CQC report explained · a nursing home
What the CQC found at Longmead Court Nursing Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, May 2021
Longmead Court Nursing Home was rated Good; inspectors found clear improvements from the previous inspection, with kind care and safer systems in place.
This was an unannounced follow-up inspection on 26 April and 4 May 2021. Inspectors spoke with staff and relatives, observed care, and reviewed care records, staff recruitment files and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines practice, good infection control, detailed care plans and kind, respectful care.
The home had previously been rated Requires Improvement, with breaches relating to staffing, nutrition, care planning and quality checks. Inspectors found enough improvement had been made and that the home was no longer in breach of regulations.
Infection control
The home had systems to reduce the risk of infection and was facilitating visits in line with guidance.
“There were systems in place to manage infection control. The service was clean and comfortable and there were no unpleasant odours.” from the report
Personalised care plans
Care plans gave staff detailed information about people's health, preferences, communication and daily care.
“Care plans had been rewritten and were highly personalised.” from the report
Kind and respectful care
Inspectors saw calm, gentle interactions. Relatives also spoke positively about the kindness and patience of staff.
“People were treated with dignity and respect and interactions were kind and caring.” from the report
Management oversight
The manager was visible, knew people well and used audits and meetings to monitor care and improve communication.
“The registered manager was visible within the service and knew each person well.” from the report
Activities and family contact
People could take part in group and individual activities, and the home offered different ways for relatives to stay in contact.
“Activity coordinators were employed within the service. They organised a variety of events in the communal area which people could attend as well as individualised activities on a one to one basis.” from the report
Staffing during unexpected changes
minorStaff said staffing was usually sufficient, but an unplanned absence or a sudden change in people's needs could reduce the time available for people.
“Staff spoken with told us there was enough staff, unless there was an unplanned staff absence or people's needs changed suddenly.” from the report
Some rooms needed more personalisation
minorSome rooms were personalised, but inspectors recorded that others needed more work. The manager agreed to take this forward as an action.
“Some rooms had been highly personalised, but others would benefit from further personalisation.” from the report
Outstanding legal applications
needs fixingWhere people were being deprived of their liberty, applications had been made, but some were still awaiting progress with the local authority.
“The registered manager told us they were working with the local authority to progress outstanding applications.” from the report
- 01How do you maintain staffing levels when there is an unplanned absence or when a person's needs change suddenly?
- 02Which rooms still need more personalisation, and what has been done since the inspection?
- 03Are all outstanding deprivation of liberty applications now progressing or authorised?
- 04How will you keep families informed about changes in a person's health or care needs?
- 05How often are care plans reviewed with the person and their family?
This was an unannounced follow-up inspection after the previous Requires Improvement rating, including a review of infection prevention and control and the five key questions. This explanation was written from the published report of 15 May 2021 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, November 2019
Rated Requires Improvement; inspectors found risks around staffing, nutrition, personalised care and management.
This was an unannounced inspection on 1 and 3 October 2019. The inspection team spoke with staff, relatives and a visiting professional. They reviewed care plans, medicines records, staffing information, recruitment files and quality checks.
The home was generally clean and some staff were kind. People had access to health professionals, medicines were mostly managed satisfactorily, and complaints were investigated promptly. However, care was often task-focused rather than personalised.
Inspectors found that staffing levels and the use of agency staff affected care. People did not always get enough help with food, drinks, personal care or activities. Records and checks did not reliably show that people's needs and risks were being managed.
The overall rating and all five question ratings were Requires Improvement. The home was rated Good at the previous inspection, published in April 2017. The new manager had been in post for three weeks and had an improvement plan, but the provider needed to make significant changes.
Healthcare links
People were supported to access several health services. Inspectors found good links with specialist teams and the local surgery.
“The GP visited the home every week and staff told us that they had a good working relationship.” from the report
Medicines records
The medicines checked, including controlled drugs, matched the records. Staff were positive about the recently introduced electronic medicines system, although audits needed strengthening.
“We checked a sample of medicines including controlled drugs against the records and saw that they all tallied.” from the report
Complaint handling
Written complaints were taken seriously and investigated promptly. The home had also received compliments and thank-you letters.
“We saw evidence that where written complaints had been received they had been taken seriously and investigated promptly.” from the report
Recruitment checks
The required checks were completed for new staff before appointment, including identity, criminal records and references.
“Checks on staff suitability were undertaken on all new staff prior to their appointment.” from the report
Kind interactions
Inspectors saw individual staff members showing comfort and patience towards people, although this was not consistent across the home.
“Individual staff were observed to be kind and caring in their interactions with people.” from the report
Staffing levels
seriousStaff were not always available when people needed help. The high use of agency staff affected continuity and care, and inspectors said this put people at risk.
“The shortfalls in staffing put people at risk and demonstrated a breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Risk management
seriousSome risks were not assessed or managed properly. Inspectors found gaps involving distressed behaviour, epilepsy, repositioning, equipment checks and monitoring after head injuries.
“Risks were not always assessed and managed effectively to reduce the risks of harm.” from the report
Personalised care
seriousCare plans were not always current or detailed, and daily records did not reliably show that personal care and other planned support had happened.
“People did not always receive person centred care which met their needs” from the report
Activities and stimulation
needs fixingActivities were limited and records did not show regular participation. Inspectors saw many people sitting disengaged or asleep, creating a risk of isolation.
“People had limited access to interesting and meaningful activities to promote their wellbeing.” from the report
Leadership and oversight
seriousThere was no registered manager and quality checks had not picked up or resolved important problems. Some electronic alerts had remained outstanding for several days.
“The systems in place to oversee quality were not effective as they had not identified when support was not being delivered in line with best practice.” from the report
- 01How many permanent staff are now on each shift, and how do you make sure people are supported when agency staff are used?
- 02How do you now monitor people's food, fluid intake, weight and access to drinks?
- 03How are care plans kept up to date, and how do you check that planned personal care and repositioning have happened?
- 04What meaningful activities are available for people living with dementia, and how is participation recorded?
- 05What progress has been made with the action plan, the registered manager application and the appointment of a deputy manager and clinical lead?
This was an unannounced comprehensive inspection covering all five CQC questions, with the home rated Requires Improvement in each area. This explanation was written from the published report of 9 November 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.
Every inspection of Longmead Court Nursing Home
4 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- May 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2017Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- September 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 31 December 2010.
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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