Langdale House Residential Home

Updated 15 January 2020

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 Care Act 2014.

Inspection team

The inspection team consisted of two inspectors.

Service and service type

Langdale House 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

The inspection was unannounced.

What we did before the inspection

We reviewed any notifications we had received from the service (events which happened in the service that the provider is required to tell us about). We reviewed the last inspection report. We asked Healthwatch Nottingham for any information they had about the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We also asked commissioners for their feedback about the service.

On this occasion, we had not asked the provider to send us a provider Information return (PIR). A PIR is a form that asks the provider to give some key information about the service. This includes what the service does well and improvements they plan to make. However, we offered the provider the opportunity to share information they felt was relevant. We used all of this information to plan our inspection.

During the inspection

As part of this inspection, we spent time with people who used the service talking with them and observing support; this helped us understand their experience of using the service. We observed how staff interacted and engaged with people.

We spoke with four people who used the service and a visiting health care professional and asked them about the quality of the care provided. We also spoke with the registered manager, home manager and one care worker.

We reviewed a range of records. This included four people's care records. We looked at two staff files. We reviewed a variety of records relating to the management of the service, including accidents and incidents, numerous medicine records, policies, audits, staff training and checks on health and safety.

After the inspection

We continued to seek clarification from the provider to validate evidence found in relation to staff and resident meetings. We also contacted the GP and invited them to provide feedback about the service. We also spoke with three care staff.

Updated 15 January 2020

About the service

Langdale House Residential Home can accommodate 12 people with mental health needs in one adapted building. Accommodation is provided on two floors; a passenger lift is available. At the time of our inspection, seven people were living at the service permanently and one person was receiving respite care.

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

Some improvements were required in how people were supported to remain safe. This included written guidance for staff and clear recording of when care and support was provided. Infection prevention and control, including cleaning of the environment was not sufficiently robust. Fire safety needed further consideration to ensure people's safety. The systems used to monitor health and safety and how the service developed and improved required reviewing.

We have made a recommendation about the management of infection control practice.

There were sufficient staff employed at the service and staffing levels considered people's dependency needs. No new staff had commenced at the service since it had reregistered, and the management team were aware of the safe recruitment checks and standards they were expected to complete for new staff.

People received their prescribed medicines safely and medicines were administered and managed following best practice guidance. People were protected from abuse and avoidable harm; staff had received training and understood their role and safeguarding information was available and discussed with people. There was a positive approach to learning to reduce the risk of incidents reoccurring.

Staff received ongoing training and support. People were supported with their physical, mental and welfare needs. Staff worked with external health and social care professionals to support people to achieve good outcomes and remain well and safe.

People received enough to eat and drink and they were involved in the development of the menu.

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

People were involved in their care and support and were positive about the approach of staff who knew them well. People had information about advocacy services.

Some improvement was required to ensure there was a person centred approach in encouraging independence. People's diverse needs and lifestyle choices were known, understood and supported by staff. In house games were available and people enjoyed summer day trips and accessed the community as they wished.

People were supported to raise any concerns or complaints and any made were investigated and resolved. People's communication needs had been assessed and planned for. People's end of life wishes had been discussed with them.

Staff were positive about their role and the support and leadership of the service. The registered manager had met their registration regulatory requirements. Positive links had been developed with external professionals and the registered manager had up to date policies and procedures and used best practice guidance to support their practice.

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 requires improvement (published 25 April 2018). Since this rating was awarded the registered provider of the service has altered its legal entity. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.