Longueville Court

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Lessons were learned from safety incidents or complaints. People were protected from the risk of harm and abuse. Most risks were identified but were not always acted upon. There were enough staff with the right skills. Lessons were learned when things went wrong. Staff supported good infection and prevention control practices.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Incidents were referred to local safeguarding teams, social workers and the CQC. Complaints from people were investigated and effectively acted on. Learning was shared with appropriate staff who understood how this would be achieved.

All staff told us they felt confident to report any concerns, that they would be acted on and taken seriously as well as protecting staff confidentiality. Incidents were recorded such as staff not adhering to safe care practices. Investigations identified what learning was required and effective actions were taken to help prevent recurrences.

People felt that they were involved in their care and their views were listened to. Care and support is planned and organised with people, together with other professionals to ensure continuity of care.

People felt that they were involved in their care and their views were listened to. Care and support is planned and organised with people, together with other professionals to ensure continuity of care.

Policies and processes were in place that included working with other health and social care professionals to enable shared learning and drive improvements. Records were not always clear that advice was being actioned however there were no poor outcomes for people.

Staff had an awareness of risks to people and were involved in a joined-up approach to managing people's care journeys to keep people safe. One staff member told us, "If I have any concerns, we follow these up with deputy manager or the clinical lead. Last year we were trying to do observations for sepsis every day. We introduced observations as part of standard practice and being sepsis aware. [clinical lead] rings every day after 11am meeting. They tell us everything we need to know. Continuity is better as we know people well. We would quickly see the deterioration."

People's records showed that they had been referred to other healthcare professionals to ensure they received the care and support they required.

Staff told us they supported people to feel safe. People were kept safe from avoidable harm because staff knew them well and understood how to protect them from abuse. Staff had received training in safeguarding and were able to tell us the correct action to take if they suspected people were at risk of abuse or avoidable harm. One member of staff said, "I would report [any concerns] to the deputy manager, general manager, Peterborough local authority safeguarding team and record the concerns. I would look out for if people are crying, upset, shouting at me and find out what their concerns are.” The manager was clear about the process to follow to ensure people were protected and concerns were reported and investigated promptly.

Safeguarding adults’ information had been made available to people, relatives and care workers so they were aware of the process should they have any concerns to raise.

People told us they usually felt safe with their care workers and they looked relaxed, happy and comfortable with staff supporting them. One person told us, “I don’t have any worries about residents or staff. I would be comfortable to speak to (Deputy Manager) if I did”. Another person told us, "I feel perfectly safe here, the carers all keep an eye on me." People felt able to speak openly with the management team and able to speak up if they had any concerns regarding their safety.

There was a safeguarding policy and procedure in place to manage safeguarding concerns. There were effective systems, processes and practices to ensure people were safe from the risk of harm and abuse.

Risks to people were safely managed in most situations, such as mobility aids, regular cleaning of rooms and high contact areas such as door handles. However, we found some risks to people were not always being managed as well as they should have been. For example, an out of date medicine, which if required in an emergency may not have been safe to use. Some records had not been completed consistently to help to identify emerging risks to people. For example, fluid intake and wound assessments where we found gaps on more than 9 days. We found, risks to people such as distress and anxiety were managed well and where medicines were prescribed or changed, this was clearly documented.

Support was flexible and based around people’s needs. Staff had a good understanding of people’s needs and any associated risks and were skilled at anticipating people's needs.

Staff told us risks to people's health were managed with support from other health professionals such as a GP, podiatrist, speech and language therapist or dietician. Staff adhered to guidance from these professionals and ensured any changes to people were acted on. The staff gave GPs information to help reduce or remove medicines which helped control people’s distress and anxieties.

People told us risks to them were safely managed. One person told us that their movements outside of the home were restricted but that was due to their health issues and to keep them safe. Everyone we spoke with felt staff were skilled. However, some people felt staff whose first language was not English did not always fully understand what people said or take the appropriate actions.

People are cared for in a safe environment with equipment to meet their needs. One person told us, “I share a stand-aid with some other residents. I can’t stand up on my own so they use that. They always take their time and tell me what they want me to do.” One person told us they knew why they need bed rails and that without them they could fall out of bed.

The provider, in the main, ensured they supported people, staff and visitors in a safe place. All equipment had regular servicing and any unsafe equipment was removed or isolated in a safe way.

There was a daily walk round by the management team including checks on safe working practices. Where people needed support to stay safe, such as 1:1 staffing this was effectively deployed, but without overly restricting people’s freedom.

The general environment was safe, with regular maintenance taking place. We observed some areas for improvement however the provider had an action plan in place to address these points.

We observed that there were sufficient, experienced and trained staff deployed during our visit. The majority of the time staff were unrushed when supporting people although there were some practices that could be improved. For example, one member of staff was assisting one person to eat and then without explaining to the person what they were doing went to assist another person for a few minutes. Staff assisted those who remained in bed due to their physical frailty regularly and we saw that they were comfortable, and clean.

Staff said they had the knowledge and skills and the relevant qualifications to care for people living in the service. Training records confirmed staff had attended relevant training to their role. One member of staff told us, "We have enough staff to provide people's care. No rushing. We can act on emergencies, such as staff sickness. We use a whole team approach, so staff help each other." All staff we spoke with told us the checks they had been subjected to before being employed and that they did not start work until after their checks were completed.

There was evidence of robust recruitment procedures. All potential staff were required to complete an application form and attend an interview, so their knowledge, skills and values could be assessed. The provider undertook checks on new staff before they started work. This included checking their identity, their eligibility to work in the UK, obtaining at least two references from previous employers and Disclosure and Barring Service (DBS) checks. The DBS helps employers make safer recruitment decisions and prevent unsuitable people from working with vulnerable people. There were systems in place to review staffing levels against people's dependency, these are reviewed regularly, in line with changing needs and new admissions.

People said they had received good care and treatment from staff. Most people felt there were enough staff around to help them when needed, though some days staff were busier, and they had to wait a little longer. People were comfortable and relaxed with the staff. One person told us, “[Staff] mostly answer the bell within 10 minutes. There have been times when I have waited longer but thankfully it hasn’t caused me any problems” Another said,” I haven’t had to call for the staff but there seems to be enough of them”. One person told us,” I have got my call bell here and you do sometimes have to wait a long time. I have waited an hour sometimes especially in the last few days it has been bad. Some of them will pop in and say they will be back. I have had some toileting accidents due to having to wait."

Staff were observed adhering to good infection, prevention and control standards, such as with changes to PPE, handwashing and not touching people's medicines apart from topical skin creams where they wore gloves and changed these between each person.

The provider's Infection Prevention and Control policy was up to date, visits were enabled without restriction and if staff had COVID-19 symptoms they adhered to the policy. Where people needed equipment to help keep them safe, staff ensured safe systems of work such as bed rails. Records we looked at showed staff checked and cleaned equipment before and after use. Audits were undertaken but did not always identify infection risk such as wooden toilet seat and exposed pipes, non-pedal type bin. The provider had a plan of addressing these issues.

Staff were aware of what personal protective equipment (PPE) to use and how to use it effectively, there was enough PPE available to all staff. Staff ensured they disposed of used PPE in a safe way. Staff told us, “We have Infection Prevention Control training, refreshers on any updates, we have enough PPE, Housekeeping staff clean touch points, clean bathrooms every day.”

One person told us, “Staff always protect my privacy and [the home] it is always clean, I see staff wiping down door handles and switches, I have never had to speak with the manager about cleanliness.” Another person told us, “The cleaners are excellent. You don’t get any nasty smells. I could have a bath or a shower, but I don’t like them, so I have a good wash. I look after my own teeth and nails. The laundry works fine, I haven’t lost any of my things” Another person told us,” The cleaning is perfect, the cleaners are wonderful. I can have 3 showers a week, but I can say no if I don’t feel up to it”.

People told us they could decide if they wanted to take medicines. Where people made unwise decisions about refusing medicines this was documented appropriately. One person told us, “My medication has all been fine and I know what it is all for.” A relative said, “They know what medicines [my family member] is on already.” One person told us, "[Staff] are regular with my medication and I understand everything I am taking and they have never run out of my medicines.” Another said, “[Staff] have all been on time so far and know what I take so they don’t need to tell me.” Another person told us, “I have medication 4 times a day. I take 2 paracetamol and some other tablets”. People knew what their medicines were for.

One staff told us, “I have [many years] experience and in-depth knowledge of medicines skills for sepsis risk. I administer medicines and get updates to training. The deputy manager does my medicines competencies. We also do pharmacy supported online training.” Staff also knew what checks to complete before administering medicines, such as the person's pulse rate. One staff member told us, "I always ensure safe positioning of pain patches to avoid skin irritation and correct absorption. It is important to apply as prescribed. We have just had tissue viability training, which was fantastic, and learned more about the importance of types of nutrition. For instance, Sarcopenia' means loss of muscle tissue and not just weight loss due to age. We use specific type of topical skin cream in a stick as other creams can block skin pores and prevent healing." Staff knew how to manage people's medicines including where they were administered in other ways than oral, such as Percutaneous Endoscopic Gastrostomy (PEG).

The provider had an up-to-date policy for the management and administration of medicines. Medicines were stored securely. Only trained and competent staff administered people's medicines. Where people had been prescribed medicines, we saw how these had been effective such as for infections and where people's skin integrity had improved. However, we found out of date medicine which could be needed in an emergency, missing staff signatures, missing 'as and when needed' (PRN) information protocols and delays in requesting medicines where people were at risk of sepsis. For example, one person was prescribed Codeine as and when required, but had no care plan in place to guide staff on when this medication should be administered.