26 April 2023
During an inspection looking at part of the service
Longcliffe Care Home is a residential care home providing personal care to up to 42 older people and people with physical disabillities. At the time of our inspection there were 18 people using the service. The accommodation is over two floors of a large period property with bedrooms on the first floor serviced by a lift. The lift was out of use at the time of our inspection.
People's experience of using this service and what we found
People's medicines were not managed or administered safely. We found a number of medicine errors which had not been identified through the provider audits and which indicated people had not received their medicines as prescribed.
People were not protected from the risk of abuse or improper treatment. People who had made allegations of abuse, or actually experienced abuse, did not receive the support they needed in a timely way. The provider had not taken timely preventative action, including escalating safeguarding concerns to relevant external agencies. This placed people at significant and prolonged increased risk of harm. The provider did not consistently ensure all staff were suitably qualified, competent, skilled and experienced to be able to meet people's needs. People had confidence in most staff but felt other staff were not as willing or able to meet their needs.
The provider had quality assurance processes in place, but these were not used effectively to assess, monitor and improve the service. Audits and checks had failed to make sustainable improvements and we were concerned that full oversight had not been established. Concerns we identified at this inspection had not been identified by the provider's own systems. This is the sixth consecutive rated inspection where the provider has failed to meet regulations and achieve a good rating as a minimum standard.
People were protected from the risk of infections. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. We observed people being offered choice during both days of inspection, and people told us they were offered choice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 14 January 2023) and there was a breach of Regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.
Why we inspected
The inspection was prompted in part by notification of an incident following which a person using the service sustained a serious injury. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk of safeguarding people from abuse and improper treatment. This inspection examined those risks.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for this service has changed from requires improvement to inadequate based on the findings of this inspection.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement and Recommendations
We have identified breaches in relation to safe care and treatment, safeguarding people from abuse and improper treatment, staffing and good governance.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
The overall rating for this service is ‘Inadequate’ and the service is in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this time frame and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.