Langdale House Ltd

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

People received their prescribed medicines safely and as prescribed. Overall, best practice guidance was followed, where shortfalls were identified the provider took immediate action including lessons learnt.

Risks associated with people’s individual care needs had been assessed and was regularly reviewed. Guidance for staff overall, of how to manage and mitigate risks were detailed. We identified some examples where guidance about how to support people at times of increased anxiety needed to be more detailed. However, staff were knowledgeable about people’s individual care and support needs.

Health and safety risks in relation to fire protection, safe use of equipment and ensuring the environment was safe had been assessed, planned for and was regularly monitored.

There were sufficient staff available to meet people’s individual care needs, and staff had been recruited safely. Staff were found to be well trained, knowledgeable and competent. People and relatives were consistently positive, and highly complimentary about the caring approach of staff.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were protected as far as possible from the risk of abuse and harm. Staff had completed safeguarding training and clearly understood their role and responsibility to protect people’s safety. The provider had a robust procedure of analysing incidents and completed lessons learnt to reduce further reoccurrence and shared this with staff.

People lived in an environment which welcomed visitors and was well maintained. Infection prevention and control practice minimised the risk to people, staff and visitors.

People and relatives received opportunities to share their experience of the service they received. People reported they felt involved, listened to and respected.

Staff were positive about the support they received and complimentary about working for the provider. Staff were valued and received additional benefits as a recognition for their work.

The management team were responsive throughout the inspection and implemented some immediate changes in response to our feedback. The provider had robust systems in place that monitored quality and safety and had plans to further improve the quality of the service provided.

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 (published 27 November 2018). The service remains good.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Langdale House Ltd on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Langdale House 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.

Langdale House is registered to provide residential and nursing care for up to 31 older people living with dementia and / or physical disability. The home is on two floors with a passenger lift for access. There is a dining room, lounge and conservatory and an enclosed garden. On the day of our inspection visit there were 28 people living at the home.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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.

Staff treated people with kindness, respect and compassion. They continually engaged with people and most shared conversation with them as they went about their work supporting people. From people’s reactions and responses, we saw that this contributed to a relaxed and friendly atmosphere at the home.

The staff team was established and people had the opportunity to get to know the staff supporting them. Staff were knowledgeable about the people they supported and used information about their life histories to enhance their daily lives. For example, staff helped a person to enjoy their favourite music.

Staff understood the importance of supporting people to express their views and be actively involved in making decisions about their care and support. People chose what time they got up and when to go to bed and where they had their meals. Staff respected people’s privacy, dignity and independence.

People told us they felt safe at the home and staff were knowledgeable about how to keep them safe from accidents and incidents. People had risk assessments in place which staff followed to increase their safety. During our inspection we saw staff providing people with safe and appropriate assistance to make their way around the home.

Staffing levels were safe. People did not have to wait if they needed support including during the busiest time of the day when people were supported to have their lunch. Records showed staff were safely recruited, in line with the providers’ staff recruitment policy, to ensure they were safe to work with people using care services.

The registered manager carried out audits of the home and acted to ensure the premises and equipment were safe to use. All areas of the premises were clean and fresh.

People’s cultural needs were met and staff had a good understanding of equality and diversity and how to provide non-discriminatory care and support. Staff had the training they needed to provide effective care. All staff completed a range of training courses including health and safety, moving and handling, and safeguarding. The providers and managers were keen for staff to develop their skills and arranged training that was relevant to the needs of the people living at the home.

People told us they enjoyed their meals at the home and had a varied diet and choice. If people had any dietary requirements or preferences staff ensured these were met. People were referred to dieticians if they needed specialised support with their nutrition and records showed staff followed their advice.

People saw GPs and other healthcare professionals when they needed to. Staff worked closely with visiting health care professionals to ensure people's healthcare needs were met. Staff were trained in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards and understood the importance of people consenting to their care and support.

Activities were central to people’s lives at the home and the providers had invested time and resources into ensuring people had varied opportunities for exercise, hobbies, and entertainment.

The home was well-led and staff said they had confidence in the providers and managers to support them to deliver high-quality care. The provider carried out annual surveys to find out what people, relatives, visiting professionals and staff thought of the home and whether any improvements were needed. The survey results showed a high level of satisfaction with the service.

There were effective systems in place to monitor the quality of the service. These included a series of audits carried out by the registered manager or, in their absence, a support manager. The audits covered all aspects of the home. An area manager ensured that audits were carried out effectively. Records showed that the home’s audits led to improvements being made where necessary.

The staff worked closely with the local authority, the NHS, and other health and social care professionals to ensure people’s needs were met.