Archived: Longview Care Home Limited

Updated 9 February 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 8 and 9 January 2018 and was unannounced. The inspection team consisted of one inspector. On the first day of the inspection, there was an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert-by-experience used had experience of caring for a relative with dementia. A specialist advisor, who was a registered nurse, also attended the inspection on the first day of the inspection. The specialist nurse had experience of working with people with dementia.

Before the inspection we reviewed information we kept about the service and previous inspection reports. This included notifications of incidents. A notification is information about important events which the service is required to send us by law. This enabled us to ensure we were addressing potential areas of concern. We also emailed professionals and relatives of people who used the service to find out what they thought about the service.

During the inspection we used a range of methods to help us make our judgements. This included

talking to people using the service, their relatives and friends or other visitors, interviewing staff, pathway tracking (reading people’s care plans, and other records kept about them), carrying out a formal observation of care, and reviewed other records about how the service was managed.

We looked at a range of records including five care plans, records about the operation of the medicines system, four personnel files, and other records about the management of the service.

Before, during and after the inspection we communicated with twelve relatives of people who used the service. We also communicated with six external professionals including specialist nurses, GP’s and social workers. We also spoke with two staff.

Many of the people at the service could only answer simple questions or were unable to speak with us due to their disabilities. As a consequence, we used the Short Observational Framework Inspection (SOFI) on the first day of the inspection. SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We were however able to speak with four people about their experiences of living in the service.

Updated 9 February 2018

We inspected Longview on 8 and 9 January 2018. The inspection was unannounced. The service caters primarily for people with dementia. At the last inspection, in June 2017, the service was rated ‘Requires Improvement.’ This was because we had some concerns that people’s dignity and respect were not always promoted by staff for example how staff assisted people with eating and drinking; moving and handling, when assisting people to move about the service, was not always carried out to a satisfactory standard, and CQC was not always notified appropriately of matters, such as safeguarding concerns, as is required by law. At this inspection we found the registered manager had appropriately addressed the matters of concern. As a consequence, at this inspection, the service has been rated as Good.

Longview 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. Longview accommodates 28 people.

The service had 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.

The service was viewed by people we spoke with as very caring. We received many positive comments about the attitudes of staff aand the owners. For example, “Longview is an exceptionally well run home, the staff and owners are approachable, considerate and professional. I have seen other homes and Longview is head and shoulders above all of them,” “Care is excellent,” “Longview has always appeared to us excellent in every way. It is secure, more than adequately catered for by staff who appear both well trained and caring,” “I could not be happier with the care received from the excellent staff,” “I hold up the up most respect for Mr Patel and his care team. I find his approach to care very impressive and indeed just what is needed for local folks in dire need of good quality care,” “Immaculately clean and extremely well appointed…Very homely and comfortable.” “Happy and contented,” and “Staff at the home are very supportive and helpful.”

People told us they felt safe, and we also received positive comments from relatives that the service was “Safe and secure,” and staff were “watchful and very quick to respond,” if there were any problems. The service had a suitable safeguarding policy, and staff had been appropriately trained to recognise and respond to signs of abuse.

People had suitable risk assessments to ensure any risks of them coming to harm were minimised, and these were regularly reviewed. Health and safety checks on the premises and equipment were carried out appropriately.

There were enough staff on duty to meet people’s needs. The service had a suitable recruitment procedure, and appropriate checks were carried out on new staff to ensure they were suitable to work with vulnerable people. Staff were suitably trained. Staff received a comprehensive induction when they started to work at the service, and they received regular supervision to provide them with feedback and guidance about their work.

The medicines’ system was well managed, medicines were stored securely, and comprehensive records were kept regarding receipt, administration,and disposal of medicines. Staff who administered medicines received suitable training.

The service was exceptionally clean and hygenic. A relative told us, “I have always found Longview clean, fresh and well maintained. Unlike (my relative’s) previous home there is no smeall of urine.”The building was well decorated, well maintained and well furnished.

Assessment processes, before someone moves into the service are comprehensive. These assisted in helping staff to develop detailed care plans. The registered manager and staff consulted with people, and their relatives, about their care plans. Care plans were regularly reviewed.

People enjoyed the food and were provided with regular drinks throughout the day. Support people received at meal times was to a high standard. Meal times were very well organised, and were a sociable occasion. Comments about food included, “The food has been to a good standard and my relative is eating very well.”

The service had well established links with external professionals such as GP’s, Community Psychiatric Nurses, District Nurses, and social workers. External professionals were very positive about the standards at Longview. For example we were told, “It is a really caring home,” “ In my view, and the view of the team Longview is one of the best residential homes in the county.”

The majority of people lacked capacity due to their dementia. Where necessary suitable measures had been taken to minimise restrictions. Where people needed to be restricted, to protect themselves, and/or others, suitable legal measures had been taken. No physical restraint techniques were used at the service. Staff had received suitable training about mental capacity.

Everyone we saw looked well cared for. People were clean, well dressed, their hair combed nicely and fingernails clean and nicely manicured. People told us, “They look after me well. I find it easy to talk to the staff,” and “(The staff) respect you and are kind.” We observed staff working in a caring and respectful manner, respecting people’s privacy and dignity.

The service had a comprehensive activities programme. There was at least one, if not two, organised activities a day such as external entertainers, exercise sessions, art sessions and a drumming group. Outside the activities sessions we saw staff sitting with people, chatting with them and carrying out one to one activities such as completing jigsaws or looking at the newspaper with a person.

The registered manager, and the management team were well respected by people, relatives, staff and external professionals. They were described as “Dedicated,” “Caring,” and “Extremely helpful.” Staff also said team working at the service was good, and team members were supportive and communicated well with each other.

There was a suitable quality assurance system in place. An annual survey was completed, and the results of this were positive. The registered manager had a hands on approach, wanted to get things right, learned from mistakes and had a comprehensive system of checks and audits in place.

Relatives said communications were good between the service and them. They said they were always informed and consulted about their relative’s care. A relative said, “I am included in everything. There is good communication.”