Lansglade House

Langslade House provides residential care for up to 31 older people with physical disabilities and those who may be living with dementia. At the time of our inspection there were 25 people using the service.

Accommodation is provided over the ground and 2 upper floors with various lounges, a dining room, and an accessible garden.

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

People received safe care and felt safe within the service. Staff we spoke with understood safeguarding procedures and felt confident their concerns would be listened to and followed up. Risk assessments were in place to manage risks within people’s lives.

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 received support from staff who had undergone a robust recruitment process. They were supported by regular, consistent staff who knew them and their needs well. Staff recruitment files were comprehensive and contained all relevant employment checks. Staffing levels were sufficient, and people received the support they needed from staff promptly.

Medicines were stored and administered safely, and staff were trained to support people effectively with their medication. The service was clean, and staff understood infection control procedures and followed them.

The provider ensured that lessons were learned when things went wrong, so that improvements could be made to the service and the care people received.

The service was well managed. People, relatives, and staff were very positive and about the leadership of the service and praised the registered manager highly.

There were systems in place to monitor the quality of the service and actions were taken, and improvements were made when required. Staff felt well supported and said the registered manager was open and approachable. The service worked in partnership with outside agencies.

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 06 October 2018)

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained Good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Langslade House 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.

We found the following examples of good practice.

Systems were in place to support safe visiting to the service. All visitors were subject to a range of screening procedures, these included providing evidence of a negative lateral flow test (LFT), completing a COVID-19 questionnaire and having their temperature taken. Professionals visiting people at the home had to show their COVID-19 vaccination passes or show proof of their exemption.

People living in the care home and staff were tested regularly for COVID-19. Staff had been vaccinated against COVID-19.

Staff had received training in infection prevention and control (IPC) and on how to take off and put on their personal protective equipment (PPE). Staff were observed wearing PPE correctly during our inspection. Posters were displayed throughout the home in relation to the importance of wearing PPE. Hand sanitiser was readily available throughout the service.

Staff helped cover vacant shifts caused by staff sickness or isolation and there was no use of agency staff. This meant that people were supported by a consistent staff team who knew them well.

People had been supported to maintain contact with friends and family during the COVID-19 lockdowns through use of telephone or video calls. A smaller lounge had been converted into a garden room with safety screens to provide a further safe visiting option.

The inspection took place on 12 September 2018 and was unannounced. At the last inspection on 28 September 2015 we rated the service Good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People’s medicines were managed safely by staff who had their competencies assessed. However, there was an area that required improving and this was discussed with the operations manager.

People told us they felt safe living at Lansglade House and staff demonstrated they knew how to keep people safe. Staff received training and appropriate support from managers and seniors to carry out their roles effectively.

Risks to people`s wellbeing were identified and measures to mitigate the risks were regularly reviewed to ensure they were still effective.

The provider had policies and procedures in place to protect people from the risk of infections and staff adhered to these. There were enough staff employed through robust procedures to meet people`s needs effectively.

People, and relatives where appropriate, were involved with their care. People consented to the support they received.

People had opportunities to pursue their hobbies, interests and socialise with other people at Lansglade House.

People`s feedback was positive about the service they received. People felt they could voice their opinions in meetings and one to one conversations they had with staff.

People and staff were positive about the management of the service. There were robust systems in place to ensure the quality of the service was monitored and improved if the need was identified.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

Is the service safe?

People told us they felt safe living at Lansglade House. We found they were cared for in an environment that was safe, clean and hygienic. People's needs had been assessed, and risk assessments described how any identified risks to people were minimised. The service had sufficient staff that were knowledgeable about people's care and support needs.

We saw that equipment was well maintained and checked on a regular basis and the premises were fit for purpose and safe for the people who used them. We found that as part of the pre admission information, staff obtained information about people's needs to ensure that appropriate rooms could be given to them. This was to ensure, that the person's bedroom was big enough to manoeuvre a hoist safely.

Is the service effective?

People's health and care needs had been assessed, both pre admission and on a regular basis thereafter. We found that robust care plans were in place. People told us that they were happy with the care that had been provided and their needs had been met with kindness.

We saw that staff had received training to support people with various care needs. Some of the people had complex needs that meant they were not able to understand their care plans, we saw that where appropriate, these had been discussed with relatives so that all planned care and support was understood.

We found that the service provided people with adequate nutritious food and drink that ensured they maintained good health.

It was clear from our observations that staff had a good understanding of the needs of the people who used the service. We found that care plans were written in a 'person centred' style which reflected people's individual personal needs and preferences. Activities were offered on a daily basis and there was a 'friends' association which offered additional activities and raised funds.

Is the service caring?

People were supported by kind, courteous and attentive staff. It was clear from our observations and from speaking with the staff, that they had a good understanding of the needs of the people living in the home and knew them well. We saw that staff were able to communicate effectively with people with limited verbal communication and to meet their needs with respect and dignity.

One person who used the service told us, 'I cannot be at home, I know that, but being here is the next best thing.' We observed numerous examples of positive interactions between staff and people who used the service. Staff showed patience and understanding and encouraged people to be as independent as possible.

Is the service responsive to people's needs?

We observed that staff responded very promptly to people's needs, both physical and social. We saw that care plans and risk assessments had been updated when people's needs had changed, and that referrals had been made to other health and social care professionals when required. The service took account of individual preferences, and supported them to access a variety of activities.

We spoke with four people who used the service. They were all happy with the care received. One person said, 'They always listen, I only have to say something and it is done. You cannot ask for more than that.'

Is the service well-led?

The service had a registered manager in post and we found that they managed the service well. Quality assurance processes were in place to ensure that people received a good quality service. We saw that the provider had effective systems to assess and monitor the quality of the service they provided. They regularly sought the views of people using the service and their representatives by listening to them, and took account of their feedback to improve the service.

Records showed that staff had attended both mandatory and specific training to help them carry out their duties, and were supported with regular supervisions by the manager. We were told that the manager was very approachable to both people and staff. This meant that the service was able to benefit from a well- led team of staff, who worked together to meet the needs of the people who used the service.

At the time of our visit, 28 people were living in the home although one person was currently in hospital. We spoke with four of the 28 people, although due to some people's dementia needs, not everyone was able to tell us about their experiences. We therefore used a number of methods to help us understand the experiences of people using the service, including observation and talking with people's relatives and care staff.

One person's family said they were extremely happy with the care provided and the homely environment. People who were able to speak with us told us they felt cared for and well supported by staff. One person said the care was "wonderful", and one person said, "I can't speak highly enough of the home, the staff are all lovely."

We observed staff providing respectful care and support to people, and saw this was delivered in line with the care records we reviewed in order to meet people's needs.

We saw that the home had received a number of compliments and thank you letters which were displayed for all people to read. Clear processes were in place to manage any concerns or complaints made.

Everyone we spoke with told us they enjoyed living or working there, and said the staff were very caring. Two people said they 'couldn't want for a better place to live' and three others said 'the staff are wonderful; they really look after me well'.

We saw that people were involved in decisions related to their care, and their dignity and independence were respected at all times.