The inspection visit took place on 16, 22 and 25 January 2018. This was an unannounced inspection which meant that the staff and provider did not know that we would be visiting. We last inspected the service on 20 November 2015 and found the provider was meeting the fundamental standards of relevant regulations. At that time we rated Longlast as ‘Good’ overall and ‘good’ in four domains. We rated the service as ‘Outstanding’ in one domain, namely 'well-led’.
Longlast 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. Longlast can accommodate up to 11 people in one building and provides care for people living with a learning disability. At the time of the inspection nine people were in receipt of care from the service.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
The registered manager had been in post since 2006. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
We found staff were committed to delivering a service which improved the lives of the people who use the service in fulfilling and creative ways. Their drive and passion had created an exceptionally dynamic and vibrant service. Staff focused totally on the goals and aspirations of the people who used it and relatives told us the service provided care that was exceptional. Social workers we spoke with told us Longlast give careful consideration to ensuring people were a compatible match to existing residents. They provided high levels of care and support in a family type environment with lots of opportunities for social integration away from the home.
Staff worked collaboratively with people to assist them to ensure their voices were heard by healthcare professionals. Staff went over and above the expectations for residential care homes when people needed to stay in hospital and would provide individuals with one-to-one support from 8am to 10pm throughout their stay. The service was making a difference to people’s wellbeing by working well as a team, in harmony with one another sharing the same values and principles. The service was proactive in providing people with a range of information to assist them to make decisions about their health and wellbeing.
Staff were exceptionally caring and understood how to support and enable individuals to maximise their potential. The service's visions and values promoted people's rights to make choices and live a dignified and fulfilled life. This was reflected in the care and support that people received. Staff understood people's different ways of communicating and how to make people feel valued.
We found that the registered manager had encouraged staff to constantly think about improvements. We found that the management style had led to people who used the service and staff feeling that they were integral and essential partners in the operation of the service. People made the key decisions about who was employed, menus, the décor and the range of activities.
We found the registered manager had provided strong leadership and constantly critically reviewed the service. They routinely identified how they could enhance the service and ensure the staff remained at the forefront of best practice when working with the people who used the service. Their oversight of the service and encouragement of staff to keep abreast of developments and be innovative had led to excellent outcomes for the people who used the service and their relatives.
We observed that people were encouraged to participate in activities that were meaningful to them. People were supported to develop their independent living skills. We heard how one person had recently moved into the service and had been extending the range of activities they could complete. Staff told us that this person was becoming more confident and had learnt a variety of new skills. Staff took on dedicated roles for sourcing and setting up both activities people could do at the service and in the community. People were exceptionally complimentary about the staff.
We saw people’s care plans were person centred and had been well assessed. People’s care needs were risk assessed with risk management plans in place and support for staff when they needed it. We found staff ensured the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS) requirements were met.
People were supported to be as independent as possible and could access advocacy services if needed. Procedures were in place to investigate and respond to complaints.
We saw that staff were recruited safely and were given appropriate training before they commenced employment. Staff told us they received supervision on a monthly basis and they received annual appraisals. Staff were respected within the organisation and were provided with comprehensive range of training. We found the senior management team were consistently striving for excellence and assisting people and staff to reach their maximum potential. Staff were supported to achieve excellence in their roles by attending specialist training around working with people who had specific conditions.
There were sufficient staff on duty to meet the needs of the people and the staff team were very supportive of the registered manager, the providers and of each other.
Medicines were stored and administered in a safe manner and staff were appropriately trained.
The registered manager used effective systems to continually monitor the quality of the service and had on-going plans for improving the service people received. The provider gathered information about the quality of their service from a variety of sources including people who used the service, their family and friends and external agencies. This was used to enable the provider to identify where improvement was needed and to sustain continuous improvement in the service.
The registered manager had informed CQC of significant events in a timely way by submitting the required notifications. This meant we could check that appropriate action had been taken.