Langley Homes Also known as 37a - 39 Peel Street Villas

Langley Homes is a residential care home providing regulated activity to up to 5 people. The service provides support to people aged 13 and over. The service supports people with a learning disability and autistic people. At the time of our inspection there were 4 people using the service.

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

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.

Right Support:

Staff were recruited safely, there were sufficient numbers of staff with the necessary training to support people safely and meet their needs. People were protected from the risk of abuse and risks which affected people's daily lives were documented and known by staff. Staff supported people to access healthcare services and followed guidance from external professionals.

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.

Right Care:

There were systems in place to ensure people received their medication safely and as prescribed. Staff understood how to promote people's independence, people were supported take part in activities of interest to them, we saw evidence that people were being supported to further their skills in preparing meals and managing their own finances.

Right Culture: Following our last inspection, we found staff had received additional training and the provider had made improvements to their quality assurance systems. The registered manager was committed to continuously improving the service and had a detailed action plan in place. We found there was a positive, person-centred approach to the planning and provision of people's care. This was demonstrated by the staff knowledge and the care and pathway plans in place which had been developed to guide staff on the goals and outcomes people wished to achieve.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 21 June 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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.

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 changed from requires improvement to good based on the findings of this inspection.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

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

About the service

Langley Homes is a residential care home providing personal care to 3 at the time of the inspection. The service can support up to 5 people from ages 13 and over. The service supports people with a learning disability and autistic people.

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

Right Support

Systems and processes to protect people from abuse were not robust. Incident records had not always been thoroughly reviewed to minimise the risk of reoccurrence. The records had not been analysed for trends and patterns this meant that any learning had not been shared with the wider staff team.

There were sufficient numbers of staff deployed to ensure people were supported safely. We observed staff being responsive to people’s needs and choices and supporting people to go out when they wished.

People were supported to maximise their independence and to take part in activities of interest to them, we saw evidence that people had been supported to access further education and work towards seeking employment.

Right Care

Care plans in place provided staff with detailed information on how people wished to be supported in a person centred way taking into account their needs and the outcomes they wished to achieve, however care had not always been consistently provided in this way as one person’s care records evidenced that staff had not followed the strategies in place to support them.

There were systems in place to ensure people received their medication safely and as prescribed, however audits of medicines had not identified when required pharmacy advice or temperature checks were not in place.

Right culture

Whilst the service promoted an inclusive culture, there remained a lack of effective governance systems to monitor and assess the quality of service people received.

Staff were passionate about providing person-centred care. People were supported to identify individual goals and detailed plans were developed for staff to follow, these were regularly reviewed and evaluated, and people’s achievements had been recognised and celebrated.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (report published 28 July 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

Why we inspected

This inspection was prompted in part due to concerns we had received about the inappropriate use of physical intervention in the service. A decision was made for us to inspect and examine this risk.

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 full report.

Enforcement

We have identified breaches in relation to safeguarding people from abuse and improper treatment and governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Langley Homes is a residential care home providing personal and support for three people with learning disabilities, and/or autism and complex mental health needs. The service can support up to five people.

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

Infection, prevention and control systems were not effective to reduce the risks to people and staff. Arrangements had been made for new people to move to the service without considering how to do this safely. Staff did not always wear or use protective personal equipment (PPE) effectively to reduce the risk of transmission. When there were visitors, testing for COVID-19 was not conducted prior to them entering the home which meant there was a higher risk of bringing COVID-19 into the home. Cleanings products were not always used effectively to ensure all areas were cleaned to reduce infection risk.

Quality monitoring systems were in place to review the service provision; however, improvements were needed as these had not highlighted the shortfalls to keep people safe when managing infection control, with daily medicine audits and safe recruitment of staff. The registered manager had not understood all their legal responsibilities and had not considered the suitability and age of people moving into the home.

People were supported to understand how to keep safe and staff were clear on their role on protecting people from the risk of harm. Staff understood their responsibilities to raise concerns and record safety incidents. These were reviewed and analysed to ensure actions could be taken to reduce risks and promote a safe environment. Individual risks to people were identified and people were supported to take reasonable risks to promote independent living. Where people needed support to manage their behaviours and keep safe; this was provided in a proportionate way and monitored with the support of healthcare professionals.

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. The importance of gaining people’s consent to the support they received was understood by the staff team. Staff knew about people’s individual capacity to make decisions and supported them to make their own decisions.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. The service had been developed so people’s care was person centred. Staff took time to get to know people, find out about what they wanted and interested them and how to provide their support. People made decisions about the care they received and how they spent their time. Following restrictions for COVID-19 staff had explored community links to provide people with opportunities once the restrictions allow.

People were consulted regarding their preferences and interests and these were incorporated into their support plan to ensure they were supported to lead the life they wanted to. People were supported to be as independent. The staff team knew people well and were provided with the right training and support to enable them to promote people’s independence and autonomy.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 25/09/2020 and this is the first inspection.

Why we inspected

This was a planned inspection based on when the service was registered.

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.

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 monitor the service to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to management of infection prevention and control at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.