30 March 2021
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.
As part of CQC’s response to the COVID-19 pandemic we are looking at the preparedness of care homes in relation to infection prevention and control. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.
This inspection took place on 9 March 2021 and was announced.
30 March 2021
About the service:
Langham Court is a care home with nursing and provides care and support for up to 29 mainly older people living with dementia or mental ill health. It is set next to a general nursing care home, operated by the same provider, although registered separately.
Langham Court is a purpose-built service designed to meet the needs of people living with dementia and providing care over two floors. The service is an accredited ‘Butterfly home’. This is a well-respected non-medical model of dementia care practice.
People’s experience of using this service:
Langham Court is an award-winning service, both for dementia care practice and the quality of the environment. In the months before this inspection the registered manager in place at the last inspection had left. A new experienced manager had been appointed and was starting in September 2019. Interim arrangements and professional consultancy had minimised the impact of the lack of a registered manager, until the new manager was in post.
Quality assurance systems and regular audits were in place to assess, monitor and improve the quality and safety of the service, and ‘people’s voice’ was heard at all levels of the organisation. Effective communication systems were in place, from director level to all staff. The culture, values and philosophy of the service was well understood and demonstrated by all staff we met.
The service had a calm, happy and uplifting atmosphere. People were engaged with activities that interested them, including classical music concerts, Tai Chi and exercise groups. People told us it was a positive place to live and we saw and received feedback from relatives that told us how the service had supported both them and their relation.
The care environment had been developed in line with best practice for people living with dementia. This had contributed to people’s well-being and included many areas where objects of interest meant people could stop and spend time engaging with them. Communal areas and bedrooms were light and spacious. The service had attractive safe outdoor space where people could be involved with gardening projects, or just enjoying the views of woodland, birds and sheep. Links with the local community were encouraged. Visitors were welcomed at any time, and local schools, nurseries and playgroups were regular visitors to the service.
Risks to people from living with long term health conditions were assessed, and people received their medicines as prescribed. Risk assessments included risks such as from falls, poor nutrition or pressure ulcers, and included actions taken to mitigate risks where possible. Where people were at risk, for example from poor nutrition or hydration additional supplementation to meals could be provided. People told us they enjoyed the meals on offer.
People were supported and encouraged to take risks, and remain in control of their lives, supported by thoughtful and reflective practice. Risks within the environment were managed. The service learned from incidents or accidents and reflected on their practice to prevent a re-occurrence.
People’s rights were being respected, and the service respected and supported individual people’s equality and diversity. Decisions had been made in people’s best interests, but these had not always been recorded consistently. The general manager told us this had already been identified and plans were in place to address this. Systems were in place to safeguard people from abuse, and the service responded quickly to any concerns or complaints about people’s wellbeing.
Systems for staff recruitment helped ensure potential staff were safe to work with people who may be vulnerable. High levels of staffing were in place, and this was kept under review. These ensured care staff were available to support people’s needs at all times. Staff were positive about the home’s culture and philosophy and told us how much they enjoyed working in a service where there was enough time to spend with people. Staff received the training and support they needed to carry out their role. This included support for registered nurses to maintain their professional registration.
Care plans were based on assessments of people’s needs. They contained details about people’s wishes and guided staff on how the person’s care should be delivered. We saw people’s care plans were being followed in practice. Staff knew people well. Good end of life care was of a high priority. Staff had clear understanding of people’s needs at this time of their life and had facilities available to help people and relatives to reduce distress.
More information is in the full report
Rating at last inspection:
At their last inspection in December 2016 the service was rated as outstanding for the key questions of caring and well led, and good for the other key questions. The overall rating was outstanding.
Why we inspected: This inspection was scheduled for follow up based on the last report rating.
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.