Archived: Langtree Park

Updated 15 June 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 26 February and 3 March 2015 and was unannounced. The inspection team consisted of two adult social care inspectors, a specialist advisor with a background in dementia care and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

At the time of our inspection there were 31 people living at the home. During our visit we spoke with seven people who lived at the home, six visiting relatives, nine members of staff, one visiting healthcare professional, the registered manager and the area manager.

We spent time looking at documents and records which related to people’s care and treatment and the management of the service. We looked at five people’s care records. We also spent time observing care in the lounge and dining room areas to help us understand the experience of people living at the home. We looked at all areas of the home including the kitchen, people’s bedrooms and communal bathrooms.

Before our inspection, we reviewed all the information we held about the home, including previous inspection reports. We also spoke with the local safeguarding team.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. On this occasion the provider had not received their PIR.

Updated 15 June 2015

We inspected the service on 26 February and 3 March 2015. The visit was unannounced. Our last inspection took place on 13 May 2014 and, at that time; we found the service was not meeting the regulations relating to care and welfare of people who used the service, safeguarding people who use services from abuse and records. We asked them to make improvements. The provider sent us an action plan telling us what they were going to do to ensure they were meeting the regulations. On this visit we checked and found improvements had not been made in all of the required areas.

Langtree Park Nursing Home provides accommodation and nursing care for up to 60 older people some of whom may be living with dementia and other mental illnesses. The accommodation for people is arranged over two floors. There is a passenger lift operating between the floors. There were 31 people living at the home on the days of our inspection.

The home had a registered manager. 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.

During our visit we saw people looked well cared for. We observed staff speaking in a caring and respectful manner to people who lived in the home. Staff demonstrated that they knew people’s individual characters, likes and dislikes.

We saw people’s safety was being compromised in a number of ways. We observed areas of the home were left unsupervised at times. This was in the communal living and dining areas of the home. Staff told us due to the dependency of people living at the home they were unable to ensure communal areas were supervised at all times. We spoke staff and relatives of people living at the home who told us they were concerned about the staffing levels in place at the home. They said they were worried about people’s safety.

We found the service was not meeting the legal requirements relating to Deprivation of Liberty Safeguards (DoLS).

The service was not meeting the requirements of the Mental Capacity Act 2005. We saw decision specific mental capacity assessments had been carried out for people living at the home however, these were not related to any decisions about the care and treatment people were receiving.

We spoke with staff who told us about the action they would take if they suspected someone was at risk of abuse. We found this was not consistent with the guidance within the safeguarding policy and procedure in place at the home.

We found there were issues with regarding the management of medicines within the home. This was in relation to the administration, storage and lack of guidance in place for staff to follow when administering ‘as required’ medicines to people.

The home provided care for people living with dementia. There was little evidence of national guidance or best practice on which the home based the care they provided for people living with dementia. This meant the provider could not assure themselves they were meeting the required standards regarding dementia care.

We found there were issues with regard to the standards of record keeping within the home. This related to the storage, accuracy and the lack of guidance in place for staff to follow on how to meet people’s needs.

People told us the food at the home was good and that they had enough to eat and drink. We observed lunch being served to people and saw that people were given sufficient amounts of food to meet their nutritional needs. We were concerned however, that people did not have access to drinks at all times due to the removal of the kitchen area on the first floor. The area manager and the registered manager responded to this and on the second day of our inspection we saw work was in progress to install a beverage area.

We saw the home had a range of activities in place for people to participate in. Staff were very enthusiastic and people’s relatives told us the activities had a positive impact on the lives of their relatives. This meant people’s social needs were being met.

We looked at four staff personnel files and saw the recruitment process in place ensured that staff were suitable and safe to work in the home. Staff we spoke with told us they received supervision every three months and had annual appraisals carried out by the manager. We saw minutes from staff meetings which showed they had taken place on a regular basis and were well attended by staff.

We saw areas of the quality assurance system the provider had in place had not been completed. For example, we saw care plan audits did not show evidence of the care plans being audited. This meant the home was not monitoring the effectiveness of the care people were receiving.

We found there were issues relating to staff not receiving annual refresher training in areas such as dementia care, Mental Capacity Act 2005 and DoLS, safeguarding, health and safety, fire safety, challenging behaviour, first aid and basic life support. This meant people living at the home could not be assured that staff caring for them had up to date skills they required for their role.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.