite bedrooms and communal facilities. At the time of our inspection visit there were 28 people receiving care.
People's experience of using this service and what we found
There had been frequent changes in management and senior staff at Long Lea Residential Home which had impacted on the provider’s ability to maintain consistency in care standards. The service has not achieved an overall rating of good for the last 4 inspections dating back to January 2021.
The provider carried out a range of quality checks and audits. These had driven improvements in some areas and maintained standards in the key questions of effective, caring and responsive. However, systems to monitor people’s health and wellbeing required more day-to-day scrutiny. Important records were not always detailed enough to demonstrate people received the right levels of care and safe practices were followed. Training needed to become embedded in the everyday practice of staff to ensure risks were consistently mitigated.
There were enough staff on duty to support people with their care needs. Staff understood their responsibility to report any concerns of abuse or discrimination. Where potential safeguarding incidents had occurred, appropriate action had been taken. Medicines were ordered and stored safely, and people generally received medicines as prescribed. However, some improvements were required in the recording of medicines administration to ensure safe medicines practices were consistently followed.
Managers and staff liaised with other agencies and health professionals to meet people's specific needs. Staff told us changes to people's health and well-being were communicated effectively. Catering staff demonstrated a good knowledge and understanding of their responsibility to provide food and drinks that met people's nutritional needs and preferences. Changes in the layout of communal areas had improved people’s mealtime experiences.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People were positive about the relationships they had built with the staff and relatives told us staff demonstrated a kind and caring approach. Staff understood people’s right to be treated with dignity and respect and encouraged people to let them know how they wanted their care to be provided.
People’s care plans reflected their histories, care needs and preferences. People were supported to engage in a range of interesting things which helped keep them active and gave them opportunities to socialise with other people living at the home. People’s wishes for how they wished to be cared for in their final days had been explored and plans developed with input from their family members.
Staff told us the culture in the home had improved and the provider was working proactively to promote staff well-being. Staff felt supported and listened to and good practice was recognised.
The provider sought advice and guidance from other organisations to improve outcomes for people. They worked closely with commissioners of their service including the local authority and infection control teams, to make improvements to the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was Requires Improvement (published 13 December 2022) and there a breach of a regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.
Why we inspected
We carried out an unannounced focussed inspection of this service on 1 November 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
We undertook this inspection to check they had followed their action plan and to confirm they now met legal requirements. In addition, we had received further concerns in relation to poor-quality care.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
The overall rating for the service has remained as Requires Improvement based on the findings of this inspection. We found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.
Enforcement and Recommendations
We have identified breaches in relation to governance and safe care and treatment at this inspection.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.