Langley View Residential Home Also known as Langley View

Langley View Residential Home provides accommodation and personal care for up to six people with mental health concerns, learning disabilities and/or autism. At the time of our inspection there were four people who were living at the service.

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

People were not always supported to have maximum choice and control of their lives and staff did not always 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. People did not always have control and independence. For example, restrictions were in place which prevented people from accessing food independently.

The service didn’t consistently apply the principles of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people did not fully reflect the principles and values of Registering the Right Support for the following reasons lack of choice and control, limited independence and limited inclusion. For example, people did not have control and independence to get food when wanted or needed as cupboards were locked.

The management team did not provide clear guidance and training for staff to be understand the right attitudes and behaviours for their role, staff were observed to be task focused and people said there was limited meaningful conversation.

The quality assurance systems where not robust enough to recognise improvements were needed to meet best practice guidance and legislation.

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 requires improvement (published 21 October 2019).

Why we inspected

We undertook this targeted inspection to check on a specific concern we had as to how the service was working within the principles of the Mental Capacity Act (MCA), inappropriate use of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) and how the provider ensured that peoples basic human rights was at the centre of their care. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.

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.

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.

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 discharge our regulatory enforcement functions required 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 the lack of adherence to the principles of the MCA and the use of inappropriate restrictions.

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 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.

Langley View Residential Home provides accommodation and personal care for up to six people with mental health and learning disability support needs. At the time of our inspection there were four people living at the service.

The service was a domestic style property that was similar to surrounding property. There were deliberately no identifying signs, to indicate it was a care home.

The service has been developed and designed in line with most of the principles and values that underpin Registering the Right Support and other best practice guidance. Registering the Right Support ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

The outcomes for people using the service mostly reflected the principles and values of Registering the Right Support. People’s support focused on them having as many opportunities as possible for them to gain new skills and become more independent. However, stimulation and interaction for those with communication needs was sometimes limited.

We have made a recommendation about engaging with people with communication needs.

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

We have made a recommendation about how the provider applies the principles of the Mental Capacity Act

The environment was showing signs of wear and tear. However, pictures were utilised throughout the home to aid those with communication needs.

The service had quality assurance systems in place and people were encouraged to give feedback on the service received. However, relatives told us they did not consistently feel listened to and their concerns were not always responded to appropriately.

People felt safe at the service and there were enough staff to meet people’s support needs. People were supported to manage their medicines safely.

The service worked well with other agencies and people were supported to ensure their health and dietary needs were met.

Staff told us they received training and support to carry out their role. They felt supported by the registered manager.

Support Plans and Risk assessments were in place, these were personalised to each person. They contained detailed information about their likes and dislikes and were reviewed regularly. Staff spoke about people in a dignified, compassionate manner.

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. (Report published 24th March 2017).

Why we inspected

This was a planned inspection based on the previous rating. We have found evidence that the provider needs to make improvements. Please see the effective and responsive sections of this report.

Follow up

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Langley View provides accommodation and personal care for up to six people with a mental health condition and learning disability, some of whom live with physical health conditions. At the time of our inspection there were five people living in the home.

The service had a registered manager in post. 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.

There were risk assessments in place that gave guidance to staff on how risks to people could be minimised and how to safeguard people from the risk of possible harm. People’s medicines had been managed safely.

The provider had effective recruitment processes in place and there were sufficient staff to support people safely. Staff understood their roles and responsibilities and would seek people’s consent before they provided any care or support. Staff received supervision and support, and had been trained to meet people’s individual needs.

People’s needs had been assessed, and care plans took account of their individual needs, preferences, and choices. The service supported people with health care visits and access to the community.

There was a formal process for handling complaints and concerns. The registered manager encouraged feedback from people and relatives and acted on the comments received to continually improve the quality of the service. There were effective quality monitoring processes in place to ensure that the home was meeting the required standards of care.

One person told us "I am happy here. I go out and I go to the Gateway Club."

Staff told us "everything runs smoothly" and the deputy manager was "approachable and very good with staff". Staff felt supported by the senior staff. There were enough staff on duty, who had the right skills and training, to meet the needs of the people in the home when we visited.

We looked at the systems for handling people's medicines and found robust systems in place to ensure people were not placed at risk from the unsafe use of medicines.

The premises were decorated to a high standard and were safe and appropriate for the people in the home. The home had robust systems in place to ensure the environment and facilities were checked and maintained appropriately.

The provider had robust quality assurance systems in place to ensure that the views and experiences of the people in the home were listened to and acted upon.

Overall we found that standards were being met.