Background to this inspection
Updated
10 April 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
At the last inspection on 07 & 09 August 2018 the provider failed to comply with regulatory requirements and was served warning notices for breach of regulations 12 and 17 of the Health and Social Care Act 2008. This inspection was undertaken to check if the provider had made improvements.
Inspection team:
The inspection team consisted of three adult social care inspectors and 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 had personal and professional experience of caring for older adults.
Service and service type: Longton Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care. 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:
The inspection was unannounced.
What we did:
Before our inspection we looked at all the information we held about the service. This included any safeguarding investigations, incidents and feedback about the service provided. We looked at any statutory notifications that the provider is required to send to us by law. We used a planning tool to collate all this evidence and information before visiting the service.
We spoke with eight people who lived at the service and four relatives. We also spoke with the registered manager, the area manager, the deputy manager, one registered nurse, one support worker and the chef. We looked at a variety of records which included the care files for five people who used the service and two staff recruitment files. We also reviewed records related to the operation and monitoring of the service and medicines management. We asked health and social care professionals who visited the service to provide feedback. We received positive feedback from two visiting professionals.
Updated
10 April 2019
About the service: Longton Nursing Home is a residential care home that was providing personal and nursing care to 56 people at the time of the inspection.
People’s experience of using this service:
At the last inspection the provider was in breach of multiple regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we found the provider had made improvements and was no longer in breach of regulations.
The service was safe and people were supported to fulfil their abilities and expectations.
The registered manager had improved quality assurance systems. Care records had been improved and reflected people’s needs and preferences.
The provider had made some improvements in relation to seeking people’s consent. However, we made a recommendation about further improvement needed around the assessment of a person’s capacity before seeking consent from others and before someone is deprived of their liberty.
Individual risks to people and the environment had been identified and measures put in place to manage them and minimise the risk of avoidable harm occurring. Staff demonstrated a good understanding of their roles and responsibilities for keeping people safe from harm.
We identified people's bedrails were not always at a suitable height to keep them safe. The registered manager acted immediately on our concerns. They actioned remedial work, risk assessment and ordered bedrail height extenders as recommended by the Health and Safety Executive guidance on the safe use of bedrails.
Medicines were managed safely by trained staff who ensured people received medicines at the right time.
Staffing levels had been increased in the morning since the last inspection and staff told us they felt suitably staffed to be able to provide safe and effective care. People told us staffing levels were sufficient.
People received person-centred care and we observed staff interacted with people in a kind and compassionate way. Staff understood the needs of the people they supported and had formed trusting relationships.
We received mixed feedback from people about the quality of food provided for them. The registered manager was aware of people’s feedback and had made arrangements for a change in food provider which was due to commence in April 2019.
The registered manager was highly regarded by staff, service users and visitors. People told us they could approach the registered manager if they had any concerns and concerns were responded to.
People received person-centred end of life care and staff were trained in advanced care planning and clinical aspects of caring for someone at the end of life.
Staff received training and development to enable them to provide care in a safe and effective way.
Rating at last inspection: Requires improvement (19 September 2018).
Why we inspected: This was a scheduled inspection based on the service's previous rating and to review action taken against served warning notices for regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Follow up: We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk