The inspection of Longroyds & Pilling House Care Home took place on 7 September 2016 and was unannounced. At the last inspection on 28 April 2014 the service met all of the regulations we assessed under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. These regulations were superseded on 1 April 2015 by the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The service provides accommodation for persons who require nursing or personal care (without nursing) for up to 52 older people, some of whom are living with dementia or other mental health problems. The service is located in two separate houses; Longroyds can accommodate up to 18 people and Pilling House up to 28 people. There are also five flats and one bungalow next to Pilling House which can accommodate up to six people. Both Longroyds House and Pilling House have adequate outdoor areas for recreation and parking. The overall feeling of the location is one of a small 'hamlet' with two converted old mill owner's houses, a converted stable block and views across rolling countryside.

The registered provider was required to have a registered manager in post. On the day of the inspection there was a manager that had been registered and in post for over 15 years. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 protected from the risk of harm because the registered provider had systems in place to detect, monitor and report potential or actual safeguarding concerns. Staff were appropriately trained in safeguarding adults from abuse and understood their responsibilities in respect of managing potential and actual safeguarding concerns. Risks were also managed on an individual and group basis to minimise the risk of injury or harm.

The premises were safely maintained and there was evidence in the form of maintenance certificates, contracts and records to show this. Staffing numbers were sufficient to meet people’s needs and we saw that rosters corresponded with the staff that were on duty on the day of the inspection. Recruitment policies, procedures and practices were carefully followed to ensure staff were ‘fit’ to care for and support vulnerable people. We found that the management of medication was safely carried out.

People were cared for and supported by qualified and competent staff that were regularly supervised and had their personal performance appraised. Communication was effective, people’s mental capacity was appropriately assessed and their rights were protected. Staff were knowledge about and understood their roles and responsibilities in respect of the Mental Capacity Act 2005 (MCA). Staff understood the importance of people being supported to make decisions for themselves. The regional manager explained how the service worked with other health and social care professionals and family members to ensure a decision was made in a person’s best interests where they lacked capacity to make their own decisions.

People received adequate nutrition and hydration to maintain their health and wellbeing. The premises were suitable for providing care to older people, and to people living with the early stages of dementia, but not for those people living with a more advanced dementia. This was acknowledged by the registered provider.

We found that people received compassionate care from staff that were kind. Staff knew about people’s needs and preferences and met these. People were involved in all aspects of their care and were always asked for their consent before care and support tasks were undertaken.

People’s wellbeing, privacy, dignity and independence were monitored and respected and staff

This was a scheduled inspection, which also followed up on our last visit in which two areas were non-compliant.

• Supporting workers.

• Records.

The inspection visit was carried out by two inspectors. During the inspection, they spoke with the regional manager, administrator, a team leader, two care staff and the activities co-ordinator. We also spoke with four people who lived at the home and two relatives. The inspectors also looked around the premises, observed staff interactions with people who lived at the home, and looked at records.

We considered all the evidence we had gathered under the outcomes we inspected.

We used the information to answer the five key questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well led?

This is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service, their relatives and the staff told us.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People were cared for in an environment that was clean and hygienic.

People were treated with respect and dignity by the staff.

Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

One person who used the service said, “I feel safe.”

Is the service effective?

We looked at four people’s care records, we saw their individual needs were assessed thoroughly and care and support was developed from an assessment of their needs.

We saw a programme of supervision was in place for staff.

We saw there were plans in place to ensure mandatory training requirements were met.

Is the service caring?

People were supported by kind and attentive staff who obviously knew people well. We saw that care assistants were patient and encouraging when supporting people.

People’s preferences, interest and needs had been recorded and care and support had been provided in accordance with people’s wishes.

One visitor told us, “The staff are all nice. They can’t do enough for us and mum loves them too.”

Is the service responsive?

People had access to activities and were supported to maintain relationships with their friends and relatives.

We saw from the care records that people’s needs had been assessed before they moved into the home. The care, treatment and support provided at the home met their individual needs.

Is the service well-led?

The registered manager has been in post since 2011.

We saw that the senior management team were developing more robust quality audits and taking action to improve the service for people.

The service acted upon comments and suggestions made at service user meetings.

On the day of our inspection there were 39 people living at the home. During our inspection we spoke with the registered manager, regional manager, activities co-ordinator, housekeeper, a kitchen assistant, three people living at the homes, two visitors and a care assistant. We also observed lunch in both dining rooms. People were provided with suitable and nutritious food and drink.

The manager explained that the maximum number of residents the home could accommodate was actually 46. This was because six larger rooms in Pilling House were originally for two people and the home now used them for single occupancy.

We looked round the two homes and saw that the accommodation was clean, tidy and generally well-maintained. We noted some areas that were in need of repair; the manager told us they were aware of these and that refurbishments at the homes were ongoing. We looked in six people’s bedrooms in the two houses and saw that people’s bedrooms had been personalised and contained items such as photographs and soft toys. People appeared well-dressed and well cared-for.

We looked at four people’s care records and saw their individual needs were assessed thoroughly and care and support was developed from an assessment of their needs.

The activities co-ordinator we spoke with told us, “I’m a big advocate for this place; it’s a privilege to work here. I’ve worked at a lot of care homes and this one is very good.”

One person who uses the service said "If I needed assistance I’d go and find some staff. My clothes are washed for me and I chose what I want to wear and the carers help me to get dressed".

During our visit we found evidence that showed staff training was not currently up to date. We also noted that some people’s care records were not up to date and fit for purpose. We have asked the provider to make improvements in these areas.

During our inspection we spoke with five people who used the service and a relative. People told us they were happy living at the home. Comments included;

“Staff are very good, some more than others. The majority are helpful.”

“It’s good to have the company.”

“I have a visit from the optician and the doctor when I need one.”

“I am quite happy living here.”

A visitor told us they came to the home regularly and said the staff were caring and looked after their relative well.

People told us they were offered a choice of food at meal times. People told us that the cook gave out the mid-morning drinks and asked everyone what they would like for their lunch. One person said; “The food is plain but good, and it’s up to you where you have your meal. I choose to eat in my room.”

No-one raised any concerns with us during our visit. The people we spoke with said if they were not happy they would tell the staff.

One person said, “I have never had to complain. I know what I would do and that is go to the manager.”

Some people living at the home had complex needs and were not able to verbally communicate their views and experiences to us.

Some people told us they were visited by the staff before they came into the home and their care was agreed.

People said the staff were alright and they felt looked after, but there was not always enough going on during the day. One person said, “I’m a bit fed up. I’m not doing anything, am I?”

People who use the service are protected from abuse, or the risk of abuse and staff know the procedure to follow.

Staff were observed providing support in an unhurried way, and they confirmed there were sufficient staff to meet the needs of people in their care.

The NHS Kirklees Infection Prevention and Control Team recently carried out an audit of the home and a score 93% was achieved.

Achievements by the home include:

‘Scores on door’ 5 star rating, food hygiene award which is a national award, awarded by the council.