Archived: Longmore Nursing Home

Updated 3 August 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

One inspector, an expert by experience and a specialist advisor undertook the inspection. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service. A specialist advisor is a qualified health professional. Our specialist advisor was a qualified nurse who had particular expertise in supporting older people.

Service and service type

Longmore Nursing home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we held about the service since the last inspection. We sought feedback from commissioners who work to find appropriate care and support services for people and fund the care provided. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We used the information to plan our inspection.

During the inspection

We spoke with two people and three relatives to gather their views of the service. We also spoke with the registered manager, one deputy manager, the provider, the maintenance person, the cook, one nurse, the activities coordinator and three care assistants.

We observed the care and support provided and the interaction between people and staff throughout our visit. We reviewed three people's care records to ensure they were reflective of their needs. We looked at a sample of people’s medicine administration records. We reviewed records relating to the management of the service such as quality audits, complaints and people's feedback. We reviewed two staff files to check staff had been recruited safely.

Updated 3 August 2019

About the service

Longmore Nursing Home is a care home. It provides personal and nursing care for up to 22 older people in one building. At the time of our inspection 21 people lived at the home.

People's experience of using this service and what we found

People felt safe living at the home and safeguarding procedures were in place to protect people from harm.

Staff were recruited safely, and enough staff were on duty to provide safe care during our visit. People felt staff had the skills they needed to support them effectively.

People and relatives spoke positively about the way staff administered their medicines. However, previously demonstrated standards of medicines management had not been maintained. We found staff did not always follow safe administration practices. Immediate action was taken in response to our findings.

Quality assurance processes were not always effective to drive forward improvement. Checks had not identified the issues we found. The registered manager understood their responsibility to be open and honest when things had gone wrong. They welcomed our inspection feedback and took immediate action in response to the issues we found.

People, relatives and staff spoke highly of the registered manager and the positive culture they created. Whist people confirmed they could talk to the managers at any time we found more could be done to engage people. People and relatives felt comfortable raising concerns with staff and managers at the home.

People's needs were assessed before they moved into the home to make sure it was the right place for them to live. Care plans demonstrated the inclusion of people and those closest to them which helped staff to provide personalised care. However, plans had not always been updated when people’s needs had changed.

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. However, whilst staff understood the importance of offering people choices we saw this did not always happen in practice.

People and relatives spoke positively about the level of care they received. People were encouraged to be independent. Care was provided in a dignified way and people’s right to privacy was respected. Staff received training to support people as they neared the end of their lives.

The home environment met people’s needs. Plans were in place to refurbish the conservatory area to benefit people. The home was clean and tidy, but the management of risk related to infection control required improvement.

People were provided with information in a format they could understand, and signage helped people to locate their way around the home. Overall, people were satisfied with the social activities provided to occupy their time.

People liked the food. However, staff did not support some people to eat their meals in the best way possible. People confirmed they had access to health professionals when needed to maintain their health and wellbeing.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 17 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to the safety and the governance of the home at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.