Longhill House Care Home

Updated 21 July 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 2 inspectors and an Expert by Experience. An Expert by Experience also made calls to relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Longhill House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Longhill House Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed the information we had received about the service. 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 (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 7 people who used the service and 10 relatives to ask about their experience of the care provided. We spoke with the area manager, the personal care manager, the head housekeeper, 6 care staff and 1 professional. We looked at 3 care files along with a range of medication administration records (MARs). We looked at other records relating to the management of the service including recruitment, staff training and supervision, and systems for monitoring quality.

After the inspection

We reviewed further records relating to the management of the service.

Updated 21 July 2023

About the service

Longhill House Care Home is a residential care home providing personal care to up to 41 people. The service provides support to older people some of whom may be living with dementia, people with mental health needs, people with a physical disability and younger adults. At the time of our inspection there were 39 people using the service. Accommodation is provided in one adapted building across 2 floors and has a mixture of smaller and larger communal areas for people to use.

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

Medicines were not always managed safely. Discrepancies in stocks of medicines had been identified meaning some people had not received their medication as prescribed.

Governance systems were not always reliable or effective and actions from audits were not always followed.

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.

There were effective safeguarding systems in place and safeguarding concerns were managed promptly. Staff understood their responsibilities in relation to safeguarding and felt comfortable to raise concerns.

Risk assessments were person centred and contained enough information to guide staff in their practice.

There were enough competent, trained staff to meet people’s needs. Recruitment checks were robust.

Infection, prevention, and control was managed well, and the cleanliness of the home was of a high standard. People had access to outside space.

The provider worked collaboratively across services to understand and meet people’s needs, and people experienced positive outcomes regarding their health and well-being.

The service had a positive culture that was person-centred and empowering. People, their relatives and staff spoke positively about the registered manager and felt involved with 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 and update

The last rating for this service was requires improvement (published 25 November 2020) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations and the service remains rated requires improvement. The service has been rated requires improvement for the last 2 consecutive inspections.

We also made a recommendation the provider seek advice and guidance regarding the Mental Capacity Act (2005). At this inspection the provider had acted on our recommendations and had made improvements.

Why we inspected

We carried out an unannounced inspection of this service on 29 September and the 1 October 2020. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve their governance processes.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remains requires improvement. This is based on the findings at this inspection.

You can read the report from our last inspection, by selecting the ‘all reports’ link for Longhill House Care Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to the safe administration of medicines and good governance.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.