Longridge Court

Longridge Court is a residential care home providing personal care to 11 younger adults with learning disabilities and/or autistic spectrum disorder needs at the time of the inspection. The service is registered to support up to 12 people.

The service was developed and designed before Registering Right Support came into existence. Despite this, the service was managed in line with the principles and values that underpin Registering Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. Six people could be accommodated in the main house, three people in ‘the annexe’ and three people in ‘the view’ (flat above the main house). Each unit was self-contained with its own front door and communal rooms. The building design fitted into the residential area and was in keeping with other large domestic homes in the area. There were deliberately no identifying signs, intercom or cameras outside to indicate it was a care home. Staff did not wear a uniform when supporting people at home and when accessing the wider community with them.

People’s experience of using this service and what we found

People felt safe and staff treated them with respect and dignity. People were comfortable and relaxed when interacting with staff and had formed positive relationships with them. One staff member told us, “Because we care about them, we tend to look after them as if they were our family, which they enjoy.” Staff were trained to meet people’s specialist needs and had been recruited safely. Risks to people were managed through person-centred support plans, following guidance from health professionals and regular reviews of people’s needs.

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. When restrictions were needed to maintain people’s safety, for example, when going out into the community, the least restrictive approach was taken. Arrangements made on people’s behalf were made in line with Mental Capacity Act requirements when people could not consent to decisions about their care

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. People’s wishes and support needs were reviewed regularly, with the staff member they chose to work with. Staff were committed to helping people achieve their goals and to ensuring people’s disabilities did not prevent them from living a fulfilled and happy life. People were supported to participate in activities they enjoyed and were interested in.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on opportunities to gain new skills and become more independent. People who wanted to contribute to life at Longridge Court, for example, by growing vegetables or making drinks for others, were empowered to do so. People enjoyed daytrips out, going out for meals and going to the pub. They had formed relationships with members of the community through regular activities they attended. People were supported to maintain relationships with others who were important to them, through visits and use of the internet.

The service was caring and person-centred. People using the service and the staff supporting them, were valued and listened to. The provider and registered manager understood their responsibilities and monitored the service to ensure any improvements needed were carried out. The registered manager worked openly and transparently with outside agencies.

For more details, please see the full report which is on the CQC website at www.cqc.co.uk

Rating at last inspection

The last rating for this service was ‘Requires Improvement’ (published 21 September 2018).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Longridge Court provides accommodation and personal care for up to 11 people with a learning disability or autistic spectrum disorder. There were nine people living in the home at the time of our inspection. Longridge Court consists of the main house which has six bedrooms and an additional three bedroomed flat on the upper floor. An adjacent annexe has three bedrooms. People had access to a secured outdoor space.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection we rated the service good. At this inspection we rated the key question ‘Is the service safe?’ as “Requires Improvement” as we found additional improvements were required to ensure the management and monitoring of people’s risks were continually recorded by staff who were familiar with their needs. We also rated ‘Is the service well-led?’ as “Requires Improvement” as the systems used to monitor people’s care and the governance of the service were not always effective in driving improvement. Therefore the overall rating of the service is "Requires Improvement."

A registered manager was in place as required by the service’s conditions of registration however they were on maternity leave. 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. An interim manager was newly in post and intended to register as a registered manager during their management period.

People benefited from a safe service where staff understood their safeguarding responsibilities. Staff had been trained to recognise signs of abuse and report any concerns to their managers and other relevant authorities. Effective recording systems were not in place to monitor people’s risks. Risks to people’s personal safety had been assessed and plans were in place to minimise these risks. Some risk management plans had not always been updated to reflect people’s current needs and the care they had received to remain safe. Accident and incidents where people had become distressed had been reported.

Due to a recent turnover in staff, the home had used agency staff. However, some people’s care plans were not current and therefore did not provide staff with the information they needed to support people if they were unfamiliar with their needs. On occasions, people’s recreational needs had not been met due to staffing constraints.

People’s privacy, dignity and decisions were respected and valued by staff. People who could make decisions for themselves were involved in the planning of their care and consented to the care and support being provided. They were encouraged to express their choices and preferences about their daily activities. When people’s needs had changed, staff had appropriately referred them to health and social care services. However, people had not always been supported to maintain their health and wellbeing by attending regular health care appointment’s such as the dentist.

People's dietary needs and preferences were catered for and known by the staff. Improvements had been made to the management of people’s medicines to ensure they were managed and administered safely in accordance to their assessed needs.

Safe recruitment systems were in place. Records showed staff were supported and trained to meet people’s diverse physical and emotional needs.

Relatives were concerned about the continuity of familiar staff who supported people and felt communication from the home needed to improve. Quality assurance systems were in place although not always effective in monitoring the quality of service being delivered and evaluating the actions being taken.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Care Quality Commission (Registration) Regulation 2009. You can see what action we told the provider to take at the back of the full version of this report.

Longridge Court provides residential care and support for up to 11 people with a learning disability, autistic spectrum disorder, physical disability or sensory impairment. The service has three separate areas to provide for the scope of people’s needs. Eleven people were accommodated when we completed this inspection.

There was a registered manager. 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 observed staff responding to people in a calm and compassionate manner consistently demonstrating respect. Staff knew peoples individual communication skills, abilities and preferences. Staff supported people to choose activities they liked. People had taken part in activities in the community and holidays with staff. A person told us, “Its excellent here, I do gardening, a paper round and go to college. We recommended that people had additional social contacts.

People were supported by sufficient staff and they were able to access the community with them. Staff supported 11 people and there were usually seven staff all day, including the registered manager. Additional staff were deployed for some activities in the community to support people individually. Recruitment checks had been made and we recommended the service considers improvements to the recruitment procedure. People were involved in interviewing new staff during the recruitment process.

People and a relative told us they felt the home was a safe place to be. Staff were trained to identify any abuse and take appropriate action. Individual risk assessments were completed which minimised risk for people helping to keep them safe and independent. All accidents and incidents were recorded and had sufficient information to ensure preventative measures were identified.

Staff were aware of the Mental Capacity Act 2005 to protect people when they needed support for certain decisions in their best interest. Support care plans included people’s mental capacity assessments which showed how choice for each person was displayed by them. Most people made everyday decisions as staff knew how to effectively communicate with them.

A range of social and healthcare professionals supported people. They told us the service was quick to refer people to them when it was necessary. Medicines were well managed and given safely. People’s care plans identified how people liked to take their medicines. People were supported by staff who had the skills and knowledge to meet people’s needs.

Special diets were provided to maintain and improve people’s health and wellbeing. People had a choice of meals but improvements could be made to ensure they were offered more choice in an appropriate format. People and staff usually had their meals together which created a sociable gathering.

People had personalised care plans and staff supported them to be involved in making decisions about their care as much as possible. Additional communication systems may help people know what they were doing each day. People’s care plans and risk assessments were reviewed regularly. There were appropriate complaints procedures in place that included an easy read version for people. Complaints and concerns were taken seriously and used as an opportunity to improve the service.

Quality checks were completed and examples told us that action plans identified where changes were made to address any shortfalls. People were given the opportunity to answer questions about the service in an appropriate way to make sure they were satisfied and were involved in monthly meeting with staff. Relatives, supporters and health and social care professionals were asked for their opinion about the service. Regular staff meetings were held for staff to be involved in the running of the home and improvements had been made or were planned as a result. The registered manager was accessible and supported staff, people and their relatives through effective communication.