CQC report explained · a residential care home
What the CQC found at Longlands
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Some risks were not clearly recorded and checks were not always recorded as completed. Temporary agency staff affected how well staff knew people and how quickly some support was provided, although medicines, safeguarding and infection control were found to be safe.
- Effective?
- Requires improvement
- Mental capacity assessments, consent records and best-interest decisions were not always complete or legally correct. Care plans and records of health appointments, oral care and personal support also needed improvement.
- Caring?
- Good
- People described staff as kind and caring. Inspectors saw positive interactions, and found that staff promoted privacy, dignity, independence and people's choices.
- Responsive?
- Good
- People received personalised care and choices about their routines, food, clothes and activities. Communication needs were recorded, activities were offered and complaints were well managed, although some care plans lacked personal history and some end-of-life plans needed more detail.
- Well-led?
- Requires improvement
- Management systems did not reliably keep records, care plans and risk assessments complete and up to date. Relatives and staff gave mixed views about feedback and information sharing.
What inspectors found, December 2022
Rated Requires Improvement; inspectors found kind and responsive care, but important safety, records and management systems were not reliable enough.
This was an unannounced inspection on 31 October and 3 November 2022. Inspectors spoke with five people, five relatives and 11 staff. They reviewed care records, medicines records, staff files and management records.
People were protected from abuse and medicines were handled safely. The home was clean and homely. People described staff as kind and caring, and said they had choices about their care, activities and daily routines.
However, risk assessments and care plans were sometimes missing information or out of date. Records did not always show that safety checks, personal care, oral care or health follow-up had happened. The use of temporary agency staff also affected continuity and information sharing.
The overall rating was Requires Improvement. Safe, Effective and Well-led were rated Requires Improvement. Caring and Responsive were rated Good. The home breached Regulation 17 because its oversight systems did not reliably identify and manage risks.
Kind and respectful staff
People said staff were kind and caring. Inspectors saw positive interactions and found that staff respected privacy and dignity.
“People told us the staff supporting them were kind and caring.” from the report
Safe medicines practice
Staff had suitable medicines training and understood how to administer medicines. Records showed when medicines were given and why.
“People received their medicines safely, by staff who had received adequate training and understood best practices to administer medicines to people.” from the report
Choice and activities
People had choices about their daily routines, care, meals and activities. Activities were offered throughout the day and people said they enjoyed them.
“People told us they had choice and control over the care provided.” from the report
Clean, homely environment
The home was clean and homely, with personalised bedrooms and several communal areas.
“The environment was homely and well presented.” from the report
Safeguarding and infection control
Staff understood how to recognise and report abuse. Inspectors were assured about infection prevention, personal protective equipment and visiting arrangements.
“People were protected against abuse.” from the report
Incomplete risk records
seriousSome risk assessments did not explain the risks or the steps staff should take. Records did not always show that safety checks or thickener instructions had been followed.
“Risks were not consistently recorded with identified strategies in place.” from the report
Care and health records
needs fixingCare plans contained missing or conflicting information. Records did not consistently show that personal care, oral care or follow-up after health appointments had happened.
“Records did not consistently evidence people's needs and choices were being met.” from the report
Mental Capacity Act records
seriousSome capacity assessments, consent records and best-interest decisions were missing or completed incorrectly. CQC recommended a review of staff training and understanding.
“Not all people had mental capacity assessments or best interest decisions completed for relevant decisions.” from the report
Agency staff and continuity
needs fixingPeople and staff said the amount of temporary agency staff affected waiting times, record keeping and how well staff knew people. The provider was recruiting permanent staff.
“Staff told us, temporary staff did not always have time to read people's care plans.” from the report
Weak oversight and communication
seriousManagement systems did not reliably identify and fix concerns. Relatives reported inconsistent updates about health and appointments, and some people, relatives and staff said they were not asked for feedback.
“Systems and processes were not effective in ensuring documentation was in place and kept up to date.” from the report
Water temperature checks
seriousSome recorded water temperatures were too high and there was no recorded action to reduce the possible scalding risk. The registered manager contacted maintenance during the inspection.
“Water temperatures were at times recorded as too hot and therefore presented a scalding risk.” from the report
- 01What has changed since the inspection to make sure risk assessments contain clear instructions and completed safety checks are recorded?
- 02How do you check that care plans are complete, consistent and updated after health appointments or changes in need?
- 03How many temporary agency staff are currently being used, and how do they learn about each person's care and moving needs before providing support?
- 04How are mental capacity assessments, consent and best-interest decisions now checked for legal accuracy?
- 05How will relatives receive regular updates about health concerns, appointments and changes in wellbeing?
This was an unannounced first inspection of the whole care home, covering all five key questions and infection prevention and control; the previous provider's service had been rated Good in April 2020. This explanation was written from the published report of 7 December 2022 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, April 2022
Inspected but not rated; inspectors found strong infection prevention and control arrangements.
This was an unannounced, targeted inspection on 24 January 2022. It focused on infection prevention and control during the COVID-19 pandemic, and asked about staffing pressures.
Inspectors found that staff had infection control training and checks of their practical skills. Staff used protective equipment correctly, the home was cleaned regularly, and testing and risk assessments were in place.
People could keep in touch with family and friends through several visiting rooms and outdoor areas. The home was inspected but not rated, so this report does not give an overall judgement on the full range of care.
Staff infection control
Staff had infection prevention training and their ability to put on and remove protective equipment was checked. Protective equipment was used and disposed of safely.
“People were supported by staff who had received infection prevention and control (IPC) training, had their competencies assessed and reviewed regarding donning and doffing.” from the report
Clean environment
Inspectors found regular cleaning throughout the day, including of frequently touched areas. The home appeared clean and had no unpleasant smells.
“The service was cleaned to a high standard, cleaning of all areas including high touch areas had been completed regularly throughout the day.” from the report
Oversight of infection control
The registered manager carried out regular checks of infection control arrangements. Testing was provided for people, staff and visitors in line with government guidance.
“The registered manager completed regular IPC audits to maintain oversight and ensure correct procedures were in place and being completed.” from the report
Contact with families
People had ways to meet friends and family safely, including several visiting rooms and outdoor areas.
“People were supported to stay in contact with friends and family. The service had multiple rooms for visiting and external areas to meet outside.” from the report
Inspectors raised no specific concerns in this report.
- 01How are you currently managing staffing pressures linked to COVID-19, and what effect has this had on care?
- 02How often are infection prevention and control audits carried out now, and what happens when an issue is found?
- 03How do you currently test people, staff and visitors for infections?
- 04How do you support a new resident to self-isolate safely when needed?
- 05What visiting arrangements are currently available for relatives?
This was an unannounced targeted inspection of infection prevention and control and COVID-19-related staffing pressures; it did not assess the other four key questions or provide an overall rating. This explanation was written from the published report of 27 April 2022 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 Longlands
Each visit the CQC has published, newest first, back to the day the home was registered.
- December 2022Requires improvementcurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2022Inspected but not ratedSafe: Inspected but not rated
- April 2021
Registered with the Care Quality Commission on 1 April 2021.
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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