Longford is a care home which provides care and support for up to six people who have a learning disability. At the time of our inspection five people were living in the home.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. The registered manager was present on one day of our inspection.

Although people had access to activities, we found that they lacked creativity. The registered manager had already identified this and had commenced work to improve people’s experience in relation to how they spent their time. We also found that people lived in an environment that lacked a homely feel. The registered manager told us they had started to take action in this regard.

Staff had access to the provider’s mandatory training as well as training in subjects relevant to the people who lived in the home. For example, epilepsy or autism.

Where people’s liberty was restricted or they could not make a decision due to their level of understanding, staff followed legal requirements in relation to the Mental Capacity Act. However, some staff did not have a good understanding of the MCA and DoLS.

People were cared for by a sufficient number of staff to enable them to receive the care when they required it, or attend external activities. People’s care records contained detailed information about people’s care and health needs.

Risks to people had been identified and recorded and any accidents or incidents were dealt with by staff appropriately. The registered provider followed good recruitment processes to help ensure only suitable staff worked in the home. Quality assurance checks were carried out to help identify areas that required improvement.

Should people need to be evacuated in the event of an emergency there were arrangements in place to help ensure the continuity of their care. Staff had a good understanding of their responsibility in relation to safeguarding and knew who to report any concerns too.

People’s medicines were handling safely by staff and people received the medicines they had been prescribed as well as those they could have that did not need a prescription. People were supported to access external health care professionals when appropriate.

People were involved in choosing what they ate. People could make their own choices in their care and were treated with care and respect by staff.

Visitors were welcomed into the home and people were supported to maintain relationships that were meaningful to them.

Complaints information was made available to people and complaints were acted upon by the registered manager. People and their relatives were encouraged to give their feedback on the care they received. Staff were involved in the running of the home and felt supported by the registered manager.

During the inspection we made some recommendations to the registered provider.

Longford is a care home which provides care and support for up to six people who have a learning disability, such as autism. At the time of our visit there were six people living at the home.

There was a registered manager in post.

A registered manager is a person who has registered with the Care Quality Commission

(CQC)

to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

The area manager was acting as the manager and had begun the application process to become the registered manager. The registered manager was not present during our inspection and we were assisted by the shift leader, deputy manager and the assistant residential services manager.

Although we found staff treated people in a kind and caring manner, we observed occasions when staff did not treat people with the dignity and  respect they deserved. 

People were safe living at Longford as staff carried out appropriate checks to make sure that any risks of harm were identified and managed. Any risk of harm to people had suitable controls in place. These were done in the least restrictive way. For example, if someone wished to go out of the home.

Where there were restrictions in place, staff had followed legal requirements to make sure this was done in the person’s best interests. Staff understood the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) to ensure decisions were made for people in the least restrictive way. However, we found that staff did not always review decisions which had been made. We have made a recommendation to the provider.

Staff were aware of their responsibilities to safeguard people from abuse and were able to tell us what they would do in such an event.

People’s care would not be interrupted in the event of an emergency and people needed to be evacuated from the home as staff had guidance to follow.   

Staff were provided with training specific to the needs of people. This allowed them to carry out their role in an effective way. It was evident staff had a good understanding of the individual needs and characteristics of people. This was confirmed by relatives and our observations on the day.

There were enough staff deployed in the home. The registered manager ensured people who required one to one care were provided with this at all times. There were enough staff to enable people to go out each day.

People received their medicines in a safe way. People were encouraged to eat a healthy and varied diet and were involved in choosing the food they ate.

Appropriate checks were carried out to help ensure only suitable staff worked in the home.

People were supported to keep healthy and had access to external health services. Professional involvement was sought by staff when appropriate. Relatives told us staff referred people to health care professionals in a timely way.

Staff encouraged people to be independent and to do things for themselves, such as help around the home or do some cooking.

Staff supported people in an individualised way. They planned activities that meant something to people.

Relatives were involved in developing the care and support needs of their family member.

Staff responded to people’s changing needs and encouraged individuals to try different things to give them a varied and stimulating life. 

A complaints procedure was available for any concerns and relatives and people were encouraged to feedback their views and ideas into the running of the home.

Staff had a good understanding of the aims and objectives of the home. The provider and staff carried out a number of checks to make sure people received a good quality of care. 

Staff felt supported by the registered manager and the provider and had the opportunity to meet regularly with each other as a team as well as on an individual basis with their line manager.

During the inspection we found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

A person who used the service told us they liked the home, their room and said the people were alright and let them choose, and that they would tell staff if anyone upset them.

People’s relatives told us that the building and their relative’s room were suitable and always clean. One told us how their relative’s room had been decorated and personalised to their tastes and that their relative loved the home and their room. They also told us the food people cooked was wonderful and there was often a lovely smell of cooking in the home.

People’s relatives explained how the staff were always welcoming, communicated well with them and kept them informed about their relative’s care. They felt their relative was very well looked after, well cared for, cared about, and was safe there.

We found that where people did not have the capacity to consent, the provider acted within legal requirements.

We found that the provider protected people against the risks associated with the unsafe use and management of medicines, by making appropriate arrangements for the obtaining, recording and using, of medicines

We found that although the building was in reasonable decorative condition, hygienic and clean, but the provider had not always taken steps to provide care in a home that was suitably designed and adequately maintained in all areas.

We found that the provider had an effective system to regularly assess and monitor the quality of service that people receive.

We spoke with two of the six people who were living at the service to check and also observed people in communal areas. We spoke with two staff and the manager to help us assess compliance.

We found proper steps had not been taken to make sure people were involved in decisions about care and treatment. This meant there were risks that their rights would not be upheld.

One person told us they had not seen their care plan, another person could not express whether they had or not. We found there was no consistent format for care planning and this created a risk that the care provided would not be consistent.

Staff felt that people’s health and recreational needs were met well.

One person told us, “The staff look after my tablets, it’s ok.” We found people received their medicines as their doctor had prescribed but there was no clear record of how much medication was or should be on the premises. This meant medicines could go missing and this may not be noticed.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

People’s comments and concerns were responded to and action was taken to resolve these to their satisfaction.

There were four people living in the home on the day of our visit. Three of them were out on our arrival undertaking individual activities. Due to people’s communication needs it was difficult to ask people directly about the outcomes within this planned review. It was possible to communicate with one person with the help of a staff member who was supporting him on a one to one basis. He signed that he enjoyed living in the home and was able to point and gesture at activities he likes. He was able to indicate that he was enjoying his food.

Other people on their return to the home were relaxed and confident in their environment and were supported by staff to prepare lunch and communicate to us through sign language that they enjoyed living in the home. One person told us the staff were kind and caring, and helped him to go out to various events and activities.

There were four people living in the home on the day of our visit. Three of them were out on our arrival undertaking individual activities. Due to people’s communication needs it was difficult to ask people directly about the outcomes within this planned review. It was possible to communicate with one person with the help of a staff member who was supporting him on a one to one basis. He signed that he enjoyed living in the home and was able to point and gesture at activities he likes. He was able to indicate that he was enjoying his food.

Other people on their return to the home were relaxed and confident in their environment and were supported by staff to prepare lunch and communicate to us through sign language that they enjoyed living in the home. One person told us the staff were kind and caring, and helped him to go out to various events and activities.