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Archived: Langdale House Care Home Requires improvement

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Inspection Summary


Overall summary & rating

Requires improvement

Updated 25 April 2018

Langdale House Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. Langdale House is registered to accommodate up to 12 people with needs including a diagnosis of mental health, older people and people who are living with dementia; at the time of our inspection, there were 8 people living in the home.

At our last comprehensive inspection on 30 November 2016, we rated the service as requires improvement. The service was rated as requiring improvement in the Responsive and Well-led domains. This was because care plans were not always current and up to date, systems in place to monitor the service were not accurate and people sometimes had to wait for care.

At this inspection we found the service remained requires improvement. This is the third time the service has been rated as requires improvement.

The inspection took place on the 6 March 2018 and was unannounced.

A registered manager was not in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 was a manager in place. The manager told us they would be applying to become the registered manager.

Risks to people were assessed and monitored regularly. However, the information included in the assessment was not always based on guidance from a health professional.

People were not always protected from the risk of infection. The premises were not maintained and presented a risk to people who used the service.

Staff were not always appropriately recruited. Checks to ensure they were suitable to work with people had not always been completed before they started work.

The quality of the service was monitored through limited audits carried out by the management team and provider. These had not been effective at identifying the areas of concern we found.

People felt safe when they were receiving care from staff. Staff understood their roles and responsibilities to safeguard people from the risk of harm.

There was clear guidance for staff about how to support a person if they became aggressive.

There were sufficient staff to meet people’s needs. Although people sometimes had to wait for staff support if the staff did not hear them calling for assistance.

People were supported to take their medicines as prescribed. Staff who administered medicines had not always received training to ensure they were competent.

People's health and well-being was monitored by staff and they were supported to access health professionals.

People were cared for by a staff team who were friendly, caring and compassionate. Positive relationships had been developed between people and staff. People were treated with kindness.

People's care and support needs were monitored and reviewed to ensure care was provided in the way they needed. People had been involved in planning their care.

Plans of care were in place to guide staff in delivering consistent care and support in line with people’s personal preferences and choices. These were being reviewed and updated, however did not always reflect people's current needs or up to date guidance. End of life wishes were discussed and plans put in place.

Staff did not always have access to the supervision and training they required to work effectively in their roles. The manager told us they were working to develop more detailed staff training. People were supported to maintain good health and nutrition.

People were supported to have choice and control of their lives and staff supported the

Inspection areas

Safe

Requires improvement

Updated 25 April 2018

The service was not always safe.

Risks to people had been identified and assessed. These had not always been updated when a person�s needs changed. People were not protected from the risk of infection. The premises had not been well maintained and presented a risk to people using the service.

People were protected from abuse and harm by staff who knew their responsibilities for supporting them to keep safe.

People were supported to take their medicines in line with the prescriber's instructions. Some staff were undertaking this task without appropriate training and supervision.

Staffing levels had been assessed. The provider did not always follow safe recruitment practices when employing new staff.

Effective

Requires improvement

Updated 25 April 2018

The service was not always effective.

People were cared for by staff who had not always received the appropriate training and support they required to carry out their roles.

People�s consent was sought before staff provided care. People were supported to access healthcare services.

Caring

Good

Updated 25 April 2018

The service was caring.

People got to know staff well. People were treated with dignity and respect and staff ensured their privacy was maintained.

People�s private information was not always kept secure to maintain their confidentiality.

People were encouraged to make decisions about how their care was provided.

Responsive

Requires improvement

Updated 25 April 2018

The service was not always responsive.

People did not always receive care that met their needs as guidance from health professionals were not recorded in their care plans.

People were not always offered activities or tasks.

People had information on how to make complaints and the provider had systems in place to deal with the complaints.

Well-led

Requires improvement

Updated 25 April 2018

The service was not always well led.

Limited quality assurance systems were in place to monitor and review the quality of the service which was provided. These had not been used effectively to drive improvement in the service.

People had not been asked for their feedback through a survey in the last 12 months.

The provider had notified CQC of allegations of abuse which they are required to do.