Longwood Lodge Care Home

Longwood Lodge is a care home located in Oldham and can accommodate up to 40 older people. The home is operated by Longwood Lodge Care Limited. At the time of this inspection, there were 37 people living at the home.

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

Some improvements were required to ensure medicines were given safely. During the inspection, we identified concerns regarding medicines given with food, PRN (when required) plans, stock levels and the storage of some medicines. Records regarding topical creams and drink thickeners also needed to be improved. Audits were carried out to check medicines were managed safely, however they did not provide a focus on the areas of concern identified during the inspection.

People said they felt safe living at the home as a result of the care they received. Staff were recruited safely, and staffing levels were sufficient. Appropriate infection control procedures were in place and relevant safety checks of the building and equipment were carried out.

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.

There were systems in place to seek feedback from staff, relatives and people living at the home, through meetings and satisfaction surveys. The home also had good links within the local community and worked in partnership with a number of different organisations.

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

Rating at last inspection

This last rating for the service was good (Published July 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements with regards medication and governance of the service. Please see the safe and well-led sections of this full report. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Longwood Lodge on our website at www.cqc.org.uk.

The overall rating for the service is requires improvement. This is based on the findings at this inspection.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to medication and governance 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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

The provider had policies and procedures in place to ensure staff followed effective infection control guidance, while considering the impact on people living at the service. Staff, visitors and people had access to personal protective equipment (PPE) and stock was plentiful. Staff wore PPE in line with current guidance.

Visiting professionals were required to show a negative lateral flow test and evidence of COVID-19 vaccination status. Visiting arrangements were robust and in accordance with the most recent government guidance. The provider had implemented systems to ensure people maintained contact with their relatives when they were unable to visit the home. Social distancing was observed wherever possible and staff had completed training in infection control and COVID-19.

Guidance around the home on how to use PPE and maintain good hand hygiene was plentiful but not intrusive to areas of the home people used. Staff and people using the service were tested regularly for COVID-19. The home was very clean throughout and the management team had good oversight of the increased cleaning measures in place.

At our last inspection in May 2016 we rated the service good overall, although we found one breach of the Health and Social Care Act. This was because the required Deprivation of Liberty Safeguards (DOLs) were not in place. At this inspection we found improvements had been made and the service was no longer in breach of the regulations. We found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Systems remained in place to help safeguard people from abuse. Staff had a good understanding of safeguarding procedures, how to identify signs of abuse and what action they would take to protect people in their care. Risk assessments had been completed to show how people should be supported with everyday risks, such as risks with their mobility.

Recruitment checks had been carried out on all staff to ensure that they were suitable to work in a care setting with vulnerable people. There were sufficient numbers of appropriately trained staff on duty to respond to people’s needs promptly. Staff received regular supervision which ensured that the standard of their work was monitored.

The home was well-maintained, clean and decorated to a good standard. There were effective infection control and prevention measures within the service. Checks and servicing of equipment, such as for the gas, electricity and hoists were up-to-date.

Medicines were safely administered by staff who had received appropriate training. The service had recently introduced an electronic medicines management system which enabled the management team to have clear oversight of how staff administered medicines and helped easily identify medicines errors.

The service was working within the principles of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS).

Staff interacted with people in a warm and caring way and respected people’s privacy and dignity when supporting them. Staff worked closely with health and social care professionals to ensure people were supported to maintain good health. People were supported to eat a well-balanced diet and were offered choice and variety. Meals were provided by an external catering company and cooked on site by the kitchen staff.

The service operated an electronic care documentation system. Care plans and risk assessments were person-centred, and reflected the needs of each individual.

The service had a formal process for handling complaints and concerns. We saw that complaints had been dealt with appropriately.

There was strong, committed leadership from the registered manager and home owners and staff told us they felt supported by the management team. Audits and quality checks were undertaken on a regular basis to ensure standards were maintained and any issues or concerns addressed with appropriate actions.

Provide a brief overview of the service (e.g. Type of care provided, size, facilities, number of people using it, whether there is or should be a registered manager etc).

N.B. If there is or should be a registered manager include this statement to describe what a registered manager is:

‘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.’

Give a summary of your findings for the service, highlighting what the service does well and drawing attention to areas where improvements could be made. Where a breach of regulation has been identified, summarise, in plain English, how the provider was not meeting the requirements of the law and state ‘You can see what action we told the provider to take at the back of the full version of the report.’ Please note that the summary section will be used to populate the CQC website. Providers will be asked to share this section with the people who use their service and the staff that work at there.

We saw that the provider had implemented a computerised care management system. Staff had received training on operation of the system and it was now used to maintain peoples' personal details and the records of all aspects of their care. For example, their care plans, risk assessments, daily notes and vital observations.

The programme automatically scheduled a monthly review of each person's care records and a visual prompt appeared in the manager's diary as a reminder the task was due. Each member of staff had a password to enter the system and this created an audit trail.

The provider had systems in place to ensure that they were able to act in accordance with any advance decisions a person had taken about their care or the handling of their affairs.

The provider had a policy in place in relation to the Mental Capacity Act 2005 which provided some instruction and guidance to staff on compliance. Arrangements were in place for staff to attend training on the subject.

A relative of one person living at the home told us that they were 'absolutely confident that [their relative] was being looked after and that their needs were being met'. A member of staff told us that the provider 'really does put the residents first'.

One person living at the home told us the meals were 'very good' and said that they thought there was a good variety of food on the menus.

Staff told us that people living at the home had responded positively to the programme of refurbishment work that was taking place. One care worker said that the provider 'really does put the residents first and there have been vast improvements to the home'.

Staff spoke positively about their work. One said the provider rightly had 'very high standards' and that they were 'well supported' by management in carrying out their role.

We looked at the care records of four people living at the home and we found that some were not accurate.

We spoke with three people staying at the home, two care assistants, the manager and the owner. People receiving a service were unable to tell us in detail about their experiences of living there but one person said 'The staff are very nice, you can have a banter with them' and 'I like it here. When I first came here, I couldn't walk. I am walking now'.

People confirmed their privacy and dignity were respected. They told us they were satisfied that their health care needs were met.

One person told us they had seen their care records and another person said 'If I am unhappy about anything I tell someone about it and they [the staff] sort it out.'

Staff told us they were trained and felt supported to do their job

We saw that the furniture and fittings in the home were being renewed. People told us they were happy with the improvements being made.