Langdale House

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

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

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.

All staff received training in safeguarding. The provider ensured senior staff received enhanced safeguarding training so there was always a safeguarding lead on site. Managers were confident staff were able to identify any abuse and report it. Staff gave examples of recent safeguarding incidents and could talk us through lessons learned. Lessons learnt were shared with staff via team meetings and during supervision.

The provider monitored safeguarding through annual audits and a safeguarding log. The audit included information about staffing, training and an action plan was present to monitor actions required. Senior staff members attended quarterly regional safeguarding forums.

Leaders maintained a safeguarding log. The log showed the provider monitored and raised safeguarding concerns with the local authority. Incidents were investigated and evidence of lessons learnt were shared in team meetings. Managers also kept a lessons learnt folder in the office which was shared with staff. The provider was open and transparent regarding safeguarding concerns and steps they were taking to mitigate risks in relation to this.

Safeguarding was also discussed with people during meetings. People were asked what it meant to be safeguarded and asked how they could keep safe. People’s voice was included. The service also displayed information in easy read formats about safeguarding in communal areas to ensure people understood what safeguarding was.

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

Risks relating to people were appropriately assessed and managed. People had detailed risk assessments in place which outlined their risk, the benefits to the person managing the identified risk and what actions needed to be taken to reduce the risk. This included information relating to falls, use of equipment, road awareness, physical health and choking risks. Risk assessments were person-centred.

Each person had detailed positive behavioural support plans in place. The plans included people’s own voice of how to support them when they were presenting with an emotional reaction. The plans included strategies to help guide staff to provide safe and consistent support. For example, the plans included proactive strategies on preventing emotional reactions from occurring, early warning signs before the behaviour starts and active strategies on how to stop the behaviour from escalating. The positive behavioural plans were tailored to meet individual needs. Managers created a one-page guide on how to support people which condensed the information from the risk assessments and care plans, to enable staff to efficiently support people.

The service had a low level of incidents. Staff had not carried out any physical interventions in the last 12 months. Staff told us they were able to safely manage people, using verbal de-escalation and supporting them in ways unique to them.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider ensured there were enough qualified, skilled and experienced staff. Staff were proactively supported and encouraged to acquire new skills, use their transferable skills, and share best practice.

Leader coordinated and adapted strategies to manage issues relating to staffing and had systems and processes that support this.

The service did not use agency staff but had bank staff who were previously permanent staff at the service. This meant staff were skilled in supporting people and were familiar with their needs. Managers told us the service had a low turnover of staff.

The provider had a protocol for staff shortage which was regularly reviewed. The provider’s staffing numbers were above the safe staffing levels. This meant, in the event of staff shortage, the service could still deliver care safely to people. Senior staff told us they would often work to cover shifts where necessary. Staff always had access to an on-call manager, if a manager was not present on site.

All staff had access to a variety of training courses, with high level of compliance. Training included, safeguarding, physical health training i.e. constipation and bowel management for people with learning disabilities, care plan implementation, epilepsy awareness, skin integrity, falls management, learning disabilities and autism training, medication management, positive behavioural awareness and using incident reporting systems. Leaders were proactive at identifying new training courses in line with the needs of people. For example, at the time of the inspection the provider sourced training for staff who supported a person with eyesight issues.

Staff completed detailed handovers daily for day and night shifts. The handover detail included any actions required and information about people. For example, it included people’s daily activities, their mood and planned events for the day. The handover details were detailed and had emergency contact information on them for example, who the Fire Marshall was each day, the first aider and who to contact during out of hours. The handover information incorporated information about any safeguarding concerns.

Safe recruitment processes were in place. The provider had a central recruitment team who obtained relevant records included references and Disclosure and Barring Service (DBS) checks. Staff received regular supervision and yearly appraisals. New staff were provided with a two-week induction programme with shadowing opportunities.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.