The home is registered as Longley Health Care Limited but is known as Longley Park View. The home is registered to provide accommodation and nursing care for up to 59 people who may be living with dementia, have mental health difficulties and whose behaviours may also challenge. The home has four units over two floors, accessed by a passenger lift. The home is purpose built and situated in a residential area of Sheffield, close to local amenities and transport links. The home has a garden and car park.

At the time of this inspection the home was undergoing a major refurbishment and one unit was closed to accommodate this.

There was a manager at the service who was registered with Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

Our last inspection at Longley Park View took place on 19 July 2016. We found two breaches in the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, in regard to Regulation 18: Staffing and Regulation 19; Fit and proper persons employed. The registered provider sent an action plan detailing how they were going to make improvements. At this inspection we checked improvements the registered provider had made. We found sufficient improvements had been made to meet the requirements of Regulation 18: Staffing, as staff had been provided with regular supervision in line with the registered providers policy. We also found sufficient improvements had been made to Regulation 19: Fit and proper persons employed, as records were in place to show the registered provider had obtained all of the required information for each person employed.

This inspection took place on 21 August 2017 and was unannounced. This meant the people who lived at Longley Park View and the staff who worked there did not know we were coming. On the day of our inspection there were 41 people living at Longley Park View.

People spoke positively about their experience of living at Longley Park View. They told us they felt safe and they liked the staff.

Staff were aware of safeguarding procedures and knew what to do if an allegation was made or they suspected abuse.

Shortfalls in the systems for the proper and safe management of medicines had been identified and were being dealt with. Some aspects of these systems required further improvement.

Risk assessments were in place that identified risk and the actions required of staff to mitigate these risks. Systems would be more robust if records clearly detailed the support provided was in line with this.

Sufficient numbers of staff were provided to meet people’s needs.

Staff were provided with relevant training, supervision and appraisal so they had the skills they needed to undertake their role.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The registered provider’s policies and systems supported this practice.

People had access to a range of health care professionals to help maintain their health. A varied diet was provided, which took into account dietary needs and preferences so people’s health was promoted and choices could be respected.

Staff knew people well and positive, caring relationships had been developed. People were encouraged to express their views and they were involved in decisions about their care. People’s privacy and dignity was respected and promoted. Staff understood how to support people in a sensitive way.

A programme of activities was in place to provide people living at the home with a range of leisure opportunities.

People living at the home said they could speak with staff if they had any worries or concerns and they would be listene

The home is registered as Longley Health Care Limited but is known as Longley Park View. The home is registered to provide accommodation and nursing care for up to 67 people who have mental health difficulties and whose behaviours may also challenge. The home has four units over two floors. One unit on the first floor is dedicated to supporting people living with dementia.

The registered manager of the service left three months prior to this inspection. 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.

A temporary manager had been in post since 6 June 2016. The registered provider was recruiting a permanent manager who would register with us.

Our last inspection at Longley Health Care Limited took place on 3 July 2014. The home was found to be meeting the requirements of the regulations we inspected at that time.

Prior to this inspection we received significant concerns about the home. We spoke with healthcare professionals from Sheffield and Doncaster local authorities who had identified these concerns. In response the registered provider implemented a voluntary suspension on all new placements of new people at Longley Health Care Limited on 15 June 2016 until improvements to the service had been made.

This inspection took place on 19 July 2016 and was unannounced. This meant the people who lived at Longley Health Care Limited and the staff who worked there did not know we were coming. On the day of our inspection there were 52 people living at Longley Health Care Limited.

People we were able to speak with told us they felt safe.

Relatives we spoke with said they had no concerns about the service.

We found systems were in place to make sure people received their medicines safely.

Staff recruitment procedures were not always fully completed. Gaps in staff recruitment records meant potential risks to people’s safety had not been considered.

Staff were provided with relevant induction and training to make sure they had the right skills and knowledge for their role. Staff understood their role and what was expected of them. They told us they were well supported by the new temporary manager and morale had significantly improved.

Staff were not consistently provided with supervision for development and support.

The service followed the requirements of the Mental Capacity Act 2005 (MCA) Code of practice and Deprivation of Liberty Safeguards (DoLS). This helped to protect the rights of people who may not be able to make important decisions themselves.

People had access to a range of health care professionals to help maintain their health. A varied diet was provided for people which took into account dietary needs and preferences so their health was promoted and choices could be respected.

Relatives said they could speak with staff if they had any worries or concerns and they would be listened to.

We found activity workers were employed to improve people’s choice of activity.

Systems to monitor and improve the quality of the service provided had been reviewed and changes implemented so that monitoring would be effective. These need to be sustained to ensure the service was well led. Regular checks and audits were being undertaken to make issues were identified and acted upon. People using the service and their relatives had been asked their opinion via questionnaires. The results of these had been audited to identify any areas for improvement.

We found two breaches in the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were breaches in regulation 18: Staffing and 19; Fit and proper persons employed.

You can see what action we told the provider to take at the back of the full versio

Two adult social care inspectors carried out this inspection. At the time of this inspection 52 people were living at Longley Health Care Limited. We spoke with six people living at the home and three of their relatives to obtain their views of the support provided. We used both formal and informal observation throughout our inspection. This was because some people were not able to tell us about their experience of living at the home due to dementia or other health difficulties. In addition, we spoke with the manager, the clinical nurse manager, four nurses, eight care staff, an activity worker and the head of housekeeping about their roles and responsibilities.

We gathered evidence against the outcomes we inspected to help answer our five key questions; is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People supported by the service told us they felt safe. Staff had been provided with training in safeguarding people and relevant policies were in place to promote people’s safety. Staff were aware of the procedures to follow if they suspected abuse or if an allegation was made.

People told us they felt their rights and dignity were respected.

Appropriate systems were in place to safely manage the storage and administration of medications so people’s health and safety was promoted.

Systems were in place to make sure managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

We found risk assessments had been undertaken to identify any potential risk and the actions required to manage the risk. This meant people were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made and how to submit one. This meant people would be safeguarded as required.

Is the service effective?

People’s health and care needs were assessed with them and their representatives, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People’s preferences and interests had been recorded and care and support had been provided in accordance with people’s wishes.

Staff were provided with training to ensure they had the skills to meet people’s needs. Whilst some areas of the home were dedicated to supporting people with a diagnosis of dementia, training in dementia awareness had not been provided to staff to ensure they had the skills and knowledge to support people. Staff were provided with formal individual supervision to ensure they were adequately supported and their performance was appraised.

Visitors confirmed they were able to see people in private and visiting times were flexible.

Is the service caring?

We asked people using the service and relatives for their opinions about the support provided. Feedback from people was positive, for example, “they (staff) are all right, I can talk to them”, “the staff are good” and “they (staff) are always welcoming and keep me up to date about (my relative). My (relative) is unrecognisable since they have been here, they are so much better”.

Observations showed that people’s needs were met by staff in a patient and kind manner.

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

Is the service responsive?

People regularly completed a range of activities both inside and outside the service.

People spoken with said they had never had to make a complaint but knew how to make a complaint if they were unhappy. We found appropriate procedures were in place to respond to and record any complaints received. People could be assured that systems were in place to investigate complaints and take action as necessary.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

The service had a quality assurance system, records seen by us showed identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure people received a good quality service at all times.

We used both formal and informal observation throughout our inspection. This was because some people were not able to tell us about their experience of living at the home due to dementia or other health difficulties. Our observations enabled us to see how staff interacted with people and see how care was provided. We also reviewed a range of records and spoke with two people, one relative, five members of staff and the home manager.

Our inspection also included checking that improvements had been made to meeting people’s nutritional needs.

The direct care observed during our inspection was appropriate and took people’s individual needs into account. Care plans and other associated documents reviewed were detailed and in place for each identified are of need.

We found that people’s nutritional needs were met. We saw that people’s weight was monitored and that specialist advice was sought when needed.

We noted that people’s rooms were homely and personalised with their own belongings. We reviewed a number of documents relating to the safety and suitability of the premises and found these to be appropriate.

We found that there was an effective process to ensure that employees were of good character and held the necessary checks and qualifications to work at the home. We also found that there was an appropriate system in place to gather, record and evaluate information about the quality and safety of care provided by the home.

We reviewed seven care plans and found that people and /or their relatives had consented and been involved in decisions about their care and treatment. Staff within the home had a clear understanding of the processes they would follow in order to assess capacity and to ensure any decisions made for people who lacked capacity were made in their best interest.

People were generally pleased with the support they received at Longley Park View. One person stated, “it’s a good home and the staff are good to you and do whatever you ask.” We saw that the direct care provided was safe, appropriate and took people’s individual needs into account. We saw that care plans were in place for each identified area of need and noted that these were reviewed each month.

Our observations and conversations with staff identified that there were not enough staff to meet people’s needs during lunchtime on the Firth Park unit. The service was non compliant with this outcome area as a result of these observations. We saw that staff were visible and available on this and other units throughout the rest of our inspection.

We saw that people benefited from equipment that was used safely and met their needs.

We saw that there were policies and procedures in place to investigate and respond to complaints. We reviewed the complaints received during the past year. Most of these had been investigated in accordance with the provider's complaints policy and timescales.

People with dementia are not always able to tell us about their experiences, so we used a formal way to observe people in this inspection to help us understand. We call this the ‘Short Observational Framework for Inspection (SOFI). It included observing people’s mood, how they interacted with staff members and other people who used the service and their environment.

The home had four units. We completed the SOFI observations on the Ecclesfield Unit (downstairs) and the Firth Park Unit (upstairs).

The SOFI observation told us that overall people who used the service on the first floor had a positive experience using the service. We saw where people were engaging with staff that people were smiling, content and relaxed, indicating a positive mood state. In the main, people were awake and alert and watching was happening around them. We did not see any facial expressions or body language that would indicate signs of unhappiness, distress or anxiety or fear, indicating a negative mood state.

However, the SOFI on the ground floor showed that people’s experiences were in the main of a neutral experience, though it must be acknowledged the care provided to people on the ground floor was more complex and it was more difficult to communicate with people living on that floor. This means that most of the time there were no obvious signs of positive mood, as on the first floor.

When staff interacted with people there were good interactions. For example, all staff treated people with respect along with a well meaning and kind approach. Staff members demonstrated warmth to people through smiling, touch and language. We saw staff in the main, explaining what they were going to do when they needed to provide care for people, for example, applying an apron to protect people’s clothing whilst they were eating. We saw that staff were patient with people and offered people choices.

Staff members promoted engagement with people who used the service and interacted with people throughout the majority of the observation on the first floor. On the ground floor, there wasn’t as much engagement with people using the service, but this was more about the complex needs of people and the numbers of staff available rather than staff not engaging with people using the service. We saw staff providing activities such as reading a newspaper, chatting to people and playing bingo.