Archived: Longridge Hall and Lodge

Updated 27 February 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection team consisted of two adult social care inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service, in this case, older people.

Service and service type:

Longridge Hall and Lodge is a care home. People in care homes receive accommodation and nursing or personal care. 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:

The inspection was unannounced.

What we did:

Prior to our inspection we looked at all of the information we held about the service. This included any safeguarding investigations, incidents and feedback about the service provided. We looked at any statutory notifications that the provider is required to send to us by law. We also looked at the Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also contacted professionals who provided feedback about their experiences of the service. We used a planning tool to collate all this evidence and information prior to visiting the service.

We spoke with eight people who lived at the service and three relatives. We also spoke with the temporary cook, four support workers, a night manager, an activity coordinator, two deputy manager's and the registered manager. We looked at a variety of records which included the care records for six people who lived at the service, medicine records for three people who lived at the service and three staff recruitment and training files. We also reviewed a variety of records relating to the operation and monitoring of the service.

Updated 27 February 2019

About the service:

Longridge Hall and Lodge is a residential and dementia residential care home that was providing personal care to 54 people at the time of the inspection.

People's experience of using this service:

The provider failed to consistently ensure individual risk's for people who lived at the service had been assessed and this placed them at significant risk of avoidable harm.

The provider failed to consistently ensure that people who lived at the service had comprehensive and person centred care plans to guide staff supporting them.

People who lived at the service and staff told us that they felt staffing levels were not always sufficient to meet people's needs in a person centred way. On the day of the inspection we observed staff respond to people in a timely manner however, we listened to people's feedback about staffing and the high use of agency support workers meant that a consistent approach to support and engagement with people who lived at the service had been negatively impact on. The provider demonstrated how they had recently reviewed recruitment procedures to try and encourage more people to apply for job vacancies. Staff recruitment was safe.

Systems were in place to guide staff about how to deal with any allegations of abuse. However, we found accidents were not always fully investigated and this placed people at risk of avoidable harm.

People were protected by the prevention and control of infection.

The management of people's medicines was safe and effective.

Pre-admission assessments were not always detailed and the information collated was not always communicated to the staff team. This meant that known risks for individuals were not always effectively mitigated.

There were shortfalls in evidence to show that staff had been provided sufficient training. Staff told us that they had received mandatory training however, from our observations and from the feedback we received it was clear that the service needed to ensure staff were retrained in area's such as moving and handling, understanding dementia and record keeping.

The provider did not always ensure people's consent to care and treatment was sought in line with the Mental Capacity Act 2005.

We have made a recommendation about involving people in decisions made about their care.

Consideration had been given to menu planning following feedback from people who lived at the service in relation to the types of food available. The provider showed they had listened to people's feedback and made changes in line with their preferences. Record keeping in relation to people's nutritional and hydration intake had recently improved.

People who lived at the service and their representatives told us that they felt confident to raise their concerns and the registered manager was responsive.

We observed staff interact with people who lived at the service in a respectful and caring manner. Across both days of the inspection we observed residents laughing and enjoying the company of staff that supported them and other residents.

We received positive feedback from a visiting professional who told us that the service provided a good standard of care for people at the end of their life. The professional also told us that staff were responsive to changes in people's needs.

We have made a recommendation about end of life care.

There was a system in place for assessing quality and monitoring outcomes for people who lived at the service however, we found that it was not always effective. The service was not consistently well led.

More information is in the Detailed Findings below.

Rating at last inspection:

This was the first inspection at Longridge Hall and Lodge since the registered provider had changed in February 2018. This meant that any previous inspections or enforcement would not be considered.

Why we inspected:

This inspection was planned.

Enforcement:

Please see the 'action we told the provider to take' section towards the end of this report.

Follow up:

The overall rating for this service is requires improvement. The provider is expected to submit an action plan to show how they will make improvements within a suitable time scale.

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