Langley Haven Care Home

Langley Manor is a care home. It is registered to provide personal care and accommodation for up to 35 people across two floors. At the time of our inspection 34 people were living at the service.

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

Risks to people were not always managed safely. Peoples dignity was not always protected because of a lack of privacy when receiving care from external healthcare professionals within the service.

There were effective systems in place to monitor the quality of service, however there was a lack of oversight and governance by the registered manager, relating to the concerns we identified in relation to safety and dignity and privacy.

The premises were clean, and staff followed infection control and prevention procedures. Although one part of the home was malodourous, the registered manager was able to demonstrate how this had been identified and what actions were being taken to address this.

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 living at Langley Haven told us they received care from skilled and knowledgeable staff. Staff knew how to identify and report any concerns. People received their medicines as prescribed.

There were sufficient staff deployed to meet people's needs and the provider had safe recruitment and selection processes in place. People’s nutritional needs were assessed, and people were encouraged to maintain good diet and access health services when required.

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 26 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At our last inspection, the service was rated good.

At this inspection we found the service remained good.

Why the service is rated good:

People were protected from abuse and neglect. We found staff knew about risks to people and how to avoid potential harm. Risks related to people’s care were assessed, recorded and mitigated. The management of risks from the building were also considered. We found appropriate numbers of staff were deployed to meet people’s needs. Medicines management was safe, and staff focused on the prevention of errors. We saw some refurbishments were completed to modernise the building and provide more bedrooms and communal spaces.

Staff training and support was good. Staff had the necessary knowledge, experience and skills to provide appropriate care for people. The service was compliant with the requirements of the Mental Capacity Act 2005 (MCA) and associated codes of practice. People’s nutrition and hydration was closely monitored. Appropriate access to community healthcare professionals was available.

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.

There was a lot of complimentary feedback about Langley Haven Care Home. People and others told us staff were accommodating. People and relatives were able to participate in care planning and reviews and some decisions were made by staff in people’s best interests. People’s privacy and dignity was respected.

Care plans were personalised and reviewed regularly. There was a satisfactory complaints system in place which included the ability for people and others to escalate complaints. People and relatives told us they had no complaints, but knew the process for raising any concerns.

Management and operation of the service was outstanding. All staff worked continuously as an effective team to improve care, ensure people were safe and focus on the quality of the service. Langley Haven Care Home was awarded multiple prestigious industry awards for the improvement the care provided made to people’s lives. Innovation, research and continuous assessment of support for people were all a standard part of the service. The service had excellent working partnerships with external agencies dedicated to the improvement of adult social care.

Further information is in the detailed findings below.

The service was safe, clean and hygienic. Equipment was well maintained and serviced regularly therefore not putting people at unnecessary risk.

People told us they felt safe in the home. They told us they felt respected and their opinions were listened to by staff. Changes were made to the way care was carried out if people requested it or when their needs changed.

We noted practice emergency fire evacuations had not taken place every six months in line with the provider's policy. However, we did see documentation which showed a practice evacuation had taken place in the last two months. We also saw the fire protection equipment in the home had been regularly checked and maintained.

We saw the provider had assessed risks to people and taken action to minimise those risks. Control of Substances Hazardous to Health documentation was in place alongside a contingency plan for dealing with emergency situations.

We saw documentation related to the Mental Capacity Act 2005 and how it had been applied to people's care. We saw how the provider had worked with other professionals and family members to act in the person's best interest and in the least restrictive manner. There had been no requirement to submit a Deprivation of Liberty Safeguards application at the time of our inspection.

Is the service effective?

Each person had received an assessment of need prior to moving into the home. From this, risk assessments and care plans had been drawn up to direct staff in how to care for people safely and effectively.

We observed how staff supported people in a positive and friendly manner.

Specialist dietary and mobility needs had been identified in care plans where required. We saw people were supported with mealtimes in a positive and person centred way. We saw how people's cultural and religious needs were met through diet and support from staff.

Is the service caring?

We observed care being provided to people throughout the day. We saw people who used the service related well to staff. Staff provided reassurance and assistance in a positive and encouraging way. One person told us 'It is a very good place I am glad I am here'they look after you, they do things for you too!' When we asked another person to tell us about the quality of the care they said 'It is really excellent.'

People's preferences, interests, and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

We saw staff responded to the needs of people who used the service. We noted in care plans and records how systems were in place to ensure staff responded to their physical and mental health needs.

We saw a range of activities were carried out in the home that people engaged with which ranged from hatching chickens, ballroom dancing, singing and craft.

People knew how to make complaints. One complaint had been made by a person who lived in the home, and this had been dealt with immediately.

Is the service well-led?

The service had a quality assurance system, records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

People told us they felt the home was well managed. We saw from the documentation how people's care was monitored and changes were made where appropriate.

The service worked well with other agencies and services to make sure people received their care in a joined up way.

During our visit we spoke with three people, a relative and five members of staff. We saw the home had made improvements to ensure people were provided with a range of activities which provided them with mental stimulation and met their social care needs. One person we spoke with told us 'I am enjoying myself; I like all the activities'especially the sing along one.' Another person said 'They have a lot more activities now.' A relative we spoke with told us 'In these last couple of months I can see there has been an improvement, a real change, people now have a lot more to do. I have seen they have choices here and people are enjoying themselves with the different activities planned.'

We found the provider had taken appropriate steps to protect people from the risks of abuse. People and their relatives told us that they felt very safe at the home and they hadn't had to raise any concerns. One person told us 'I feel safe enough, I have been here for many years.'

We found there were enough qualified, skilled and experienced staff to meet people's needs. One person told us "There's always enough staff."

People told us staff knew them very well and understood their individual needs. One person said "I am in very good hands... the staff know what I need and how best to help me." People described the care delivered by staff as "very good", "excellent" and "this place is like one of the best hotel's, I just couldn't ask more from the staff."

However people's social needs were not maintained or promoted. People told us "I wish we could do fun things like earlier", "I just feel very sleepy and tired when I sit in the lounge, we have nothing to do" and "I want to do things like go out and shop for myself with the staff or go out and have a walk."

None of the people we spoke with expressed any concern about the care they had received. Comments included "I have no problems here... I have had no reason to make a complaint" and "I have lived here a long time and have not had to make a complaint." People told us, although they would speak to member of staff or the manager if they had a concern but they were not aware of the process to follow if they wished to make a written complaint.