Longfield House

Updated 16 July 2019

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 Care Act 2014.

Inspection team

The inspection team consisted of three adult social care inspectors.

Service and service type

Longfield House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced on the first and third days and announced on the second day.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service and observed communal areas. We spoke with nine members of staff including support workers, team leaders, the deputy manager and the registered manager.

We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at four 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.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 16 July 2019

About the service

Longfield House is a residential care home providing personal care to up to nine people with a diagnosis of learning disability and other complex behaviours.. There were nine people living at the home at the time of our inspection.

Longfield House accommodates five people in one building, and four others in self-contained flats in the adjacent Coach House.

The service has been developed and designed in line with the principles and values that underpin Registering the 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.

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

We had concerns which we expressed to the registered manager about the recruitment process and also the retention of staff. Although we did not find sustained impact on people, staff were concerned about how fragile the balance of staffing was at times in terms of numbers and skill mix. We have made a recommendation about the robustness of the recruitment process.

People looked happy and comfortable with staff and told us they felt safe. Safeguarding concerns were dealt with robustly and staff knew how to report such concerns. Risks assessments reflected people’s specific needs and provided guidance for staff which they spoke to us about. People with more complex behavioural needs were supported by staff trained in appropriate use of restraint and the service had worked hard to reduce incidents.

We found medicines were managed safely and all staff understood the importance of effective infection control practice. Staff had received supervision and training and understood the importance of ensuring people attended health and other appointments as necessary. Staff evidenced good communication around people’s changing 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.

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. The outcomes for people promoted choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Staff displayed kindness and reassurance for people and respected their privacy and dignity. Care documentation was detailed and provided evidence of how well staff knew people. There needed to be more evidence of written reviews although staff were very knowledgeable about people’s individual circumstances and were happy to share ideas about how best to support someone.

The registered manager was a strong advocate of person-centred practice and was working hard towards embedding this approach in 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

The last rating for this service was Good (report published 2 September 2017).

Why we inspected

The inspection was prompted in part due to concerns received about staffing, service provision and management. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe and well led sections of this full report.

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.