Background to this inspection
Updated
14 June 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was completed by 1 inspector and 1 assistant inspector.
Service and service type
OSJCT Longlands is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. OSJCT Longlands is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who worked with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 4 people who used the service and 4 relatives about their experience of the care provided. We spoke with 10 members of staff including, the registered manager, operational managers, maintenance staff and care workers.
We also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We reviewed a range of records. This included 6 people’s care records and multiple medication records. We looked at 4 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
14 June 2023
About the service
OSJCT Longlands is a residential care home providing accommodation and personal care to up to 48 people. The service provides support to older people, some who are living with dementia, in one adapted building. At the time of our inspection there were 45 people using the service.
People’s experience of using this service and what we found
Not all known risks had been assessed or mitigating strategies implemented to keep people safe from harm. People were at increased risks of skin pressure damage and risks from their health conditions. Staff had not always received appropriate training to understand people’s health conditions.
Medicine management required improvement to ensure people received their medicines as prescribed.
Care plans and risk assessments were not always kept up to date and factual. We found conflicting information had been recorded. Staff did not always have the information to support people safely.
Unexplained injuries had not always been investigated to identify a cause and reduce the risk of reoccurrence.
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 did not support this practice.
Oversight of the service required improvement. Systems and processes were not always effective in identifying improvements needed and mitigation of risks.
People and relatives had not been asked to feedback on the service. However, staff had completed annual feedback surveys, had regular supervisions, and were offered regular meetings.
People were supported by staff who had been safely recruited and who had completed an induction before working at OSJCT Longlands. Staff felt supported within their roles.
People told us they felt safe at OSJCT Longlands and were supported by staff who were kind. Relatives were positive about the support staff offered people. People and relatives told us they felt safe.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 25 December 2018)
Why we inspected
We received concerns in relation to staff understating people’s needs. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for OSJCT Longlands on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to risk management, medicine records and management oversight at this inspection.
We have made a recommendation regarding understanding the Mental Capacity Act and Deprivation of Liberty Safeguards.
Please see the action we have told the provider to take at the end of this report.
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.