Langley Haven Care 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 requires improvement. At this assessment the rating has changed to 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.

Where incidents and accidents had taken place, there was clear evidence the registered manager had thoroughly investigated and mitigated the risk of the incident reoccurring. Action was taken to understand why a person had become distressed or why an incident occurred and what could be changed to prevent further occurrences. For example, it was identified by the registered manager from reviewing their incidents and accidents, the majority of falls took place between a specific time period early in the morning. The registered manager actioned this by ensuring there was an increase in staff availability at this time in order to reduce the risk of falls. Following the registered manager identifying this, the incidence of falls had reduced. The registered manager told us how they oversaw and monitored the service and any events at the service to ensure safety was a top priority that involved everyone, including the whole staff team, people and relatives.

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.

People told us they felt safe, and relatives agreed. One relative told us, “I feel that this one of the safest homes I have visited, and I have visited a few.” The service was in regular contact with multiple professionals including the care home support team in order to ensure people received the required care. Prior to people arriving at the service, the management team conducted assessments to ensure they were able to meet the needs of the person and support a smooth transition to the service. The registered manager explained how they worked together with professionals and others, through a collaborative, joined-up approach, to ensure safety and continuity of care was a priority throughout people’s care journey. For example, if the service was preparing for a potential admission, the manager worked together with the person, their family, and professionals to gather and create plans of care so they could receive the care and support they needed.

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.

Staff were aware of the service’s safeguarding policy and procedures. Staff were also able to explain different types of abuse and how to raise concerns in order to keep people safe. One staff member told us, “I would report it [the concern] to the manager. If [they took] no action, I would go to the higher authority, local authority and CQC.”

All staff had received safeguarding training, and this was up to date. People and their representatives were involved in all aspects of their care. The staff and leaders had taken active steps to ensure there was an open culture. There was evidence that concerns could be raised safely and that poor or unsafe practice was identified and challenged. People told us they felt they could speak to the management team if they had any concerns and this was echoed by their relatives.

In cases where individuals lacked capacity, the registered manager made appropriate applications for Deprivation of Liberty Safeguards (DoLS).

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.

Risks were assessed and mitigation put in place to minimise risks where possible. People had risk assessments in place for all key aspects of their care. An electronic care planning system was in place to ensure risk assessments were able to be updated promptly and as required. The management team felt this would help them manage risks to people in the future. We observed a calm and supportive environment, where people were encouraged to move about the service independently. Staff knew people well and demonstrated an understanding of people’s risks. The service encouraged people to take positive risks, such as administering their own medication, daytrips, and assisting people to maintain their mobility. The provider responded promptly to update risk assessments where shortfalls were identified.

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

The service was in the process of refurbishing. One area had recently been painted outside of people’s rooms. During the assessment, we identified a handrail had not been put in place within this area. This was raised to the registered manager who evidenced this had been identified and it had been arranged for a handrail to be attached in the coming weeks.

There was clear signage throughout the home to support people’s orientation.

There were comprehensive maintenance and refurbishing plans in place. These were overseen by the provider’s maintenance technician. Throughout our visit we saw the environment was clean and well maintained.There were strong processes in place to show when issues had been reported or highlighted to the team by either staff at the service or via auditing processes. The provider could keep track of them and ensure work was carried out in a timely and safe way.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. Records confirmed that staff underwent a structured induction and received ongoing supervision and appraisals to support their development and performance. Staff had completed regular training in multiple areas, including those specific to meet the needs of people living within the service, which promoted safe and compassionate care practices. Staffing rotas were carefully planned to maintain an appropriate mix of skills and experience on each shift, and a trained staff member was always available to administer medication. Observations showed that staff had time to engage with individuals, respond to their requests promptly, and provide attentive support. Recruitment records demonstrated that thorough checks were carried out, including application forms, interview notes, references, enhanced Disclosure and Barring Service (DBS), right to work documentation, and identity verification.

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.

Staff received training on infection control. There was liquid soap and paper towels at hand washing areas and additional hand sanitisers throughout the service. There was a good supply of Personal Protective Equipment (PPE). Staff were trained in PPE use. Infection control audits were completed and reviewed practice, equipment and standards of cleanliness.

The provider did not always make sure that medicines and treatments were safe and met

people’s needs, capacities and preferences. Staff did not always involve people in planning

We reviewed the services management of medicines, some of which were kept separately in a locked cupboard. Precautionary medicines were prescribed to support people with pain if they needed it. We identified some medicines that required more regular monitoring had not been checked by staff for 3 weeks. It is recommended care homes review their medicines on a regular basis to make it much easier to spot and track discrepancies. This was raised to the registered manager who immediately implemented further checks on a more regular basis.

A review of medicine administration records and associated audits confirmed that no errors or missed doses had been identified. Where clinically indicated, some individuals received their medicines covertly (giving someone their medication in a disguised way, such as mixing it into food or drink without them being aware). We discussed the service’s procedures for covert administration with both staff and the registered manager. The registered manager had ensured that appropriate mental capacity assessments were completed prior to any covert administration, in line with legal and best practice requirements. Staff demonstrated a clear understanding of the process, including the importance of offering individuals the opportunity to take their medicines openly before proceeding with covert administration when necessary.