We carried out a review of the data available to us about Longrun House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Longrun House, you can give feedback on this service.
Longrun House is a residential care home providing personal care for up to 17 people who have a learning disability and physical disability. There were 15 people living at the home at the time of the inspection.
People’s experience of using this service and what we found
Communication with relatives needed to be improved. This had also been raised in the recent relative’s survey as an area for improvement. It was clear the relationship with three parents needed to be improved and trust regained.
People were safe at the home. They were comfortable and relaxed with the staff who supported them. Lessons were learnt, and changes made, when things went wrong.
Eleven relatives thought the home was a safe place for their family members to live; they had no concerns about people’s safety. Two relatives had concerns about some aspects of safety which they had discussed.
Staff knew how to recognise and report concerns about possible abuse.
Risk assessments were used to ensure people received safe care and support according to their individual needs. Risks to people’s physical health had been considered and planned for.
There were adequate numbers of staff to keep people safe and meet their needs. There was consistent staffing and that staff were allocated to specific duties each day at the handover meeting when the shift began. Ten relatives were happy with how staff were allocated and with consistency of staffing. Three relatives were not happy with this.
People received their medicines safely and at the right time. Medicines were stored safely, including medicines which required refrigeration. There were suitable arrangements for ordering, receiving and disposal of medicines. People were protected from catching and spreading infections.
The service was well-organised, with clear lines of responsibility and accountability. There was honesty and accountability when things went wrong.
There was a clear structure within the staff team ensuring staff understood their own roles and responsibilities. Staff had high confidence in the management team.
Ten relatives had confidence in the management of the home and in the provider. Three relatives did not have complete confidence in the service and had made their concerns known.
Audits, surveys and observations were used to try to improve the care and facilities for people; where shortfalls were identified action was taken to make sure improvements were made.
Staff morale and teamwork were good. Staff were positive, energetic and engaged with people, treating them with kindness, dignity and respect.
Staff worked in partnership with other professionals, such as speech and language therapists and GPs to make sure people’s individual needs were met.
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.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, Right Care, Right Culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People were at the centre of their service and had high levels of staff support so they could lead fulfilling lives. Staff treated each person with dignity, respect and as an individual, respecting their abilities, choices and human rights.
Right support:
• Model of care and setting maximises people’s choice, control and independence
Right care:
• Care is person-centred and promotes people’s dignity, privacy and human rights
Right culture:
• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives
Rating at last inspection
The last rating for this service was good (published 1 March 2019).
Why we inspected
We received concerns in relation to staffing numbers, how staff were allocated and the involvement of people’s relatives and communication with them, including when they raised any concerns with the service. As a result, we undertook a focused inspection to review the key questions of ‘Safe’ and ‘Well-Led’ only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
We found no evidence during this inspection that people were at risk of harm from these concerns. However, it was evident that communication with people’s relatives needed to be improved.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Longrun House on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Longrun House is a residential home that consists of two units. The main house accommodates ten people and The Lodge accommodates seven people. The home specialises in providing care to younger adults who have a learning disability, physical disability and/or sensory impairments. The home is staffed 24 hours a day. The home has a range of aids and adaptations in place to assist people who have mobility difficulties and all bedrooms are for single occupancy. Longrun House has links into the local community, and access to a range of facilities such as a full-sized Hydrotherapy pool and interactive sensory room that are situated within the grounds of the home.
At the time of the inspection there were 16 people living at Longrun House. The people we met had very complex physical and learning disabilities and not all were able to communicate with us verbally. We therefore used our observations of care and our discussions with staff, relatives and professionals to help form our judgements.
The home 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.
There was a registered manager in post. 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.
People living at Longrun House told us they felt safe. Staff understood how to recognise and report signs of abuse or mistreatment. Safeguarding and whistleblowing policies and procedures were available for staff to access.
Detailed risk assessments were carried out to ensure people could make choices and keep their independence. This also included environmental risk assessments such as fire maintenance and safe use of water outlets.
Recruitment processes minimised the risk of employing unsuitable staff. There were sufficient numbers of staff available to keep people safe and support people when they displayed behaviours that challenged.
People’s medicines support needs were clearly identified and staff delivered medicines in a personalised way. Staff were trained and competent to administer medicines.
Staff had received training on infection control, although we did find some concerns regarding the cleanliness of the home which the provider responded to immediately. Staff knew the reporting process for any accidents or incidents. Lessons learned were shared with staff through their electronic system and regular discussions.
People received effective care and support from competent and well-trained staff. Formal supervision and appraisals were not carried out regularly but staff felt supported by the management team in their roles and said they could ask questions when they needed to.
We observed meal times and the food looked nutritious and was cooked using fresh ingredients. Although the menus only gave one choice, people did confirm they could have an alternative if they didn’t like what was on the menu. Where needed, other professionals were contacted for specialist guidance and support to meet people's needs. Care records showed staff shared information effectively with professionals and involved them appropriately.
The provider was working within the principles of the Mental Capacity Act 2005 (MCA). Although we did observe one staff member restricting one person’s movement when we arrived at the home and had to discuss this with the registered manager.
Staff treated people with kindness, respect and compassion and care plans gave guidance on how to communicate appropriately with people. The home did not display information for people and visitors to the service on how to officially make a complaint but people told us if they had concerns they could talk to staff and they felt confident that any concerns would be taken seriously.
Records showed people had their needs assessed before they moved in to the home. People and their family members were invited to formal reviews of people’s care and staff encouraged people to access their community when they wanted to.
The leadership was visible and accessible. There was a management structure in place, which gave clear lines of responsibility and accountability. People spoke highly of the staff and management team. The providers approach to quality assurance included the completion of an annual survey. There were quality assurance arrangements in place to raise standards and drive improvements within the home although some of these checks needed more management oversight to ensure they were fully effective.