Archived: Langdale House Care Home

Updated 25 April 2018

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

This unannounced comprehensive inspection took place on 6 March 2018 and was undertaken by one inspector and one expert-by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed information we held about the service including statutory notifications. A statutory notification is information about important events that the provider is required to send us by law.

We sought feedback from commissioners that monitored the care and treatment of people using the service. We also contacted Healthwatch for their information about the service. Healthwatch is a consumer organisation that has statutory powers to ensure the voice of the consumer is strengthened and heard by those who commission, deliver and regulate health and care services.

As part of this inspection, we spent time with people who used the service talking with them and observing support; this helped us understand their experience of using the service. We observed how staff interacted and engaged with people who used the service during individual tasks and activities.

During our inspection, we spoke with three people who used the service. We also spoke with the manager, a senior care worker, a member of care staff and a representative from the provider.

We reviewed records relating to the care of three people, medicines records and storage, the minutes of resident meetings and staff meetings. We also reviewed three staff recruitment records, staff training records, management audits and health and safety checks completed by the provider and arrangements for managing complaints.

Updated 25 April 2018

Langdale House Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. Langdale House is registered to accommodate up to 12 people with needs including a diagnosis of mental health, older people and people who are living with dementia; at the time of our inspection, there were 8 people living in the home.

At our last comprehensive inspection on 30 November 2016, we rated the service as requires improvement. The service was rated as requiring improvement in the Responsive and Well-led domains. This was because care plans were not always current and up to date, systems in place to monitor the service were not accurate and people sometimes had to wait for care.

At this inspection we found the service remained requires improvement. This is the third time the service has been rated as requires improvement.

The inspection took place on the 6 March 2018 and was unannounced.

A registered manager was not in post at the time of the inspection. 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. There was a manager in place. The manager told us they would be applying to become the registered manager.

Risks to people were assessed and monitored regularly. However, the information included in the assessment was not always based on guidance from a health professional.

People were not always protected from the risk of infection. The premises were not maintained and presented a risk to people who used the service.

Staff were not always appropriately recruited. Checks to ensure they were suitable to work with people had not always been completed before they started work.

The quality of the service was monitored through limited audits carried out by the management team and provider. These had not been effective at identifying the areas of concern we found.

People felt safe when they were receiving care from staff. Staff understood their roles and responsibilities to safeguard people from the risk of harm.

There was clear guidance for staff about how to support a person if they became aggressive.

There were sufficient staff to meet people’s needs. Although people sometimes had to wait for staff support if the staff did not hear them calling for assistance.

People were supported to take their medicines as prescribed. Staff who administered medicines had not always received training to ensure they were competent.

People's health and well-being was monitored by staff and they were supported to access health professionals.

People were cared for by a staff team who were friendly, caring and compassionate. Positive relationships had been developed between people and staff. People were treated with kindness.

People's care and support needs were monitored and reviewed to ensure care was provided in the way they needed. People had been involved in planning their care.

Plans of care were in place to guide staff in delivering consistent care and support in line with people’s personal preferences and choices. These were being reviewed and updated, however did not always reflect people's current needs or up to date guidance. End of life wishes were discussed and plans put in place.

Staff did not always have access to the supervision and training they required to work effectively in their roles. The manager told us they were working to develop more detailed staff training. People were supported to maintain good health and nutrition.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the home supported this practice. There were limited activities available for people. Family and friends were welcomed to visit.

The service was run by a manager who had only recently started their role on a full time basis. They planned to review the service and identify areas for improvement. They had not done this at the time of our inspection. The service aimed to develop a positive ethos and an open culture.

People knew how to raise a concern or make a complaint and the provider had systems to manage any complaints they received.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.