Archived: The Langston

At the last inspection in December 2015 the service was rated Good in all domains and Good overall.

At this inspection we found the service remained Good.

The service was well run by the new manager who was supported by a team of nurses, care staff and support staff. The manager who had taken over the service had applied to Care Quality Commission (CQC) to become the registered manager. A registered manager is a person who has registered with the 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 an open and transparent culture that valued people, their relatives and staff. The provider had systems to monitor the quality of the service provided and appropriate action was taken when required. The service worked well with various external professionals when required. People and relatives were positive about the new manager.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People’s rights to make their own decisions were respected. Staff were knowledgeable about MCA and knew how to adhere and act in practice. People’s care plans outlined people’s abilities in relation to their decision making and stressed the importance of respecting people’s rights. We however found the records surrounding people’s capacity needed to be clearer as these did not always reflect the specific decisions where people were deemed not to have capacity to make these decisions. We made a recommendation that the provider refers to the Code of Practice when formulating capacity assessments.

People remained safe at the service. Staff understood how to protect people’s safety and how to raise any safeguarding concerns. Risks related to people’s individual needs were identified and appropriate guidance was in place how to manage these risks. People were supported to access various external health professionals when needed and meet their nutritional needs.

There were enough staff to keep people safe. On the day of our inspection people were assisted promptly. The provider followed safe recruitment procedures. Staff were skilled and had the relevant training and they told us they were well supported.

The service continued to provide care and support in a compassionate way. Staff respected people’s privacy and treated people with dignity. People were involved in decisions about their care and their independence was promoted as much as possible. People’s confidential information was respected. People’s individual needs in relation to access to information were respected and we saw the provider used information in easy read, such as pictorial format when required.

People’s needs were assessed prior to admission to The Langston. Individualised care plans ensured people’s needs were respected. Staff knew people’s needs well and knew how to support them effectively. People were provided with a choice of social activities, according to their needs and preferences.

We observed care workers providing care in a sensitive and dignified manner. Personal care was carried out behind closed doors ensuring people's privacy was maintained.

We spoke with four care workers during our visit. Care workers were very motivated and caring and attentive to people. One care worker told us 'I like it, it can be busy but I like working here'. Another care worker said 'I like to think that I treat people with compassion'.

The Langston employed two activities co-ordinators who between them provided a programme of activities based on what people who lived in the home had requested. People we spoke with, who wanted to be involved in activities told us, 'there is usually something going on during the day'.

We saw that the provider had medication policies and procedures in place. We observed the administration of medication and conducted spot checks on the Medicine Administration Sheet (MAR). No errors were found.

During our visit we observed that there were enough care workers to meet the assessed needs of the people who lived in the home. One person said 'they are always popping in and out'.

The provider had effective quality assurance systems in place to monitor and record that the service was meeting the needs of the people who lived there. They did this by gaining and recording feedback from the people who used the services, their relatives and visiting professionals.