Langbury House

Updated 17 November 2022

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 Health and Social Care Act 2008.

Inspection team

This inspection was carried out by three inspectors and one assistant inspector.

Service and service type

Langbury House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Langbury House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 6 October September 2022 and ended on 17 October 2022. We visited the location’s service on 6 and 7 October 2022.

What we did before the inspection

Before the inspection, we reviewed information we held about the service. We considered the information which had been shared with us since the last inspection by the provider, the local authority and other agencies and health and social care professionals. This information helps support our inspections.

During the inspection

We spoke with and observed the support of four people who used the service and their experience of the care provided. We spoke with seven members of staff, including the registered manager and the regional manager. We reviewed a range of records. This included four people’s care and medication records. We looked at training data and quality assurance records and a variety of records relating to the management of the service, including policies and procedures. We received feedback from health and social care professionals. We spoke with or received email feedback from six relatives of people using the service.

Updated 17 November 2022

About the service

Langbury House is a residential care home providing personal care to four young people with learning disabilities and/or autism. The service can support up to five people. The service was a semi-detached bungalow with a garden, in a small coastal village. People had their own bedrooms and bathrooms. There were shared eating and living areas.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right Support:

Risks to people were not always assessed, monitored and managed safely. Systems in place did not always protect people from abuse and improper treatment. There were enough staff to meet people’s needs. People’s medicine support was being managed safely. The service was clean and hygienic. There were safe recruitment practices.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Right Care:

Staff did not always communicate or support people in dignified or respectful ways. Improvements were needed to make sure people were involved and included in a personalised way when being supported by staff. Professionals who worked with staff and relatives of people at the service gave us mixed feedback about the quality and safety of the support people received.

People and their relatives gave us mixed feedback about how involved and engaged they were with planning their support or developing the service, to help them achieve good outcomes.

Right Culture:

Leaders and the culture they created did not always support the delivery of high-quality, person-centred care. Internal quality assurance systems and processes to maintain and develop the safety and quality of care were not always operating effectively. Staff and relatives told us some aspects of the culture and leadership of the service required improvement to ensure people achieved good outcomes from their support. Staff, relatives and management told us on-going staffing turnover and vacancies at the service were impacting on staff morale and performance.

The provider was aware of and were committed to providing resources to make any necessary improvements as quickly as possible. Staff equality and diversity was respected and promoted at the service and within the provider’s organisation.

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 21 April 2021).

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support, right care, right culture.

We received concerns in relation to staffing, uncaring support and people not being kept safe from abuse and improper treatment. As a result, we undertook a focused inspection to review the key questions of safe, caring and well-led only. 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. We have found evidence that the provider needs to make improvement. Please see the safe, caring 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Langbury House on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to dignity and respect, risk management, abuse, and governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.