Archived: The Langston

Updated 20 March 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 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 look at the overall quality of the service.

This inspection took place on 13 February 2018 and was unannounced. The inspection team consisted of two inspectors and an 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.

Before the inspection we reviewed the information we held about the service and the service provider. The registered provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at the notifications we had received for this service. Notifications are information about important events the service is required to send us by law.

Throughout our inspection we spent time observing care at the service. We spoke to 10 people and five relatives. We also spoke with the manager, two nurses, one care coordinator, two care assistants, the maintenance man, the activity assistant and the chef.

We looked at records, which included four people’s care records and the medication administration records (MAR) for three people. We checked recruitment, training and supervision records for four staff. We also looked at a range of records about how the service was managed. Following the inspection we contacted five of external health and social care professionals and commissioners to obtain their views about the service.

Updated 20 March 2018

We inspected this service on 13 February 2018. The Langston is a residential setting which means people receive accommodation and nursing or personal care as single package under one contractual agreement. Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The Langston is registered to provide support for up to 36 older people. On the day of our inspection there were 32 people using the service.

At the last inspection in December 2015 the service was rated Good in all domains and Good overall.

At this inspection we found the service remained Good.

The service was well run by the new manager who was supported by a team of nurses, care staff and support staff. The manager who had taken over the service had applied to Care Quality Commission (CQC) to become the registered manager. A registered manager is a person who has registered with the 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 an open and transparent culture that valued people, their relatives and staff. The provider had systems to monitor the quality of the service provided and appropriate action was taken when required. The service worked well with various external professionals when required. People and relatives were positive about the new manager.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People’s rights to make their own decisions were respected. Staff were knowledgeable about MCA and knew how to adhere and act in practice. People’s care plans outlined people’s abilities in relation to their decision making and stressed the importance of respecting people’s rights. We however found the records surrounding people’s capacity needed to be clearer as these did not always reflect the specific decisions where people were deemed not to have capacity to make these decisions. We made a recommendation that the provider refers to the Code of Practice when formulating capacity assessments.

People remained safe at the service. Staff understood how to protect people’s safety and how to raise any safeguarding concerns. Risks related to people’s individual needs were identified and appropriate guidance was in place how to manage these risks. People were supported to access various external health professionals when needed and meet their nutritional needs.

There were enough staff to keep people safe. On the day of our inspection people were assisted promptly. The provider followed safe recruitment procedures. Staff were skilled and had the relevant training and they told us they were well supported.

The service continued to provide care and support in a compassionate way. Staff respected people’s privacy and treated people with dignity. People were involved in decisions about their care and their independence was promoted as much as possible. People’s confidential information was respected. People’s individual needs in relation to access to information were respected and we saw the provider used information in easy read, such as pictorial format when required.

People’s needs were assessed prior to admission to The Langston. Individualised care plans ensured people’s needs were respected. Staff knew people’s needs well and knew how to support them effectively. People were provided with a choice of social activities, according to their needs and preferences.