We carried out a review of the data available to us about OSJCT Langford View on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about OSJCT Langford View, you can give feedback on this service.
Langford View is a care home providing accommodation for up to 60 older people, including people living with dementia. At the time of the inspection there were 53 people living at the home.
People’s experience of using this service and what we found
We received information raising concerns about staffing levels, management of falls, management of medicines, management of weight loss, unclean environment and poor provision of activities.
We inspected the home, which included visiting the home and speaking with people. We also spoke with staff who were on duty and sought feedback from relatives as well as healthcare professionals who often visited the home.
We found the service had enough staff to meet people’s needs. People told us they did not have to wait to be attended to. During the inspection, call bells were answered in a timely manner and staff did not look rushed. Relatives told us they had never had any reason to think there were not enough staff to care for people. Staff told us there were enough staff to meet people’s needs, however, there were a few times when they were short if staff called in sick at short notice.
We found risks in relation to falls had been identified and there were management plans in place. Equipment was used to help prevent the risk of falls, such as sensor mats.
We found people were protected from the risk of acquiring infections and the service was clean. Personal protective equipment was readily available and all staff were following the latest guidance.
We also found risks in relation to weight loss were identified and managed positively. Healthcare professional advice around nutrition was sought in a timely manner and some people had put on weight.
People had limited access to activities and the provider was looking at improving days out when visiting guidance changed.
Prior to the inspection we received anonymous concerns of poor communication and that the service was poorly managed. There was a long-standing registered manager who had been in post since the opening of the home nine years ago. People and relatives told us the home was well managed and that communication was effective. Staff told us the manager was supportive and included them in decisions about the changes. The provider had effective quality assurance systems in place which were used to drive improvement.
Rating at last inspection
The last rating for this service was Good (Published 9 May 2018)
Why we inspected
We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in response to concerns received about staffing levels, management of falls, management of weight loss, poor provision of activities, poor communication and poor management of the service. A decision was made for us to inspect and examine those risks.
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 coronavirus and other infection outbreaks effectively.
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
The overall rating for the service has not changed following this targeted inspection and remains Good
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Langford View on our website at www.cqc.org.uk.
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.
At our last inspection 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.
At this inspection we found the service remained Good
At our previous inspection on 22 October 2015. We identified that the service did not always maintain accurate medicines administration records (MAR). This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we found that the registered manager had made significant improvements to address our concerns. MAR were completed to show when medication had been given. People's medicines were managed safely and kept under regular review.
People told us that they felt safe. Staff were aware of how to safeguard people from harm and were aware of potential risks and signs of abuse. There were sufficient staff to meet people's needs
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 support this practice.
People's health care needs were taken care of and they had access to a range of healthcare professionals. Where required, appropriate referrals were made to external health professionals such as G.P’s or therapists. People told us they enjoyed the food provided by the home.
People and their relatives were very complimentary about the staff and management at the home. They told us staff were kind, caring and compassionate. Staff members, including the management team, were knowledgeable about individuals' care and support needs and preferences.
The provider had systems in place to receive feedback from people who used the service, their relatives, and staff members about the service provided. People were encouraged and supported to raise any concerns with staff or management and were confident they would be listened to and things would be addressed.
There was an open and inclusive culture in the home and people, their relatives and staff felt they could approach the management team and were comfortable to speak with the registered manager if they had a concern.
We inspected Langford View Care Centre on 22 October 2015. The inspection was unannounced.
Langford View Care Centre is a nursing home run by The Orders of St John Care Trust. The home provides support and nursing care for up to 60 older adults. This includes support for people living with dementia.
The home had a registered manager. 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.
At our last inspection in December 2014 we found medicines were not always administered and recorded safely. This was a breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations which corresponds with Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection in October 2015 we found the provider had taken action to ensure medicines were administered safely. However, we have asked the service to continue making improvements to the recording of medicines. This was because an accurate record of people’s medicines and the administration of those medicines were not always kept.
People felt safe and supported by competent staff. Staff felt motivated and supported to improve the quality of care provided to people and benefitted from regular supervision and training in areas such as dementia awareness.
People were cared for in a caring and respectful way. People were supported to maintain their health and were referred for specialist advice as required. People were provided with person-centred care which encouraged choice and independence. Staff knew people well and understood their individual preferences. Risks to people’s health were identified and plans were in place to minimise the risks. Visiting professionals were complimentary about the level of care provided at the service.
People were supported to have their nutritional needs met. People liked the food, regular snacks and drinks were offered and mealtimes were relaxed and sociable. People who had lost weight had a plan in place to manage their weight loss. People were supported with specialist diets and nutritional supplements as prescribed.
People told us they enjoyed the many and varied activities. People who were living with dementia benefitted from an interesting and stimulating environment.
The provider, registered manager and staff understood their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be unable to make their own decisions or who may be deprived of their liberty for their own safety.
People, relatives, staff and visiting professionals were complimentary about the registered manager and the management team. The registered manager sought feedback from people and their relatives and was continually striving to improve the quality of the service. There was an open culture where people and staff were confident they could raise any concerns and these would be dealt with promptly.
We inspected Langford View Care Centre on 11 December 2014. The inspection was unannounced. The home was last inspected on 17 October 2013.
Langford View Care Centre is a nursing home run by The Order of St John Care Trust. The home provides support and nursing care for up to 60 older adults. This includes support for people living with dementia. At the time of our inspection there were 58 people living at the home.
The home had a registered manager. 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.
People’s medicines were not always administered and recorded safely. Staff administering medication did not always follow the provider’s policy.
Some people’s care records were left outside their room which meant their personal information was not kept confidential.
Quality assurance systems were not always effective as some care records contained information that was not up to date. Some audits had identified issues and action plans showed how these would be managed. Accidents and incidents were audited by the registered manager to identify trends and patterns.
There were sufficient numbers of staff to meet people’s needs and people were positive about the staff supporting them. Staff understood their responsibilities regarding safeguarding adults and felt confident to raise any concerns.
Throughout our visit the atmosphere was pleasant and relaxed. People were supported in a friendly, respectful manner. People were positive about living in the home and complementary about the staff. People were not rushed and staff took to time to sit and talk with them.
People were able to join in activities of their choice. People who preferred to spend time in their rooms had regular visits from staff. Staff knew people well and were able to talk to them about things that interested them.
People were supported by staff who were knowledgeable about their needs. Staff had access to training and development to ensure they had skills necessary to support the people living in the home. Staff felt well supported by the management in the home and told us morale in the home was good.
Staff understood their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be unable to make their own decisions.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.
On the day of our visit there were 54 people using the service. We spoke to five people who told us that they liked the home and that things had improved. One person said "they always need more staff but my bell gets answered promptly and they seem to have time to chat". Another said "they are lovely and work so hard. I do think things have got better lately, especially mealtimes".
We spoke with five care workers who told us things had improved. One said "I think there is enough staff now. I don't feel rushed and I believe we are supported to do our job". Another said "now we get help with mealtimes we get more time with the residents".
We looked at six care worker's files and saw they had been recruited and selected appropriately. All the files contained Disclosure Barring Service (DBS) checks, references and proof of identity. We also saw that care workers received an induction training programme and a period of shadowing with a named mentor before being signed as competent.
Care workers were supported. We saw evidence that monthly 'staff meetings' were held. Supervisions were conducted, recorded and fed into annual appraisals.
We spoke with five members of care/nursing staff who told us they felt supported and well trained. They all said they liked working at the home. One said "I have worked here since we opened. I love my job". Another said "It is lovely here". However, all the care workers we spoke said they felt there was not enough staff working at the home. One said "It has been getting a little better but the last couple of months have been terrible". Another said "If I am honest, no, there is not enough staff. Even when everyone turns up it is still very tight". We saw that care workers were rushed throughout the day and that call bells often took a long time to be answered.
People told us they felt safe and we saw that they were involved in their care. Care workers were attentive and respectful and we saw a good range of activities for people.
People told us they were kept informed of progress through the project by means of regular news letters. People said that they had breakfast in their old home and dinner in the new. People liked the new home ' my bathroom is the best ' one person said, although at the time of the visit there was a design fault that meant the showers could not be used. This was being addressed and in the mean time people were having baths. People we spoke with told us ' every day there is something to do ' ' I have had my nails done today '. People also said that the food was good and that they were given a choice. One person said ' my nephew visited and he was very impressed '. Visitors were made welcome to the home and there were no set visiting times. There were rooms available on both floors for people to have visitors in private. On the day of the visit there was seven staff on duty for 31 residents.
During the visit we used our SOFI (Short Observational Framework for Inspection) tool to help us see what people's experiences and staff interaction during this session was like.