Langham Manor

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this newly registered service. This key question has been rated Good: This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them.

People’s nutrition and weights were monitored, and they were supported to live healthily however, feedback on the quality of the meals was inconsistent.

People told us that staff gave them choices and explained what they were doing before giving care. Staff understood that if a person was assessed as not able to make a decision, then staff could support in their best interest. However, they were less clear about the process to follow for complex decisions and restrictions.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us that that they received effective care, and staff consulted them about their needs and wishes. Relatives were aware of the care plans and said information sharing was generally very good.

Staff told us information was handed over between each shift from the person leading the shift on each unit to the nurse/team leader and then team leader to carers. There were also daily management meetings and head of department meetings. Needs were assessed on an ongoing basis, for example through daily meetings, resident of the day review and care plan reviews.

Processes for review were positive however, there were gaps in care planning processes and records did not always evidence that people had been consulted as part of the review processes.

The service planned and delivered people’s care and treatment with them, however, feedback on the quality of the meals was variable. Most people did not know what the meal was being served. They told us that they had been asked to make a choice the previous day but had forgotten what they had chosen. There were no menus on display to remind people what choice was available.

People told us that they were promised a fine dining experience but did not feel that the home was meeting these expectations. On the day of our assessment, we observed people sending meals back to the kitchen as they were difficult to eat and unappetising. We observed that other people enjoyed the meal.

One person told us, “The food is like school dinners and not fine dining. The food is sometimes not as you would hope for, it should be restaurant standard, and, in a restaurant, you would send the food back to the kitchen. The Home is very expensive, there has been some improvements on the food, but it is not consistent. Food is the important part of the day.” Another told us, “Meals are lovely, normally with the fish cakes you can’t find the fish meat, not these ones today……Good variety, food is hot, get enough vegetables, not enough fruit.”

People were given opportunities to live healthy and this included supporting people to eat well and exercise. Staff monitored people’s weight if needed.

Staff told us that the food was satisfactory, and the cook tried within the limitations of their budgets to produce tasty meals. One said “It is not terrible but often people don’t like it. Sometimes it goes down well but other days it is less positive.”

The registered manager told us that where issues were raised regarding meals, they had organised meetings with the chef to try and resolve the concerns. In one example the chef had used one person’s own recipe to prepare a favourite meal to their taste.

Support was delivered in line with legislation and current evidence-based good practice and standards. Staff used nationally recognised tools appropriately to assess and monitor people’s needs. For example, the Malnutrition Universal Screening Tool (MUST) was used to identify people at risk of malnutrition. Staff supported people appropriately at meals times to ensure that people had enough to eat and drink. Where there was a concern in this area staff had completed a referral to the relevant health professional requesting additional support.

People told us that staff across the home worked together to meet their needs.

Staff knew people well and had access to information they needed about people’s health and wellbeing. The registered manager told us that information was shared within teams to ensure care is coordinated.

No specific concerns were raised by partner agencies about the coordination of care.

Admission processes considered people’s individual needs and specific equipment that they may require. Processes were in place to ensure information about people’s care needs were up to date and shared with staff. Daily handovers were in place to discuss people’s care, and staff had access to people’s care records. The service worked in partnership with local healthcare professionals. We saw evidence in people’s records of people being referred to a range of professionals, including dietitians, specialist nurses and physiotherapists.

People told us they had access to health care professionals and staff supported them with health care appointments as and when needed. One person described how they liked the nurse to attend health consultations with them as this meant that they were able to later discuss the information they had received.

Staff were able to explain people’s health conditions and how best to support people. For example, assistance with repositioning to maintain people’s skin integrity. Staff told us they reported any concerns with people’s health and wellbeing to the nurse, or to the management team and these were escalated through the clinical oversight systems.

We saw evidence in records of health and social care professionals’ involvement in people’s individual care on an on-going basis. For example, people’s GP, physiotherapists and specialist nurses. Assessment and monitoring tools such as flood and fluid charts, Waterlow and oral health assessments were all reviewed monthly to identify changes to people’s needs and monitor outcomes.

People received support, which was coordinated, and they told us that they were well cared for. One person told us “All the professionals involved in my care are talking to each other.”

Staff described how they monitored people’s needs and flagged to senior staff if there were concerns such as for example in skin integrity. One told us, “The nurses and team leaders here are brilliant, and we have every confidence that if there is a problem they will sort it.”

People’s care was continuously monitored and reviewed to promote good outcomes for people. An electronic care planning system was in place that recorded care delivery. Monitoring records were scrutinised by senior staff and the registered manager on a daily basis. This meant that any alerts indicating care had not been delivered, were identified and action taken to address this.

People told us that staff gave them choices and always explained what they were doing before giving care. People we observed were able to make decisions such as what to wear, choices of meals and to give consent to see the GP. However, a person had recently been admitted with some restrictions in place regarding smoking which had not been fully considered in terms of the Mental Capacity Act.

Staff understood the principles of the Mental Capacity Act and were able to explain the need to ask for consent before completing tasks. They understood that if a person was assessed as not able to make a decision, then staff could support in their best interest. However, they were less clear about the process to follow for more complex decisions.

People had documentation in their records about their mental capacity and their ability to make decisions regarding areas such as the use of call bells, bed rails and the delivery of personal care. However, records were not always sufficiently detailed to show the level of involvement people, and their representatives had in these assessments and decision making meetings.

Applications had been made, as appropriate, where restrictions were in place, and these were monitored on a regular basis.