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Inspection carried out on 28 August 2019

During a routine inspection

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 en

Inspection carried out on 19 December 2016

During a routine inspection

Langham Court is a family run nursing home that provides support to up to 28 people. The home is located in a rural area outside Hindhead. On the day of the inspection there were 28 people living at the home. The home specialises in supporting people who are at the later stages of living with dementia and are supported with a full range of tasks, including maintaining their health and well-being, personal care, support with nutrition and activities.

Langham Court was specifically designed to meet the needs of people living with advanced dementia. There was a clear vision that was centred around the principles of Dementia Care Matters’s Butterfly Household Approach. This is a national scheme aimed at improving the lives of people living with dementia. The service was consistently praised for the positive outcomes staff had achieved to ensure that people living with dementia received exceptional care. The ethos and values of the service created a caring and compassionate environment and ensured that the care delivered was truly focused on meeting the holistic needs of people.

Langham Court was last inspected on 13 January 2014 and there were no concerns.

On the day of inspection we met the registered manager. A registered manager is a person who has registered with the Care Quality Commission 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.

The inspection was unannounced and took place on 19 December 2016.

People said that they were safe at Langham Court as they were protected from harm. Staff had the training and the ability to understand risk, and reported accidents and incidents in a timely manner. Staff understood how to report suspected abuse so that action could be taken if necessary.

Incidents and accidents were investigated and the manager reviewed reports to prevent them from re-occurring. Any potential risks to individual people had been identified and appropriately managed.

Risk assessments had been completed to ensure the home was safe for people to live in and there were arrangements in place should there be an emergency.

People were supported by sufficient numbers of staff who were recruited safely and had the skills and knowledge to support people. All nurses had an up to date PIN number to prove they were registered.

Medicines were managed and administrated in a safe way and staff had a good understanding of the medicines they were administrating.

Staff had the knowledge and skills to support people with dementia. Training was available to staff, which included training courses related to people’s needs. When a training need was highlighted the registered manager arranged for it to take place.

The requirements of the Mental Capacity Act were being fully met. Best interest meetings had taken place and the registered manager had submitted Deprivation of Liberty Safeguard applications when people were being deprived of their liberty. The registered manager was aware of the people who could legally make decisions for people who lacked capacity.

People’s nutritional needs were met and people had a varied diet. People were positive about the quality of food served and they had access to food throughout the day. Staff ensured that people had enough to eat and drink.

Staff ensured people were supported to maintain their health and wellbeing and people received support from specialist healthcare professionals when required.

The environment was adapted to support people with dementia. The vibrant and interactive corridors were praised in a recent Dementia Care Matters audit. Equipment had been introduced to help people maintain their independence.

The caring and compassion offered by staff was exceptional. People were cared for by staff who put them at the centre of all they did. People