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Inspection Summary


Overall summary & rating

Good

Updated 11 April 2017

Langholme is a care home which provides care and accommodation for up to 39 older people, some of whom are living with dementia. It is part of the MHA group, a Methodist charity and housing association providing a range of care services for older people On the day of the inspection there were 38 people using the service. We carried out this inspection on 8 March 2017. The service was last inspected in June 2015. At that time we were concerned the arrangements for the management of medicines were not robust and we found the service was in breach of the regulations.

The service is required to have a registered manager and at the time of our inspection a registered manager was 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 and associated Regulations about how the service is run.

The service was split into two units. People who were living with dementia lived in the ground floor unit. People who required residential care had their accommodation on the first floor unit. Each unit had a dining and lounge area and a small kitchen where drinks and light snacks could be prepared. A larger kitchen was used to prepare meals for both units.

People told us they were happy with the care they received and believed it was a safe environment. One person told us; “I tell them if I need anything at all.” A relative said; “My [relative] is well cared for. They are considerate and make allowances for people. They do what they can to assist.”

The service was consistently staffed in line with the staff numbers identified as necessary. Staff told us people’s needs were increasing and it was becoming more difficult to deliver care in line with people’s preferences with the staffing levels in place. We have made a recommendation about this in the report. Staff completed a thorough recruitment process to ensure they had the appropriate skills and knowledge for their role.

New staff completed an induction before starting to work directly with people delivering personal care. Training was updated and refreshed regularly. Staff told us the training they received was good and equipped them to carry out their roles effectively. Staff had received safeguarding training and knew how to recognise and report the signs of abuse. They were confident any concerns would be dealt with.

People received their medicines on time. Medicines administration records were accurate and consistently completed. Staff supported people to access to healthcare services such as occupational therapists, GPs, chiropodists and dieticians.

People were assessed in line with the Mental Capacity Act (2005) where relevant and the management team followed the legislation to help ensure people’s human rights were protected. Best interest meetings were held when people had been assessed as not having capacity to make specific decisions. These involved other professional and family members to help make sure people’s voices were heard.

Care plans were up to date and relevant and staff told us they were a useful and accurate tool. Any risks in relation to people’s care and support were identified and integrated into the care plans. Risks specific to people’s individual health and social needs were identified. People had regular opportunities to contribute to their care plan with the support of their families if they wished.

An activity co-ordinator was employed to organise planned events. The care staff were supported by additional staff who worked with people to support their emotional and spiritual needs. People told us they were able to make day to day decisions about how and where they spent their time. Care plans and risk assessments recognised the need to support people to maintain their independence.

There was a management structure in the ser

Inspection areas

Safe

Good

Updated 11 April 2017

The service was safe. There were robust systems in place for the management and administration of medicines.

The service was staffed according to the staffing levels identified as necessary for the service. However, staff reported that, due to people's increased needs, more staff was needed to deliver care according to people's preferences.

Staff completed a thorough recruitment process to ensure they had the appropriate skills and knowledge. Staff knew how to recognise and report the signs of abuse.

Effective

Good

Updated 11 April 2017

The service was effective. Staff had a good knowledge of each person and how to meet their needs. Staff received on-going training so they had the skills and knowledge to provide effective care to people.

People had access to a varied and healthy diet.

Staff worked in accordance with the legal requirements of the Mental Capacity Act 2005 and the associated Deprivation of Liberty Safeguards.

Caring

Good

Updated 11 April 2017

The service was caring. Staff recognised and respected people's diverse needs.

Staff had a good understanding of people's backgrounds and were compassionate in their approach to people.

People were protected from the risk of social isolation.

Responsive

Good

Updated 11 April 2017

The service was responsive. Staff were aware of people's changing needs.

Care plans were informative and reviewed regularly.

People had access to a range of activities.

Well-led

Good

Updated 11 April 2017

The service was well-led. There were clear lines of accountability and responsibility in place which were understood by all.

The staff team worked well together to help ensure people's needs were met.

There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed.