Langham Manor

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

This is the first assessment for this registered service. This key question has been rated Good: This meant people’s needs were met through good organisation and delivery.

People told us that they were supported appropriately by staff and received good care. Staff knew people well and were able to describe their care needs and the support they required as individuals. However, this was not always reflected in people’s care records which did consistently provide details of triggers, or actions that staff should take to support people in distress. The registered manager told us that they had already identified these shortfalls and had a plan to address them.

There was a complaints process in place and findings were shared where necessary, to drive improvements.

This service scored 68 (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 they were supported well by staff and received appropriate care. One person told us, “I would recommend it, people are friendly, it is comfortable to live here, got your own privacy, it is like home but with your dinner made for you.” Another said, “I would recommend it, generally it is homely, and I am made welcome, I don’t feel I am being a nuisance, staff are bright and very chirpy.”

Staff knew people well and were able to describe their care needs and the support they required as individuals. However, this was not always reflected in people’s care records. For example, where mental wellbeing needs were identified there was not always corresponding notes to provide staff with details of triggers, or actions on to meet these needs and support people. It was not always clear from people plans how they would like to be supported at night or what specific sling they required to be moved safely.

Peoples likes and dislikes were recorded in their care plan, which also outlined important people in the person’s life and how they communicated as well as any care preferences. Daily records were however task based and did not always focus on people’s mood, behaviour or social interaction.

The registered manager told us that they had identified shortfalls in care planning, and this was outlined in their service improvement plan. They told us that they were in the process of reviewing care plans and had a plan in place to update them. This included regular reviews were being undertaken and changes were discussed at the daily head of department meetings and clinical meetings.

We saw a person distressed and while staff were kind and well-meaning in their response, they did not understand the reasons that the person was anxious or have a clear plan in how best to engage with them.

Care plans did not always provide sufficient detail as to how staff should direct or engage with people. Individual staff sought assistance from health professionals but there was no evidence of a multidisciplinary approach or effective analysis.

People looked well-presented and we observed that people had access to regular baths and showers. There was not however always evidence that people received oral care on a regular basis. The registered manager told us that they would remind staff of the importance of oral care and monitor through the daily walk arounds.

People told us that they received support from a consistent team of staff and the home worked with other agencies as appropriate, to ensure their care was coordinated. Relatives told us they were kept updated with their relatives changing health needs.

People received a service which was generally joined-up, flexible and supported choice and continuity. For example, where equipment was needed, referrals were made promptly.

No specific concerns were raised by partner agencies.

There were clear processes in place to review people’s needs and ensure that people received the support they needed to access health services.

People did not always have access to information or written information in different formats. There were for example no menus on the tables and people told us that while they made a choice, they could not always remember which meal they chosen. Newsletters were produced outlining the activities which people had participated in the previous months and details of what was planned. However, some of the people we spoke with were not aware of the newsletters or what activities were planned.

The registered manager was aware of the need to provide accessible information to people and told us that they would adapt their communication methods according to need and would share information verbally when necessary.

Staff were aware of people’s communication needs and their communication abilities were recorded in their care plans.

People’s health and sensory needs were identified as part of assessment processes and appropriate referrals made to health professionals.

The registered manager confirmed that information collated met the data protection legislation requirements and passwords and other safeguards were in place to protect people. There was surveillance at the entrance to the home and the registered manager was reminded of their responsibilities under the legislation with regard to this. As a consequence, information was put on display advising people of the surveillance.

People told us they felt confident in raising complaints and that their concerns were listened to, taken seriously.

The registered manager confirmed that there was a complaints process in place and findings were shared where necessary to drive improvements.

Where complaints had been received records were maintained and records showed that outcomes, actions and learning was documented.

People could access care, treatment and support when they needed to and in a way that worked for them and protected their rights.

People spoke highly of the activities provided and the commitment of the activity organiser in providing a wide range of interesting trips into the community. However, one person who had accessibility requirements expressed concern about their ability to participate and whether proper consideration had been given to the adjustments needed to ensure access and remove barriers. Further efforts are required to evidence how care and support is provided to ensure equality and reduce barriers.

The building had been designed with accessibility in mind.

Managers had good working relationships with local health professionals and knew how to contact the appropriate teams to support and promote equality when the need arose. Staff understood people’s right to equity in accessing care and support.

The activity coordinator told us they produced a weekly planner and tried to provide a range of both organised and more spontaneous activities. They told us that over the course of the week they tried to spend time with each person including those who spent all their time in their room.

No specific concerns were raised by partner agencies.

Systems were in place to assess people’s needs to ensure the service could meet them. Managers took into consideration the needs of people who lived at the service to ensure there was equality of opportunity for all.

People told us that they were in control of their care and directed how their support was provided.

There were clear management arrangements outside office hours to ensure that people experienced equality of outcomes.

Care plans recorded what is important to the person, one person had expressed a wish to attend a religious service, and we saw that they had recently been assisted to access these.

There were systems in place to ascertain people’s views and hear peoples voice such as through the resident of the day, resident meetings and quality questionnaires. However, it was acknowledged that these systems were not well developed and during the inspection the provider sent out questionnaires to key partners to ascertain their views. They told us that they intended to collate the feedback and would ensure that results were published.

People told us that they were involved in care planning and their care preferences were discussed with them.

The syringe driver had not been serviced so was not available to people. This could have an impact on people in that may not receive good quality end of life care. When we raised this with the provider, they took immediate steps to obtain a syringe driver from another of the providers services.

Whilst staff knew people well, people’s care plans didn’t always reflect their wishes when they reached the end of their life. As a result of our feedback the registered manager told us that they developed a questionnaire for staff to use as an aide memoir to assist staff to have meaningful discussions with people about their care preferences and help them prepare and inform a care plan about how they wished to be cared for at the end of their life.

The majority of staff had not completed training in end of life care and the registered manager acknowledged that this was an area where improvements were needed.

Some people had authorisations in place such as Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) and respect forms in place which took into account each person’s individual circumstances and their preference for what action should be taken in the event of a cardiac arrest.