Archived: Langley Oaks

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this new service. We have rated this key question as good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this. The provider used evidenced based approaches to support people to live healthier lives, and worked with other health services to improve outcomes.

This service scored 67 (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 made sure people’s care and treatment were effective by assessing their health, care, wellbeing and communication needs; but did not involve people or their relatives (where necessary) in the assessment review and ensure they understood and met people’s individual needs.

People’s relatives told us, “I’ve not really been involved in developing [relative’s] care plan. However, they will telephone to notify me of changes” and “I haven’t seen their care plan, but I feel they care for [relative] well.” Other relatives told us they had been involved, one said, “My [relative] had a full assessment when they went to live there, and it's been reviewed since. It was a holistic assessment looking at their likes and dislikes and a little bit about his life experiences.” Another relative said, ‘The manager discussed [relative] care needs with me when they moved in. It's always an accessible, open door with ongoing conversations happening as needs arise.” This meant people’s experiences varied and the provider did not always include people or their representatives in the assessment of people’s health, care and wellbeing needs. We reviewed care records, and noted only 2 people (1 person and 1 relative) had been included in discussions about their needs. This is a further example of the provider not always including people or their relatives in their needs assessments.

Carers were allocated as keyworkers on the electronic case system; however, team leaders were responsible for updating people’s care plans and risk assessments. Care workers and team leaders told us did not always work on the unit with the people who they were the nominated keyworker for, and care workers were not involved in the monthly reviews of people’s care. This meant people’s care was not always reviewed by care staff who knew them well. This was discussed with the registered manager who confirmed keyworker roles had not been working effectively. They have since implemented a new process to ensure carers are more involved and accountable in updating people’s care plans and risk assessments, in line with their keyworker responsibilities guidance document. We will monitor the progress of this work and will review it either at the next inspection or earlier if the need arises.

Managers had daily handovers and weekly clinical meetings to review when there were changes to people’s needs, and the registered manager had oversight of people’s monthly care reviews. The provider worked in partnership with other health providers, and a partner agency told us the managers were responsive and shared information with them to help assess people’s needs.

The provider planned and delivered people’s care and treatment in line with legislation and current evidence-based good practice and standards.

The provider used evidenced based tools to identify risks and plan people’s care. They followed best practice guidelines and used evidence-based tools, for example, to identify and meet people’s nutrition and hydration needs. They worked closely with other professionals such as dieticians and speech and language therapists to ensure people’s needs were assessed and modified diets provided. We reviewed people’s care records and could see these assessments were being used effectively to inform people’s care plans.

Staff received guidance and training to support people’s dietary needs, and an emergency “Hypo box” was held in the clinical rooms to support people with diabetes who experience low blood sugar levels and may require emergency glucose for example. District nurses supported blood glucose monitoring and diabetes management, and the GP supported screening and treatment plans.

The provider worked well across teams and services to support people. They worked with other professionals to ensure people’s needs were met in a timely way.

They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Systems were in place to ensure information about people was shared appropriately with other services when needed. Staff worked well together and completed handovers to ensure all staff were updated on people’s care and health. A healthcare partner told us they felt the service was safe and responsive to people’s changing needs. However, they felt there was room for improvement in how the service shared information. They said, “Handovers can be a bit sparse as to the reason for a review, and sometimes staff can’t always respond to queries, which can cause delays.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Most people’s relatives were positive about people’s wellbeing. A relative said, “There are no restrictions, and my [relative] is enabled to maintain daily living skills such as helping with the washing up, helping to set the table, and making their own bed in the mornings. I want to extend my grateful thanks to all the staff there - they do a wonderful job.” Another relative explained, ‘The core group of staff, know [my relative] well. The staff are always asking [relative] to do things in a consensual way. For example, they say, ‘Would you like to. . .? Should we. . .? “.

People were supported to access a range of health care professionals and staff monitored people’s health and well-being daily. There were regular visits from health care professionals including GPs, district nurses and dentists. A relative told us “The staff have sorted out follow up appointments with GPs, etc and it's all been effectively managed and well documented.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The provider used clinical tools to assess and monitor emerging health needs. Digital care plans and risk assessments were updated regularly on the electronic care record. The deputy manager was responsible for the oversight of this, and was supported by the registered manager who had oversight of other clinical processes such as slips, trips and falls. These reviews had prompted the registered manager to introduce a paper system of 72 hourly falls monitoring to ensure actions are taken to reduce future risk of falls. As an example, the registered manager explained a care plan was updated to provide additional bed and sensor mats, and a medicines review. The registered manager told us this had resulted in a significant reduction in falls since April 2025, and this was evidenced in the falls data we reviewed.

The provider worked in partnership with the GP, holding a weekly clinic on site to assess and monitor people’s health needs, including reviews of their medicines. Care records showed the provider liaised well with other health professionals, facilitating timely reviews and following clinical advice to maintain or improve people’s health and wellbeing.

However, care records were not always person-centred and did not always reflect people’s own outcome goals, so we could not be assured these were meeting the hopes and expectations of people themselves. More detail about this is given later in this report.

The provider respected people’s rights around consent and decision making on a day-to-day basis and involved people and their relatives or representatives during the admission process however consent was not consistently documented.

The provider worked with other professionals during the assessment and admission process to explore people’s capacity to make decisions and consent to their care, and included people’s relatives and representatives. However, consent was not always clearly documented. We reviewed 3 pre-admission forms and consent to share information with other health professionals was inconsistently recorded in these records. Consent to care documents were not included in the electronic records provided during this assessment.

Staff were able to identify when people did and did not lack the mental capacity to give consent. The registered manager understood the requirements of the Mental Capacity Act. The registered manager understood how to take appropriate action to make sure decisions were taken in people’s best interests, involved the right people (family, friends, carers or advocates) and were made in accordance with legislation. The registered manager was able to give examples and demonstrate the steps taken to ensure these processes were improved as highlighted earlier in this report. We will monitor the progress of this work and will review it either at the next inspection or earlier if the need arises.