Archived: Longcroft Cottage

Longcroft Cottage provides accommodation and personal care for up to three people living with a learning disability, autistic spectrum disorder and a sensory disability. At the time of our inspection two people were being supported by the service.

People’s experience of using this service:

People were safe. There were enough staff to meet people’s needs. Staff were aware of their responsibilities to report concerns and understood how to keep people safe and we saw risks to people's individual safety and well-being were managed through a positive risk management process.

There were systems in place to manage safe administration and storage of medicines. People received their medicines as prescribed.

People had their individual needs assessed prior to receiving care to ensure staff were able to meet people’s needs. This included people’s emotional and well-being needs. Staff worked with various local social and health care professionals. Referrals for specialist advice were submitted in a timely manner.

People were supported by staff that had the right skills and knowledge to fulfil their roles effectively. This included an in-depth knowledge of people’s individual needs. This ensured their care was personalised and specific to their support requirements. Staff told us they were well supported by the management team.

People were supported to meet their nutritional needs and maintain an enjoyable and healthy diet. People could choose what they wanted to eat, and we saw staff supporting them appropriately.

People were treated with respect and their dignity was maintained. People were also supported to maintain their independence. One person had worked with staff, so they could now walk independently. The provider had an equality and diversity policy which stated their commitment to equal opportunities and diversity. Staff knew how to support people without breaching their rights. The provider had processes in place to maintain confidentiality.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. This meant people were able to pursue activities they enjoyed on a regular basis.

Sufficient staff were consistently deployed to enable people to receive one to one support. This approach allowed people to bond with staff and form positive relationships. Relatives told us people benefitted from these relationships.

Relatives knew how to complain, and a complaints policy was in place. Relative’s input was valued, and they were encouraged to feedback on the quality of the service and make suggestions for improvements.

The service was well-led. Relatives and staff were complimentary of the registered manager and the management team. The registered manager promoted a positive, transparent and open culture where staff worked well as a team. The provider had effective quality assurance systems in place which were used to drive improvement. The provider worked well in partnership with other organisations.

The service met the characteristics of Good in Safe, Effective, Caring, Responsive and Well-led.

At the last inspection in November 2016 the service was rated Requires Improvement in well-Led. We asked the service to make improvements to their quality monitoring systems. At this inspection we found these improvements had been made.

Follow up:

We will monitor all information received about the service to understand any risks that may arise and to ensure the next planned inspection is scheduled accordingly.

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

At the last inspection on 4 August 2015, we asked the provider to take action to make improvements to poor infection control measures, to submit authorisations to the supervisory body for people deprived of their liberty, maintain accurate records and improve medicines administration. In addition, improvements were needed to recruitment procedures and ensuring staff had access to training as well as improving quality assurance processes. The provider sent us an action plan detailing when these improvements would be made. We found this action had been taken.

There was a registered manager in place who was also the provider and nominated individual. 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 2008 and associated Regulations about how the service is run.

Quality assurance systems although in place were not being completed to make sure people and those important to them had the opportunity to give feedback about people’s experience of their care and support. Systems had been developed to audits within the home to ensure that standards and checks were being maintained. These had not yet been carried out with so that improvements could be evidenced.

People’s care was individualised reflecting their personal wishes, likes and dislikes and routines important to them. Their care records were personalised providing clear guidance about how they wanted to be supported. Their communication needs were highlighted and staff had a good understanding of how to promote positive communication. Staff were observed using sign language and said they understood what people were feeling by “their facial expressions.” People at times became anxious or upset and staff knew how to support them to find peace and become calmer.

People enjoyed a range of meaningful activities including carriage driving, swimming and walks around their home. They liked to help out with the chores and recycling and were encouraged to be as independent as they could be. Staff treated them with kindness and respect, reassuring them when needed. People had positive relationships with staff, requesting their company or asking them questions. Staff responded sensitively and professionally. People were supported to make day to day choices and decisions and when needed decisions were made in their best interests in line with the Mental Capacity Act 2005. Deprivation of liberty authorisations had been submitted to keep people safe from harm.

People were supported by staff who had access to training and individual meetings to help them to develop and carry out their roles and responsibilities. Staff said communication was good between them and management. They knew how to keep people safe from harm and would raise concerns with managers if they had any. Systems for the recruitment of staff were satisfactory and there were enough staff to support people.

The registered manager was supported by a manager on a day to day basis. Staff said they could talk through any issues or ideas with the management team at any time. The management team kept up to date with changes in legislation and best practice through support from external organisations. They recognised the challenges of delivering a service whilst resources were being cut but endeavoured to make sure they continued “keeping the girls happy and content. Having a good life within the home and themselves”.

Staff were very happy with the standard of care provided at the home. One staff member told us that people benefitted from 'really good arrangement of activities' and said 'there's always something to go out and do'. All three staff on duty demonstrated understanding of their responsibilities in safeguarding people and could name different forms of abuse they would report. They were unclear about local safeguarding arrangements but knew they could report any concerns to their managers, to us or to the police. We were satisfied that no incidents had occurred at the home that must be reported to us.

We looked at records for the two members of staff who had been employed since October 2010. We found that all required checks had been carried out before new staff started work. We checked a sample of records for all three people living at the home. These were up to date and were detailed in describing the care people required.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences.