Longlea Nursing Home

The service had a registered manager. 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 and associated Regulations about how the service is run.

We previously inspected the service on the 19 and 20 May 2016. Following our visit the service received an overall rating of 'requires improvement' with a rating of 'good' in the key question is the service caring. We found there were no records to show what actions had been taken by the service when people had sustained unwitnessed injuries. The service's safeguarding policy was not updated and did not provide staff with the necessary information to handle suspected abuse or unwitnessed injuries. The service did not ensure there were sufficient staff to provide care and support to people at night time. The service did not have sufficient suitably qualified, skilled and experienced staff to meet people's care needs in the absence of the registered manager. There was no structured support for new staff that required additional help whilst undertaking the induction programme and people's social needs were not always being met. After our visit we asked the provider to complete an action plan with a date when they would be compliant. The provider submitted the action plan by the required timescale and informed us improvements would be made by November 2016.

During this visit we found the service had made improvements in all areas previously identified.

People received safe care, treatment and support from staff who were aware of their safeguarding responsibilities. Appropriate action was taken when unexplained injuries occurred and there were sufficient staff to provide care for people during the day and at night. Medicines were administered and handled safely.

People received care from staff who were appropriately inducted, supervised and appraised. The service sought consent from people in line with current guidance and legislation. People were supported to have a well-balanced diet and had access to health services and on-going health care support in order to maintain good health.

Positive caring relationships were formed between staff and people who used the service. People expressed their views and were involved in making decisions about their care. People's privacy and dignity was respected and promoted. The service sought people's wishes and preferences in regards to end of life care.

People received personalised care that was responsive to their needs. The service responded to people's social well-being in order to prevent them from being isolated. People and relatives knew how to raise

concerns and felt they could confidently do this if they needed to. We have made a recommendation for the service to ensure all relevant external agencies contact details are placed in their complaints policy and 'resident's guide'.

People who used the service, relatives and staff felt the service was open and inclusive. Comments received included, "Management are very good and approachable" and "They (management) are most definitely supportive. They are approachable, we have no closed doors." People received care from a service that ensured its staff members' supervision and leadership were met. The service acted upon feedback received to improve on the quality of the service provided. Quality assurance systems were in place to monitor the quality of service being delivered and the running of the home.

The five questions we ask about services and what we found