Long Meadow

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Some improvements were required to ensure daily records and charts were fully completed to demonstrate people had received the care and support they needed. People were supported to maintain good nutrition and hydration. Overall, people and relatives were involved in the assessment and review process. Staff worked well as a team, and worked collaboratively with a range of healthcare professionals which meant people were supported to live healthier lives. The Mental Capacity Act (2005) was understood and followed by staff in relation to supporting people to make decisions.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Some relatives told us they were not involved in any discussions about people’s care. However, most relatives told us they were involved in assessments of people’s needs. For example, “Before it was more of a tick box and fill the form in – But now we have a discussion about [person’s] care; everyone is helpful now.” And, “Yes and they do invite me to attend reviews of [person’s] plan – There is a formal annual review but if they are seen by the GP and there are any changes made, I am informed of individual risk management.”

The manager explained they review documentation via daily walk-around which checks all appropriate assessments are in place and reflective of people’s needs. Senior staff told us they were responsible for writing and reviewing people’s care plans. All senior staff we spoke with confirmed they aim to involve people and their families as much as possible in this process.

People’s care records showed that they, and their families, were involved in the assessment process. Care plans and risk assessments were reviewed on a monthly basis as part of the resident of the day process, as their needs changed, and also annually with people and those important to them. A range of nationally recognised tools were used to assess people’s needs.

People fed back positively about the food and drink choices provided by the service. Relatives felt people’s nutrition and hydration needs were well met. One relative told us, “Yes, they do make sure [person] is hydrated and they are gaining weight”. Another said, “In fact [person] has been given those milk shakes to build up calories as they have been trying to build their calorie intake up and [person] always has glass of juice by the bed – they have tea and biscuits mid-morning and afternoon.”

The manager explained they were aware of improvements required in charts and records. To address this, they had implemented daily checks of records to review for any gaps or inconsistencies. They explained they work alongside the staff team to ensure progress is made in this area. Leaders explained they were moving over to an electronic based care record system imminently which would aim to reduce gaps or inconsistencies. Staff were aware of the people who required close monitoring and the importance of record keeping. For example, those who were on a food and fluid chart due to potential weight loss. Senior staff explained it would be their responsibility to report any changes and refer to relevant agencies if needed. One staff explained they had referred to speech and language therapy when noticing one person was having more difficulties swallowing. Kitchen staff reflected positively on changes implemented by the new manager and as a result the service now had improved food suppliers, using local businesses and reducing food waste.

Whilst nationally recognised tools were used to inform people’s care and support, we identified some gaps within daily charts which meant we could not be fully assured care was being delivered in line with assessed needs.

Relatives fed back they had noticed improvements in team working and were satisfied referrals were made appropriately. One relative told us, “The residents seem much happier. Staff no longer sit around and are more involved and more caring – There has been improvement, and I am much happier with them – In general I have not met a member of staff who is not willing to help.”

All staff spoke positively about the morale within the staff team and systems in place to ensure information was shared effectively between staff. Staff had responded positively to the resident of the day initiative. Staff were able to inform us about how they would refer to relevant agencies.

Professionals told us that the change in leadership had a positive impact on the team working at the service. They described the staff team as more engaged and willing to work with them as a team.

Systems were in place to ensure staff had the information they needed to deliver people’s care and support. This included a daily safety huddle. The purpose of this meeting was to discuss issues such as the resident of the day, any tissue viability concerns, falls, referrals, incidents or accidents, documentation, safeguarding and visiting professionals.

Relatives fed back they were satisfied people were supported to live healthier lives confirming people had access to a range of health care services. One relative told us, “If there were any illnesses, they would call an ambulance or doctor and get [person] to the hospital.” Another said, “[Person] has a chiropodist come in to see them and they made the referral, the doctor also comes into the home.” During our assessment people were seen by a visiting GP. People told us the GP visited regularly.

Staff were aware of who had involvement from relevant healthcare professionals and any advice or recommendations made. For example, some people were supported by the dementia rapid response team, which is a mental health community team for those with dementia. Staff were aware of techniques to support people who communicated signs of distress.

People’s care records showed healthcare advice was sought and documented. Changes to people’s care and support was clearly communicated with the staff team.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

Relatives confirmed staff sought consent from their loved ones prior to carrying out care tasks. Some relatives were able to confirm their involvement in best interest decisions where people lacked capacity to make decisions. For example, one relative said, "Yes the discussions are not about what is convenient for the home but about what is best for [person]; for example, how to get [person] to take her medication, should it be sprinkled on food, or can it be reduced if it is not life threatening."

The manager had implemented additional training in relation the Mental Capacity Act (MCA) and showed resources which had been made for staff to keep on their persons to remind them of the key principles of the MCA. Overall staff understood the basic principles of MCA. They confirmed they had received training.

People’s care records showed mental capacity assessments were in place where people were deemed to lack the mental capacity to make decisions themselves. Overall, these followed the principles of the MCA. The provider had identified the need for mental capacity assessments to be more person centred and this action was noted to be in progress. Training records confirmed staff had received MCA training.