Langley Lodge Residential Home

Updated 13 January 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

One inspector carried out this inspection.

Service and service type

Langley Lodge Residential Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Langley Lodge is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with six people who lived at Langley Lodge Residential Home, we also observed the care and support people received in communal areas of the home. We spoke with the registered manager, deputy manager, one senior carer and three carers. We also looked at three people's care records, recruitment records and management records including audits.

Updated 13 January 2023

About the service

Langley Lodge Residential Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

At the time of our inspection there were 20 people using the service. Langley Lodge Residential Home can accommodate up to 20 people in individual or double bedrooms in one adapted building. It is a two-storey building with a stair lift to access the first floor.

People’s experience of using this service and what we found

Staff took action to keep people safe from possible harm. However, actions taken were not always done in the least restrictive way. This included measures to restrict some people's movement around the service. This meant that people were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. The registered manager took action immediately to make the necessary improvements.

Fire policies and risk assessments had not considered all the necessary information to ensure that the risks to people’s safety had been reduced as much as possible in the event of a fire. We informed the fire service of our concerns and they completed a full audit and issued a Notice of Deficiencies.

The governance system had failed to identify the areas for improvement that we found during the inspection. Potential new staff to the service underwent checks to make sure they were suitable to work with people. However, a lack of auditing of these records showed there were gaps in some staffs' employment history that had not been explored. Not all staff had completed their refresher training when due. The registered manager had not always completed notification of certain events to the CQC as required. The manager had not reviewed the tool they used to determine staffing levels to ensure that the number of staff working was appropriate to meet the needs of people in a timely and safe manner. Feedback was mixed about if the staffing levels were adequate.

Staff were following current government guidance around good infection control procedures. Medicines were being administered as prescribed. Written procedures were in place to advise staff when to administer “When required” medications. Accidents and incidents were being analysed to ensure that themes and trends were identified and the necessary action taken to prevent a recurrence.

Staff used their training knowledge to safeguard people wherever possible and support people to keep safe from poor care and abuse. If staff had any concerns about people, they knew where to report this both internally and outside of the service. Staff spoke favourably of the management team and stated that they felt supported in their roles.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (report published November 2018).

Why we inspected

We received concerns in relation to restricting people’s movements and choices in the home and the quality of the service being provided. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this report.

You can see what action we have asked the provider to take at the end of this full report.

As a result of our findings the registered manager has taken immediate actions to implement the required improvements and mitigate risks to people’s safety.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Langley Lodge residential home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to reducing risks to people, restricting people’s liberty and quality assurance. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.