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Inspection carried out on 9 May 2017

During a routine inspection

This inspection was carried out on 9, 10 and 12 May 2017 and was unannounced. Langley Park provides residential care for up to 46 people over two floors in the centre of a village in County Durham. At the time of our inspection there were 45 people using the service. The home is not registered to provide nursing care.

Following our last inspection in March 2015 Langley Park was rated overall as “Good”.

There was a registered manager in post. 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.

We found staff in the home were extremely caring. People who used the service, relatives and visiting professionals were highly complementary about the staff team. They used words such as, “Brilliant” or “Outstanding” to describe them.

Staff had very positive relationships with people and their relatives. We found staff knew people exceptionally well and had found ways to engage with people which promoted their emotional and physical well-being to a high degree. We saw every member of staff approached people with kindness. Staff anticipated people’s needs and offered their help.

We saw the staff in the home provided people with meaningful activities which met every aspect of the National Institute for Health and Care Excellence (NICE). The activities and events in the home permitted relatives to have social times with the people who used the service. We found staff had successfully engaged people in a wide variety of activities which met their preferences and reflected their individual preferred lifestyles. The home was full of laughter. Music was used to enhance people’s emotional well-being and this was infectious through the home. Relatives described their family members as being “Happy” and “Content.”

People received consistent, personalised care and support which was documented in detail in people’s care records. These were regular reviewed and updated when people’s needs changed. Staff demonstrated they clearly understood people’s needs and were able to provide several examples of how they delivered individualised care to each person who used the service.

Visiting professionals told us they were confident in the care provided to people at the end of their life. One professional said, “They give people very good end of life care.” Relatives had sent cards to the home to say “Thank you” to the staff for providing sympathetic and thoughtful care when people who used the service approached the end of their life.

We found if relatives raised any concerns or wished to discuss issues these were promptly addressed by the registered manager. There had been no complaints in the last 12 months. Seven relatives had used a web based review site to leave comments about the service. All of their reviews highly praised the staff.

We checked people’s medicines records and talked to staff about how they administered people’s medicines. We found people received their medicines in a safe manner. Guidance was given to staff on signs to look out for if people were in pain.

We found regular checks were carried out on the building to ensure people lived in a safe and secure environment. People had personal emergency evacuation plans in place which were accessible to emergency services to help them locate people in the building and support them to leave.

The registered manager maintained safe staffing levels. Relatives told us they thought there were enough staff on duty. We found staff were able to respond quickly to people’s care needs.

Robust checks were carried out on staff to ensure they had the appropriate skills, experiences and attitudes to work in the home. Once recruited, staff were supported through internal and external training, supervision and apprai

Inspection carried out on 09 and 10 March 2015

During a routine inspection

The inspection took place on 09 and 10 March 2015. The inspection was unannounced.

The home provides care for up to 46 older people, and includes a dementia care unit for 24 people located on the first floor. On the day of our inspection there were 41 people using the service.

The home had a 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.

We spoke with care staff who told us they felt supported and that the registered manager was always available and approachable. Throughout the day we saw that people and staff were very comfortable and relaxed with the registered manager and staff on duty. The atmosphere was calm and relaxed and we saw staff interacted with people in a very friendly and respectful manner.

Care records contained risk assessments. These identified risks and described the measures and interventions to be taken to ensure people were protected from the risk of harm. The care records we viewed also showed us that people’s health was monitored and referrals were made to other health care professionals where necessary. We saw records were kept where people were assisted to attend appointments with various health and social care professionals to ensure they received care, treatment and support for their specific conditions.

We found people’s care plans were written in a way to describe their care, treatment and support needs. These were regularly evaluated, reviewed and updated. The care plan format wasn’t easy for service users or their representatives to understand; they lacked plain English and were long and complex. However, we were informed by the registered manager that a new care plan format was being piloted. We viewed these and saw immediately that they were much more user friendly. We did see evidence to demonstrate that people or their representatives were involved in their care planning.

The staff that we spoke with understood the procedures they needed to follow to ensure that people were kept safe. They were able to describe the different ways that people might experience abuse and the correct steps to take if they were concerned that abuse had taken place.

Our observations during the inspection showed us that people were supported by sufficient numbers of staff. We saw staff were responsive to people’s needs and wishes.

When we looked at the staff training records they showed us staff were supported to maintain and develop their skills through training and development activities. The staff we spoke with confirmed they attended face to face and e-learning training to maintain their skills. They told us they had regular supervisions with a senior member of staff where they had the opportunity to discuss their care practice and identify further training needs. We also viewed records that showed us there were appropriate recruitment processes in place.

The registered manager and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

During the inspection we saw staff were attentive and caring when supporting people. When we spoke with people who used the service and their relatives. We were told they were extremely happy with the care, treatment and support the home provided. Other professionals we spoke to were very positive about the care provided

We observed people were encouraged to participate in activities that were meaningful to them. For example, we saw staff spending time engaging people with dementia on a one to one basis, and others were involved in arts, crafts and baking. Others and some relatives were using the shop and cafe that had just opened on the dementia care unit.

We saw people were encouraged to eat and drink sufficient amounts to meet their needs. We observed people being offered a selection of choices. For some people who had communication needs, we saw pictorial menus were used to help them to choose what they wanted to eat. For those people that required assistance to eat their meal, this was carried out in a dignified and discreet manner.

We found the building met the needs of the people who used the service. For example, the environment was suitable for people who used a walking aid and wheelchair users. We saw the dementia care unit had been specifically designed using colours, signs, memory orientation boards and memory box’s to aid people’s stimulation, independence and their wellbeing. This was in line with a number of different national best practice guidance documents.

Risks to people’s safety in the event of a fire had been identified and managed, for example, fire risk assessments and evacuation plans were in place.

We saw a complaints procedure was displayed in the main reception of the home. This provided information on the action to take if someone wished to make a complaint.

We found an effective quality assurance system operated. The service had been regularly reviewed through a range of internal and external audits. Prompt action had been taken to improve the service or put right any shortfalls they had found. We found people who used the service, their representatives and other healthcare professionals were regularly asked for their views.

We saw the home had received nine recognition of kindness awards (ROC) these were awards provided by the organisation following nominations from health and social care professionals and people’s representatives.

Inspection carried out on 7 May 2013

During a routine inspection

The arrangements for supporting people to make decisions about their daily lives and preferences were recorded in their care plans. Each person was supported to take appropriate risks to promote as much independence as possible.

The relationships between staff and the people who they cared for were good and personal support was provided in a way that promoted and protected their privacy and dignity. This was confirmed when we spoke with people who used the service and to people's relatives.

A visiting professional told us the care provided at the home was very good.

Suitable arrangements were in place for protecting people from abuse. There was a competent staff team who had the training, skills and experience to meet the specific conditions of the people they supported.

Inspection carried out on 9 October 2012

During a routine inspection

Some of the people using the service had complex needs which meant they were not able to tell us their views, we therefore used a number of different methods to help us understand their experiences.

Those people living in the home we spoke with said that they were happy with the service provided by the staff. One person told us, when asked about the way they were treated, “If you’re talking about dignity and kindness they’re tip top” and ”100%”.

One visitor told us she thought the home had “looked after” their relative really well and that she was “really pleased” with the care. Another visitor, when asked about the care being given to their relative, said “The staff asked about me about the kind of things that my relative liked to do and the kind of food she likes.” All of the relatives we spoke with had been involved in developing the initial care plan for the people who lived here and were happy with the content of the documents.

Staff were given relevant training to equip them for their role and were being supported through appraisals and supervisions. They told us they were confident in their job and would go to senior staff and manager for guidance and advice.

We spoke with a small group of people sitting in a lounge. They told us they were very happy with the service and how much they appreciated the staff and the manager. They told us the food was “excellent” and one suggested, “If you can stay you should have your dinner as it’s really nice.”