CQC report explained · a residential care home
What the CQC found at Longfield House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Inspectors found detailed individual risk assessments, safe medicines management and good safeguarding practice. However, recruitment was not always robust, staff retention was a concern, and some vehicle checks were incomplete.
- Effective?
- Good
- Staff had induction, supervision and relevant training. People received support with food, health appointments, communication, decision-making and independence.
- Caring?
- Good
- Staff were kind and knew people well. People were supported with dignity, privacy, relationships, cultural needs and personal choices.
- Responsive?
- Good
- Care records reflected people's interests, routines and communication needs. People took part in regular activities, but written care plan and development plan reviews were not always completed often enough.
- Well-led?
- Good
- The registered manager promoted person-centred care and independence. There were audits, staff meetings, feedback systems and action plans, although staffing and retention remained an acknowledged issue.
What inspectors found, July 2019
Rated Good overall; inspectors found kind, person-centred care, but safety systems and staffing needed improvement.
The inspection took place over three days in June 2019. It was unannounced on the first and third days, and announced on the second day. Inspectors spoke with people and staff, observed the home, and checked care, medicines, recruitment and management records.
People appeared happy and comfortable and said they felt safe. Inspectors found detailed risk assessments, safe medicines management, kind support and good attention to choice, independence and health needs.
The safe rating fell from Good to Requires Improvement. Inspectors found weaknesses in recruitment, staff retention and some vehicle safety checks. Written care plan reviews and development plan reviews were also not always completed often enough.
The overall rating remained Good. This means the home was judged to provide good care overall, but the safety concerns needed attention and there was limited assurance that all aspects of the service were consistently safe.
Safe medicines
Inspectors found medicines were stored securely, records were current and staff were trained and checked as competent.
“Medicines were managed safely. They were stored securely and records were up to date.” from the report
Kind, individual support
Staff knew how people communicated and supported their individual needs, preferences and feelings.
“Staff knew people well. One staff member spoke with us about how they communicated with one person and recognised alterations in tone and sounds to indicate their different feelings.” from the report
Choice and independence
People were supported to make choices, develop skills, use the community and become more independent.
“The outcomes for people promoted choice and control, independence and inclusion.” from the report
Learning from incidents
Managers reviewed incidents and restraint, shared learning with staff and had evidence of reduced incidents for people with complex behaviour.
“We saw evidence of a reduction in incidents for people with the most challenging forms of behaviour.” from the report
Recruitment checks
seriousThe recruitment process did not always follow the provider's own policy. Inspectors recommended making it more robust.
“We found a lack of rigour with the recruitment process which had not adhered to the provider's own policy.” from the report
Staffing and retention
seriousThere were staff vacancies and staff said there were sometimes too few staff, or not enough experience, on duty. Managers sometimes had to cover shifts.
“Staff told us they felt there were sometimes insufficient staff, both in terms of numbers and experience on duty.” from the report
Care plan reviews
needs fixingWritten care plan reviews were completed irregularly. Development plans were not always reviewed often enough to check progress or make changes.
“Although we found written care plan reviews were sporadically completed, we were aware staff spoke daily about people's changing needs.” from the report
- 01What has changed in the recruitment process since the inspection, including how references and interviews are checked?
- 02How do you make sure there are enough permanent staff with the right experience and skill mix on every shift?
- 03Have all vehicle checks been completed properly, and how are staff concerns about vehicle safety now dealt with?
- 04How often are each person's care plan and development plan reviewed, and how is completion monitored?
- 05How do you ensure all staff receive important information at shift changes, including incidents from earlier shifts?
This was a comprehensive inspection covering all five key questions; it was prompted partly by concerns about staffing, service provision and management. This explanation was written from the published report of 16 July 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, September 2017
Rated Good overall; inspectors found safe, kind care, but some planned community activities were missed.
The inspection was unannounced and took place on 3 August 2017. The inspector observed care, spoke with people, staff, relatives and health professionals, and checked medicines, care records, staff files and other service records.
The home was rated Good overall. Safe, effective, caring and well-led were rated Good. Inspectors found people were safe, medicines were managed properly, staff were trained, and people were treated with kindness, dignity and respect.
Responsive was rated Requires Improvement. Some people who needed two staff to support them in the community did not always receive their planned activities. Some care plans and health action plans also needed updating, although the manager had identified this and was working on it.
The previous inspection in October 2014 rated the home Good overall and Good in every area. This inspection kept the overall Good rating, but the responsive rating fell to Requires Improvement.
Safety and risk management
Staff knew people well and understood how to manage individual risks while still supporting choice and independence. Safeguarding concerns and incidents were recorded, investigated and reviewed.
“People were supported safely by vigilant staff who knew them well.” from the report
Medicines
Medicines were securely stored, given as prescribed and recorded clearly. Inspectors found no recent medicine errors and saw regular checks of medicines and staff competence.
“There was a well organised medicine management system in place and people received their medicines as prescribed.” from the report
Management and oversight
The home had a registered manager and approachable management team. Regular audits and reviews were used to find areas needing improvement.
“Systems were in place to assess, monitor and improve the service.” from the report
Missed community activities
needs fixingSome people who needed two staff to support them outside the home did not always receive planned activities. Staff deployment and the number of car drivers affected this, and records showed some activities had been cancelled.
“Some people who required 2-1 support in the community had not consistently received this support.” from the report
Care records needed updating
needs fixingSome care plans and health action plans were not fully up to date. The manager had recognised this and had an action plan to address it.
“Some updating was needed to some care plans.” from the report
Key worker meetings
needs fixingMonthly meetings to discuss people's goals and review their care had not consistently taken place in recent months. Inspectors said this reduced the home's response to changing needs, views and choices.
“However, we noted these had not consistently taken place in recent months.” from the report
- 01How do you now make sure people receive all their planned community activities when they need two staff or transport?
- 02How many planned activities have been cancelled recently, and what happens when this occurs?
- 03How often are each person's care plan and health action plan reviewed and updated?
- 04Are monthly key worker meetings now taking place consistently, and how are people's goals recorded?
- 05How has the home maintained stability since the change of registered manager and the recent support worker vacancies?
This was an unannounced inspection of the overall service and all five CQC areas, with the overall rating remaining Good but Responsive rated Requires Improvement. This explanation was written from the published report of 2 September 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Longfield House
3 rated inspections over 5 years: the service has held its Good rating throughout.
- July 2019Goodcurrent ratingstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- January 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2013
Report published without a new overall rating.
- February 2013
Registered with the Care Quality Commission on 12 February 2013.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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