This inspection took place on the 31 August and 4 September 2017 and was unannounced.

Longlands provides accommodation for older people requiring support with their personal care and nursing needs. The service can accommodate up to 51 people. At the time of our inspection there were 37 people using the service. The home is divided into three distinct areas which are situated over the two floors of the home. On the first floor there was Pippin area which provided care for older people with complex nursing needs, Minstrel which provided residential care for older people and Jay which provided respite care for older people. On the ground floor Primrose and Kingfisher areas provided residential care for people living with dementia and in Siskin and Harlequin areas respite care was available for people living with dementia. People live in the area that is best suited to their assessed needs.

At the last inspection September 2016 the service was rated as Requires Improvement; at this inspection we found that improvements had been made.

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 2008 and associated Regulations about how the service is run.

People felt safe and there were risk assessments in place which ensured that measures were put in place to mitigate the risk. People could be assured that they were protected from any avoidable harm or abuse. Staff knew how to protect people and recruitment practices ensured that people were cared for by staff that were suitable and safe to support them.

People were cared for by staff that were kind, friendly and attentive to people’s needs. However, at times interaction with people in parts of the home was task focussed. Staff understood people’s needs and preferences. They ensured that people were treated with respect and protected their privacy and dignity.

There were sufficient staff to meet people’s needs and people received their medicines on time. There was a system in place to ensure that medicines were safely administered, stored and disposed of when no longer required.

People were involved in decisions about the way in which their care and support was provided. Staff understood the need to undertake specific assessments where people lacked capacity to consent to their care and / or their day to day routines.

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.

Care plans detailed people’s preferences, likes and dislikes and the plans were regularly reviewed to ensure they remained relevant to meeting people’s needs.

People were encouraged to follow their interests and there was a variety of activities that people could take part in if they wished. Families were welcomed and encouraged to take part in activities with their loved ones.

People’s nutritional needs were being met and people were given a choice as to what they ate and where they ate. Support was available if needed and staff sat with people to help encourage people to eat.

Relatives spoke positively about the care their loved one received. People’s health needs were carefully considered and relevant health care professionals were appropriately involved in people’s care.

Staff were supported through regular supervisions and undertook training which helped them to understand the needs of the people they were supporting. Quality assurance systems and audits were in place which helped to monitor the quality and safety of the service.

There were opportunities for people and their families to share their experience of the home. The registered manager and deputy manager were visible and open to feedback, act

This inspection took place on the 15 and 16 August 2016 and was unannounced.

Longlands provides accommodation for older people requiring support with their personal care and nursing needs. The service can accommodate up to 51 people. At the time of our inspection there were 36 people using the service. The home is divided into three distinct areas which are situated over the two floors of the home. On the first floor there was Pippin area which provided care for older people with complex nursing needs, Minstrel which provided residential care for older people and Jay which provided respite care for older people. On the ground floor Primrose and Kingfisher areas provided residential care for people living with dementia and in Siskin and Harlequin areas respite care was available for people living with dementia. People live in the area that is best suited to their assessed needs.

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 2008 and associated Regulations about how the service is run.

There were not always sufficient staff to meet the needs of people in a timely way and in some areas of the home staff did not have the time to interact with people outside of meeting people’s basic care needs. People’s experience of care differed depending on where they lived within the home.

There were a variety of audits in place that monitored the quality and safety of the service; however these did not identify that on some occasions care staff were task focussed and lacked interaction with people who used the service.

People’s nutritional needs were being met but people did not always feel the standard of the food was consistent and there was sufficient choice.

People received care from staff that were friendly, kind and thoughtful and their right to privacy and dignity respected. Care staff knew how to protect people from harm and people’s health care was carefully considered and relevant health care professionals were appropriately involved in people’s care.

Relatives spoke positively about the care their relative received and felt that they could approach management and staff to discuss any issues or concerns they had. People had care plans which detailed their needs, preferences, likes and dislikes.

Staff were supported through regular supervisions and undertook training which helped them to understand the needs of the people they were supporting. People were involved in decisions about the way in which their care and support was provided. Staff understood the need to undertake specific assessments where people lacked capacity to consent to their care and / or their day to day routines.

There were opportunities for people and their families to share their experience of the home. Management was visible and open to feedback, actively looking at ways to improve the service.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to provide a rating for the service under the Care Act 2014.

The inspection took place on 31 July 2014 and was unannounced, this meant the provider did not know we were going to inspect. The last inspection took place on 13 June 2013 during which we found there were no breaches in the regulations.

Longlands Specialist Care Centre provides nursing and residential care for up to 51 older people, including people living with dementia. On the day of our visit there were 46 people using the service.

There was a registered manager was in post at the time of the inspection. 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 were safe at Longlands Specialist Care Centre and staff knew what to do if they had any concerns about their welfare. Staff had received training on safeguarding adults, the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). They knew how to manage risks to promote people’s safety, balanced with people’s rights to take risks.

A recent judgement by the Supreme Court, could impact on the provider’s responsibility to ensure Deprivation of Liberty Safeguards (DoLS) are in place for some people using the service. The safeguards protect the rights of adults using services by ensuring that if there are restrictions on people’s freedom and liberty they are assessed by professionals who are trained to assess whether the restrictions are needed.

The registered manager knew how to make an application for consideration to deprive a person of their liberty (DoLS). At the time of the inspection there were no people who used the service who were deprived of their liberty and we saw no evidence to suggest that anyone living in the home was being deprived of their liberty.

We found that people were supported by appropriately recruited and trained staff that had the skills needed to carry out their duties. The staff knew the needs of the people they supported and worked in a way so as to promote people’s independence.

People had access to health and social care professionals as and when they needed and prompt action was taken in response to illness or changes in their health.

People told us that they were pleased and happy with the care and support they received at the service. They told us their likes, dislikes and preferences were central to how their care was provided and that the staff respected their choices about all aspects of their lives.

The registered manager and designated staff reviewed the quality of care consistently. We saw that monthly quality management audits were carried out on all aspects of the service, such as people’s care records, staff recruitment records the premises and equipment.

The service encouraged feedback from people using the service and their representatives, to identify, plan and make improvements to the service.

We spoke with six people during our visit to Longlands Specialist Care Centre and they all confirmed they were pleased with the care and treatment they received. One person said “the staff are really brilliant, I can’t fault them in anyway, I have thoroughly enjoyed my stay here” another person said “the staff are very friendly, helpful and polite; they treat me with dignity and respect”.

People who used the service for short stay respite care told us they were able to continue with their daily routines as much as possible and make decisions about their daily lives; such as their choice of food, clothing and personal routines.

We found that staff received regular support from their line managers and training appropriate to their roles and responsibilities. We saw that the provider had appropriate systems in place to regularly monitor and review the quality of the service provision.

At our last inspection we had found that people’s plans of care were disorganised and it was difficult to locate important information about the care and treatment being provided for people using the service. We saw that improvements to the recording of people’s care and treatment and people’s care was being regularly reviewed and updated as and when their needs changed.

During our visit to the service we spoke with 10 people about their experience of using the service. All of the people we spoke with told us the staff respecting their wishes, were polite and asked them about the care they needed and how they would like to be assisted. People said “The staff are brilliant”, “I can only praise the staff, the care they provide is excellent”, “If I were to rate the staff I would give them 10 out of 10, they are very caring, respectful and helpful”

We found that two people were receiving care and treatment for pressure ulceration, however one person did not have a pressure area care plan in place to plan and record the treatment they were receiving. We also found that some care records were disorganised and important information was difficult to locate within the files. This could place people at risk of receiving inappropriate care and treatment.

Some of the people using the service had dementia and were not able to tell us what they thought about their care. As part of our inspection we used our SOFI (Short Observational Framework for Inspection) tool. This is a way of observing interactions with people who find it difficult to communicate verbally, and gives us insight into their experience of care. We spent time watching the support three people using the service received, and used the SOFI tool to record their experiences. We found their experiences were positive; the staff were attentive and responsive to people's individual needs and involved people in conversation, activities and decisions about aspects of their daily lives.

We spoke with six people using the service who were all pleased with the care and support they received. They told us that staff were supportive and we were given examples of how staff had helped people to regain their independence following a hospital admission.