Longley Hall Ltd is a supported living service supporting adults with a learning disability and/or autism. At the time of our inspection 15 people were living at the service. People lived in their own flats, which contained en suite facilities and people had access to a shared lounge, kitchen and garden. The service worked in line with the principles of Right care, Right support, Right culture. We expect providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it. We carried out an assessment of this service on 1 August 2024 to 5 August 2024. This assessment was to follow up on previous enforcement action we had taken against the service. Previously we were concerned about people’s safety, relating to managing risks, staffing and a lack of governance systems in place. During this assessment, we found that significant improvements had been made. Risks posed to people were now assessed and mitigated, people were supported by enough suitably qualified staff and governance systems were in place. People were safeguarded from the risk of abuse. Medicines were safely managed, and people received their medicines as prescribed. Care records were person centred and contained details about peoples likes, dislikes, goals and aspirations. Staff were dedicated to providing personalised support to people and people had been supported to become more independent. Staff were kind and caring in their interactions with people. The service was well led, staff told us they felt supported in their roles and we received positive feedback about how the registered manager had made improvements at the service.
PDF cached but not yet analysed by Claude; set ANTHROPIC_API_KEY and re-run npm run etl:reports -- --location 1-479579484.
Longley Hall Limited, a supported living and domiciliary care service for people with learning disabilities and autism in Sheffield, was rated Requires Improvement overall following an April 2023 inspection, with three regulatory breaches identified covering safe care and treatment (Reg 12), staffing support and training (Reg 18), and good governance (Reg 17, subject to Warning Notice). Historically poor oversight and inconsistent leadership had allowed significant shortfalls in care records, staff training, safeguarding monitoring and governance to develop, though a new manager appointed in February 2023 was driving improvement recognised by staff, relatives and external professionals.
Concerns (13)
criticalCare planning: “Staff did not have access to up-to-date and accurate information to provide safe care and support...assessments and supports plans had not been reviewed for some time.”
criticalRecord keeping: “Information about people's assessed risk were in some cases unclear due to conflicting information in their care records. Some staff we spoke with were not aware of people's assessed risks.”
criticalIncident learning: “Systems to monitor accidents and incidents were not effective and did not promote learning. Audits did not fully consider any emerging trends or themes to reduce the risk of reoccurrence.”
criticalSafeguarding: “The provider's systems to monitor safeguarding concerns had lapsed in 2022, but this had recently been re-established to ensure managers and leaders had oversight of all concerns.”
criticalStaff training: “Approximately less than half of all support workers employed at the service had been trained on epilepsy awareness, autism awareness, challenging behaviour, mental health awareness.”
criticalSupervision / appraisal: “In 2022 we saw staff had received 1 supervision out of the 6 required by the provider's policy.”
criticalGovernance: “Systems were either not in place or robust enough to demonstrate quality and safety was consistently well-managed. This placed people at an increased risk of harm. Breach of regulation 17.”
criticalLeadership: “Inconsistencies in leadership led to serious shortfalls in the provider's quality assurance processes...processes to identify risk and ensure the service was operating within the scope of regulations had not been effective.”
moderateMedication management: “During the inspection we found 2 instances where medicines had not been safely stored...People's medicine support plans did not promote safe and personalised support as these had not been reviewed.”
moderatePerson-centred care: “Some staff were not following people's positive behaviour support plans to ensure they followed all preventative and reactive strategies to enhance people's quality of life.”
moderateCommunication with families: “One professional said, 'It can be a little challenging to get any updates from staff members about people when reviewing (their care and support). Often staff don't know much about the person.'”
moderateStaff competency: “The service supported people with a learning disability and/or autism, yet only half of the staff were trained in this area.”
minorInfection control: “We found built up dirt and grime in shared bathrooms, kitchens, food cupboards and fridges.”
Strengths
· Sufficient staffing levels deployed to meet people's needs, recently increased with a business case to further improve night-time arrangements.
· Most staff appeared to know people well and understood their support needs despite gaps in documentation.
· Safe recruitment procedures in place including pre-employment checks, references and DBS certificates.
· Provider used the Positive Behaviour Support (PBS) model with detailed proactive and reactive strategies where assessed.
· People supported to have maximum choice and control and to access the community as and when they wished.
Quality-Statement breakdown (13)
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongRequires improvement
safe: Using medicines safelyRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionRequires improvement
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Supporting people to eat and drink enough to maintain a balanced dietRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawRequires improvement
effective: Ensuring consent to care and treatment in line with law and guidanceGood
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirements; Continuous learning and improving careRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringRequires improvement
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staff; Working in partnership with othersRequires improvement