Background to this inspection
Updated
6 November 2021
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.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by one inspector 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.
Service and service type
Langdale Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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 at the time of this inspection. Registered managers along with 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 site visit to the care home was unannounced. Inspection activity started on 23 September 2021 and finished on 11 October 2021. We visited the care home on 29 September 2021.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, Healthwatch and professionals who work with 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.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We used all of this information to plan our inspection.
During the inspection
We spoke with three people who were using the service and six relatives of people who used the service about their experience of the care provided. We spoke with seven members of staff including the registered manager, deputy manager, the cook, a cleaner and three care workers. Discussions with people who used the service were face to face and discussions with relatives were via telephone calls.
We reviewed a range of records. This included three people's care records and a sample of medication records. We looked at three staff recruitment files. A variety of records relating to the management of the service, including some policies and procedures, were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. This included training data and quality assurance records.
Updated
6 November 2021
About the service
Langdale Residential Home is a residential care home providing personal care for people aged 65 and over. The care home accommodates 19 people in one adapted building. At the time of the inspection there were 17 people living at the home.
People’s experience of using this service and what we found
Some improvements were needed to make sure people were safe. Risk assessments needed to be in place to make sure all risks to people’s health and safety were managed.
We were not assured that systems were in place and guidance being followed to minimise the risk of spread of infection within the home.
Improvements were needed to make sure medicines were stored safely.
We have made a recommendation the provider puts a system in place to make sure medicines are stored at temperatures recommended by the manufacturer.
Recruitment was managed safely. The staff team were consistent and experienced and had the skills to support people safely. Some people told us they thought more staff were needed and rotas showed days when only three staff were on duty.
We have made a recommendation the provider reviews staffing arrangements to make sure they are sufficient to meet people’s needs.
The home needed some refurbishment and the garden needed to be cleared of rubbish to provide a safe space for people to enjoy.
People who used the service, relatives and staff provided good feedback about their experience. People said they felt safe and staff were caring and kind.
Systems to monitor and check the service were in place but these needed to be more thorough to identify the issues we highlighted during this inspection.
There was a lack of oversight of the quality and safety of the service by the provider. We have made a recommendation they establish systems and processes to ensure they have effective and regular oversight of the quality and safety of the service.
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 18 November 2017).
Why we inspected
This was a planned inspection based on the previous rating.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this report. You can see what action we have asked the provider to take at the end of this full report.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Langdale Residential Home on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches of regulations 12 (Safe Care and Treatment) in relation to infection prevention and control and 17 (Good Governance).
Please see the action we have told the provider to take at the end of this report.
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.