Langford Park

Updated 8 March 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors; a specialist advisor, whose specialism was nursing care; and 2 Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Langford Park is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Langford Park is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was not a registered manager in post. Efforts to recruit the right person for the role were ongoing.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

During the inspection

We spoke with 8 people who used the service and 3 relatives about their experience of the care provided. We spoke with 14 members of staff including the provider, clinical lead, quality assurance lead, nursing staff, care staff, maintenance and housekeeping staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We reviewed a range of records. This included 10 people's care records and multiple medication records. We looked at 4 staff files in relation to recruitment and staff supervision. We also reviewed a variety of records relating to the management of the service, including policies and procedures.

Following the inspection, we received feedback from 3 external health and social care professionals who work with the service.

Updated 8 March 2023

About the service

Langford Park is a 'care home' registered to provide accommodation, nursing and personal care support for up to 35 older people; people living with dementia; and younger people with a physical disability. At the time of this inspection there were 31 people living there, supported over 3 floors. Langford Park is set in rural parkland close to the city of Exeter.

People’s experience of using this service and what we found

There had been 3 unsuccessful managerial appointments in 3 years. The service was being managed by the provider, supported by the clinical lead and quality assurance lead, pending the recruitment of a new manager. The management team had continued to develop and embed the systems and processes introduced by the previous manager. This was largely confirmed in feedback received from people, relatives and the staff team. One member of staff commented, “Langford have made lots of changes and there is more support from the management team and the nurses. I think we are at a very good place and all working together as a team better.”

The management team promoted a culture of openness and honesty. They were open and transparent during the inspection. They demonstrated their commitment to reflecting and learning when things went wrong and sharing this knowledge with staff to improve the quality and safety of the service. The majority of staff told us they felt well supported both personally and professionally. They were passionate about their role.

There was a robust and effective quality assurance programme in place. This meant the provider had already identified the majority of issues we found at the inspection and was taking action to address them. Where issues had not previously been identified, the provider took immediate action in response to our feedback.

We found improvements were needed to care plans to guide staff in the cleaning of equipment and recognising signs of infection. The management team acted immediately, and this information had been added to care plans before the end of the inspection. Overall, we found the management of risk had improved, with better recording and well trained and competent staff. The staff team worked in partnership with external health and social care professionals to support people. A robust pre-admission process was in place to ensure any new placements were safe and well planned, after issues had arisen following the admission of people with very complex needs.

People felt safe living at Langford Park and there were enough staff to meet their needs. The provider took action during the inspection to stagger staff breaks, to ensure communal areas were adequately staffed at all times. Last minute sickness had been a challenge, but this had been addressed by the management team and improved over recent weeks. Staff were recruited safely, and safeguarding processes were in place to help protect people from abuse. One person said, “It’s okay, they are all nice. They make sure you are clean, make sure you are comfortable.”

There were systems in place to ensure the safe administration of medicines, although some improvements were needed in relation to the recording of topical medicines administration; the storage of oxygen cylinders and protocols for the use of ‘as required’ medicines. Immediate action was taken to address these issues.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published) 25 May 2022.

Why we inspected

This inspection was prompted in part due to concerns received about the management of risk, and staffing. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe and well led sections of this full report.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Langford Park on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.