CQC report explained · a residential care home
What the CQC found at Longwood Gardens
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found suitable safeguarding procedures, enough staff, personalised risk assessments, safe medicine management and steps to reduce infection risks. They recommended better routine checks of money held for people because minor discrepancies were found.
- Effective?
- Good
- People's needs were assessed before care started. Staff had ongoing training and supervision, people could make choices, and people were supported with food and access to health professionals.
- Caring?
- Good
- People said staff treated them with respect and were caring. Inspectors saw positive relationships and found that staff supported privacy, dignity, independence, equality and confidentiality.
- Responsive?
- Good
- Care plans were personalised and regularly reviewed. People were supported to take part in activities they chose, and the complaints procedure was available in written and pictorial formats.
- Well-led?
- Good
- A registered manager and two deputy managers were in place. Inspectors found audits, meetings and surveys to check quality and gather views, and said the previous quality-monitoring breach had been addressed.
What inspectors found, February 2019
Rated Good; inspectors found safe, kind and personalised care, with minor money-checking and record issues to address.
The inspection was unannounced and took place on 15 January 2019. One inspector spoke with three people and four staff, observed care, and checked care records, medicine records, staff files, policies and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicine arrangements, suitable training, respectful care, personalised care plans and activities in the home and community.
The home had improved since January 2018, when it was rated Requires Improvement and breached two regulations. Those earlier safety and quality-monitoring problems had been addressed. Inspectors made one recommendation about checking money held for people, and also found a few smaller record and maintenance issues.
Safe medicines
Medicine records were complete and stock records matched the medicines held. Medicines were stored securely with daily temperature checks.
“Medicines were stored securely in locked cabinets, each of which was temperature controlled and the temperatures were checked and recorded daily.” from the report
Respect and dignity
People described staff as respectful, friendly and caring. Inspectors saw people relaxed with staff, who supported privacy and independence.
“People told us staff treated them in a respectful way and that they were caring.” from the report
Personalised support
Care plans covered individual needs and were reviewed. People were supported to choose activities in the home and community.
“Care plans were in place which set out how to meet people's needs in a personalised way, based on the needs of the individual.” from the report
Improved management
The home had introduced audits and other checks after earlier concerns about quality monitoring. People, relatives and staff were asked for their views.
“Various quality assurance and monitoring systems were in place to check on the quality and safety of care provided.” from the report
Safeguarding contact details
needs fixingThe safeguarding procedure listed the contact details of a neighbouring local authority rather than the authority responsible for the home. Managers said they would correct this.
“the safeguarding adult's procedure gave the contact details of a local authority that was adjacent to the one in which the service was located.” from the report
Bathroom flooring
minorThe home was mostly clean, but the upstairs bathroom floor covering was stained. Managers agreed it needed replacing.
“The service was mostly clean, with the exception of the floor covering in the upstairs bathroom which was stained.” from the report
- 01How often do you now check money held for residents, and how are discrepancies recorded and investigated?
- 02Have you corrected the safeguarding procedure so it gives the correct local authority contact details?
- 03Has the stained upstairs bathroom floor covering been replaced?
- 04Has the hospital passport with unsuitable information been updated?
- 05How will you make sure the improvements found since the January 2018 inspection continue?
This was an unannounced inspection covering the premises, care and all five CQC questions; the provider could not complete its Provider Information Return because of technical problems. This explanation was written from the published report of 1 February 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, March 2018
Rated Requires Improvement; inspectors found kind, personalised care but important safety and management systems were not reliable.
This was an unannounced inspection on 31 January 2018. It was the first inspection since the home was registered in April 2017. Inspectors spoke with two people and six staff, reviewed three care records, checked medicines and staff records, and examined safety and quality systems.
Inspectors found enough staff, suitable recruitment checks, personalised care plans and support for activities. People said staff were kind and respectful. The home was rated Good for Caring and Responsive.
There were important problems with medicines, fire safety, infection control, food storage and incident reviews. The systems used to check quality had not found these issues. The home was rated Requires Improvement overall, and also Requires Improvement for Safe, Effective and Well-led.
Enough suitable staff
Inspectors found staffing levels matched people's assessed needs. Recruitment checks included references, identification and criminal records checks.
“There were enough staff working at the service to meet people's needs and pre-employment checks were carried out on staff to help ensure they were suitable to work at the service.” from the report
Kind and respectful care
People said staff treated them well. Inspectors observed kind interactions and found staff understood privacy, dignity and independence.
“We observed staff interacting with people in a kind and caring manner and people were seen to be at ease and relaxed in the presence of staff.” from the report
Personalised activities
People were supported with activities such as swimming, shopping, bowling, cinema visits and cafes. The activity timetable was presented in a pictorial format.
“This showed activities were individualised for each person.” from the report
Support for health needs
The home worked with health and social care professionals. Records showed people attended appointments and received support with health checks.
“The service worked with other agencies to promote people's health, safety and wellbeing.” from the report
Fire and infection safety
seriousThe fire risk assessment was out of date, several doors did not close properly and water systems had not been tested for legionella. Cleaning was not recorded or monitored.
“This meant that steps to prevent the spread of fire may not have been effective if a fire broke out” from the report
Medicines management
seriousOne medicine had been given without guidance about when to use it. Medicines were not stored in a temperature-controlled environment, and one staff member did not check the medicines chart before giving medicines.
“We also found that the medicines were not stored in a temperature controlled environment and that the temperature of the storage area was not checked to ensure medicines retained their effectiveness of purpose.” from the report
Quality checks missed risks
seriousThe home's monitoring systems did not identify several safety problems, including the outdated fire assessment, medicine storage issue and missing legionella checks.
“However, quality assurance and monitoring systems were not always operated effectively to mitigate the risks relating to the health, safety and welfare of people using the service” from the report
Capacity and consent records
needs fixingMental capacity assessments had not been recorded. Some medicine consent forms and care plans had not been signed by people or their representatives.
“However, mental capacity assessments had not been recorded and although consent forms where in place to give consent to support with medicines these had not always been signed.” from the report
Incomplete assessments
needs fixingSome pre-admission assessments were incomplete and did not include information about people's sexuality. Inspectors recommended that the assessment forms be improved.
“Further, we saw that none of the assessments included information about people's sexuality.” from the report
- 01What action have you taken to make sure medicines are stored at the correct temperature and given only with clear instructions?
- 02How do you now check fire doors, fire risk assessments and water systems for legionella?
- 03How do you record and review accidents and incidents so that repeated risks are identified?
- 04How are mental capacity assessments and consent for medicines and care recorded now?
- 05Have you replaced the Common Induction Standards with the Care Certificate for new staff?
This was an unannounced inspection covering all five CQC questions, with the premises and care inspected; it was the first inspection since registration in April 2017. This explanation was written from the published report of 29 March 2018 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 Longwood Gardens
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- February 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2018Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2017
Registered with the Care Quality Commission on 6 April 2017.
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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