Langley Court Rest Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The provider had an electronic care record system which staff used to report incidents. Managers were able to view and analyse incidents and safety events in real time, and shared any lessons learned to staff through team meetings, observations and one-to-one discussions. The registered manager understood their responsibility to monitor and investigate safety incidents and to share findings with relevant parties such as GP’s and the local authority.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Pre-admission assessments were completed for all potential new admissions. The registered manager and deputy manager met with the person and their representatives if they had any, and information was gathered and assessed as to whether they could be safely supported at the service.

A manager reviewed the pre-admission assessments to ensure they held sufficient information to complete a basic care plan that would be relied upon by staff to use to provide person-centred support. Over the first few weeks following admission, as more information and needs were learned, plans are developed more fully.

The Registered Manager told us, “We review the suitability of care needs, whether we can meet them and whether we can marry this with the other residents, so as not to unsettle them in their home. Over the next 4 weeks we will continually assess and update people’s care plans and risk assessments.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

Managers and staff understood how to safeguard people. They knew how to recognise and report abuse and were able to articulate how they would spot signs if people were at risk of abuse or harm. A member of staff told us, “I would report any abuse to the person in-charge and follow our protocols.” Managers made timely safeguarding referrals when required and worked with the relevant partners to ensure people were safeguarded from further risk. Staff had completed mandatory safeguarding training and a plan to introduce safeguarding refresher sessions was being actioned by managers.

Applications had been made for Deprivation of Liberties Safeguards (DoLS) in a timely manner and best interest decisions were documented. DoLS protect the human rights of people who cannot consent to care that restricts their liberty.

People told us their relatives felt safe in the home. A relative told us, “Yes, I do feel they are safe living there. I believe they have many measures in place there and although accidents do happen, I believe and am confident that they will react to anything that happens within a reasonable time.” Another said, “Yes, they feel safe there. Every time I have had any contact with the staff there, I have felt reassured that my [relative] is definitely safe there.”

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Systems to ensure risks to people were routinely assessed, monitored and reviewed. People’s care records contained current and sufficiently detailed information about potential risks to their safety and how these risks should be prevented or appropriately managed. For example, a risk management plan for a person with challenging behaviour was clearly documented within their care plan. Risk assessments were up to date. Senior staff had systems which alerted them to when risk assessments needed reviewing.

Managers and staff were fully aware of the potential risks people might face and the steps they needed to take to prevent or safely manage them. During the assessment, staff were able to effectively de-escalate a situation with a person promptly, this demonstrated how well the staff knew the person and how they managed challenging situations. Staff remained vigilant to people’s whereabouts and were visibly present during the site visit. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff supported people to stay healthy and were in line with their assessed needs and wishes. Staff supported people to stay in regular contact with relevant external health care professionals. An external healthcare professional told us, “I have no concerns with the home, I really enjoy coming here as residents appear happy and staff are always helpful.”

Staff knew when people were unwell or in pain, discomfort or showing signs of an infection and supported people to access health care services for their health care needs. For example, staff ensured people routinely attended scheduled health care appointments and had could access a range of community-based health care professionals including, GP’s, nurses, physios and opticians.

The provider mostly controlled potential risks in the care environment. They did make sure equipment, facilities and technology supported the delivery of safe care.

There was a system to help ensure the home and equipment was maintained and serviced. There were regular servicing contracts which included lifts and hoists, and fire safety. Where improvements were identified, plans were in place to address these and make the necessary improvements.

Staff received fire safety training and regular fire drills were undertaken to ensure staff knew what actions to take in an emergency. Each person had a personal emergency evacuation plan to guide staff in case an evacuation was required at any time.

Systems were in place to comply with health and safety requirements such as water safety, and waste management. Gas and electrical safety certification were in date.

However, we observed some potential slips and trips hazards, and we asked the provider to review the placement of armchairs, personal protective equipment (PPE) station and clinical waste outside people’s rooms on the first floor to minimise potential trips or falls. A narrow and steep staircase, with minimal lighting to the second floor was accessible, although we were told it was not used by people who had rooms on the second floor as they used the lift. We advised the provider to review this risk. We found a boiler room door was unlocked and had visible exposed wires. This risk was discussed with managers on the day and has since been addressed.

The provider made sure there were enough qualified, skilled and experienced staff who worked together well to provide safe care that met people’s individual needs. Staff did not always receive regular one-to-one supervision in line with the provider’s policy.

The provider had a mixed and skilled staff team which consisted of 2 managers, senior carers, care staff, chef, cleaner, catering and laundry staff. Managers and senior care staff worked flexibly to support care staff and cover any gaps when needed. During our site visit, we saw there were enough staff to provide support, and we observed people were comfortable around staff who responded to them in a kind and appropriate manner.

Peoples’ relatives felt there were enough staff during the day but were less confident during the night. A relative told us, “I think things have improved and feel that there are more eyes now on the residents, so my only lingering concern is at nights.” The registered manager told us they were in the process of reviewing night staffing levels to ensure they had enough care staff to support people’s increasing needs.

New staff were recruited safely and records confirmed pre-employment checks were completed prior to employment commencing. Records included feedback on performance as well as a focus on discussing people’s care needs. There were a significant number of care staff who were overdue their one-to-one supervision which meant the provider did not always work in line with their own supervision policy. We discussed this with the provider. They were aware of this as it was highlighted in their monthly quality assurance audit and had a plan in place to improve this. The Registered Manager told us, “I am also on the floor a lot and always observe and give feedback (positive or negative) on what I see and will immediately correct any poor practice at the time.” Staff told us they felt supported by managers.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People lived in a clean, hygienic environment. Staff followed current best practice to reduce the risk of infections spreading. The home was visibly clean with furnishings and decorations maintained. Staff were provided with relevant training to help them prevent and control the risk and spread of infection in the care home. They had access to resources and equipment to help them reduce infection risks and used this appropriately, which included adequate supplies of PPE. Staff appropriately maintained cleaning and food safety records to provide a clear audit trail of measures taken to reduce infection risks at the service. The provider’s infection prevention, control, and food hygiene policies and procedures were current and reflected national guidance.

People’s relatives and visiting health professionals were positive about the cleanliness of the home.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

The provider’s medicines systems were well-organised and safely managed. People’s care records contained clear detailed guidance for staff about how people needed and preferred their medicines to be administered. Sufficiently detailed protocols helped to guide staff in relation to the safe administration of people prescribed medicines including, 'as required' medicines. Staff had received up to date safe management of medicines training where they performed under supervision to ensure competencies are signed off. The provider had policies relating to the safe storage and administration of medicines. Controlled medications were on site; staff were able to demonstrate how to correctly store these medications as per the providers policy. Medicines stocks, balances and records showed people consistently received their medicines as and when they should which people confirmed.

However, they did not routinely conduct a comprehensive audit to demonstrate oversight of all their medicines management processes. The Registered Manager has a plan to introduce this audit with immediate effect.