Langley View Residential Home Also known as Langley View

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 good. At this assessment, the rating has changed to requires improvement. 

Requires improvement: This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed. 

The provider did not always have a proactive and positive culture of safety based on openness and honesty. Staff did not always listen to concerns about safety and did not always investigate and report safety events. Lessons were not always learnt to continually identify and embed good practice. The registered manager told us they shared any learning from accidents and incidents with staff to consider what they could have done differently to help reduce the risk of a reoccurrence. However, no recent accidents/incidents or events had been recorded in the past 18 months This meant that there were no reflections or learning when things went wrong.

The provider did not always have a proactive and positive culture of safety based on openness and honesty. Staff did not always listen to concerns about safety and did not always investigate and report safety events. Lessons were not always learnt to continually identify and embed good practice. The registered manager told us they shared any learning from accidents and incidents with staff to consider what they could have done differently to help reduce the risk of a reoccurrence. However, no recent accidents/incidents or events had been recorded in the past 18 months This meant that there were no reflections or learning when things went wrong.

The provider made sure there was continuity of care, including when people moved between different services. People were supported to transition through services, helping to ensure continuity of care. For example, people who lived at Langley View had been supported to move following an assessment at their previous home. The service worked in partnership with other care professionals and partners including the local authority, GP’s, opticians, pharmacies and occupational therapists to support people’s holistic needs. People had a health passport to take to health and hospital appointments. They contained relevant information relating to people’s health care needs and pathways. 

The provider did not always work with people to understand and manage risks. Staff did not always provide care that was safe and enabled people to do things they liked doing. Risks were not always managed effectively. The registered manager told us certain cupboards were kept locked to ensure peoples safety. This included two kitchen cupboards that housed dangerous items.

During an evening visit we observed a Control of Substances Hazardous to Health (COSHH) cupboard in the kitchen was found unlocked. Inside the cupboard were various substances likely to cause harm if ingested, or if it came into contact with skin or eyes. At the same time, we observed another cupboard was found to be unlocked which contained a large amount of carving knives and other sharp kitchen utensils likely to cause serious harm if they got into the wrong hands. People living in the service were placed at risk of harm due to inconsistent approaches to managing safety. Staff did not work closely with individuals to understand and respond to known risks, it limited their ability to provide safe, enabling care. Following the visit staff were reminded about the importance of ensuring the cupboards are kept always locked when not in use.

People were given information to help them make appropriate choices about what the risks were and how to minimise them to help keep themselves safe. For example, people who went out to events or participating in activities in the home had a full and robust risk assessment completed. This helped reduce the risk of harm to both the person using the service and staff members.  

People were not consistently protected from harm and or abuse, placing them at risk of unsafe or inappropriate care. We observed during an evening visit to the service that one service user pushed another from one side of the living room to the other causing the person to fall backwards into the settee. The person was not injured but had they have fallen to the floor they may well have sustained an injury. Staff intervened quickly but by then the person being pushed had come to rest on the settee. The registered manager told us; this was a one-off occurrence as the person was frustrated that a planned game had been delayed. The registered manager told us that the inspection visit had interrupted a planned card game which triggered agitation for one person resulting in them pushing another person. Staff will work with the person to identify triggers for them and develop a suitable plan with distraction techniques, to reduce the risk of a reoccurrence.

At the previous inspection people's capacity was not always assessed, and this meant their liberty may have been compromised. During the current inspection we saw that people had mental capacity assessments completed to determine if they needed support to help make important decisions. This ensured people's rights were protected, and they were not deprived of their liberty. Information was shared with other professionals only on a need-to-know basis.

Staff were able to describe different types of abuse and what they would do if they suspected any abuse. They had regular knowledge checks and staff completed safeguarding refresher training annually. Staff and management knew when they needed to make a referral and notify relevant partners including the local authority and the Care Quality Commission (CQC).     

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care. For example, the environment was not well maintained in relation to décor and flooring which was soiled in places. There was a risk of infection due to a lack of visible hand washing facilities. People had individual risk assessments completed. This was usually completed prior to people moving into Langley View. Risks were assessed in relation to the environment to help keep people safe.

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 care that met people’s individual needs.

People received care from a staff team that had been recruited using a safe recruitment process, to ensure their suitability for the role. Staff confirmed the recruitment process was thorough. All staff had a disclosure and barring check [DBS] completed. This is a background check that employers use to verify an applicant's criminal history. References were taken up from previous employers. All staff completed an induction which covered all mandatory training including moving and handling, the safe administration of medicines, safeguarding people and infection control. Staff were required to attend regular training updates.  

Most staff had completed specialist Oliver McGowan training. Two staff who had not yet completed the training were booked to complete the training. The registered manager was addressing this post assessment.

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading. For example, the cleanliness of the toilets and surrounding areas were visibly dirty. Food was left uncovered in the fridge which was not dated. Staff had completed infection prevention and control training However, as the risk was not effectively managed and refresher training was recommended. Staff were provided with personal protective equipment including gloves, aprons, hand sanitizer and face masks where required. In the kitchen we observed different coloured chopping boards for use with different food types. This practice promotes good food hygiene practices and helps prevent cross-contamination.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. People were supported to take their medication by staff who had completed training in the safe administration of medicines, to ensure medicines were managed and given safely.  Staff had competency checks completed and regular observations where they were shadowed when administering medication. Staff were aware of how to report any medication errors. Medication administration records were completed at the time of administering the medication and records were completed. The registered manager completed regular audits of medicines that showed people received their medication regularly. The registered manager told us that no one at the service were prescribed any medication for mood and or agitation.  People had regular medication reviews to help ensure they were not being over medicated or taking medication, they no longer required. [STOMP]. Stop over medicating people.

This service scored 59 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. The registered manager told us they had collated as much information as possible as part of their live history which provided good oversight into their future wishes. Following the assessment the registered manager told us she would speak to people individually to make sure any special future wishes were known. Information such as religious beliefs were recorded in people’s care plans, in the event of them becoming unwell they would support individuals according to their wishes.   

The provider made sure there was continuity of care, including when people moved between different services. People were supported to transition through services, helping to ensure continuity of care. For example, people who lived at Langley View had been supported to move following an assessment at their previous home. The service worked in partnership with other care professionals and partners including the local authority, GP’s, opticians, pharmacies and occupational therapists to support people’s holistic needs. People had a health passport to take to health and hospital appointments. They contained relevant information relating to people’s health care needs and pathways. 

People were not consistently protected from harm and or abuse, placing them at risk of unsafe or inappropriate care. We observed during an evening visit to the service that one service user pushed another from one side of the living room to the other causing the person to fall backwards into the settee. The person was not injured but had they have fallen to the floor they may well have sustained an injury. Staff intervened quickly but by then the person being pushed had come to rest on the settee. The registered manager told us; this was a one-off occurrence as the person was frustrated that a planned game had been delayed. The registered manager told us that the inspection visit had interrupted a planned card game which triggered agitation for one person resulting in them pushing another person. Staff will work with the person to identify triggers for them and develop a suitable plan with distraction techniques, to reduce the risk of a reoccurrence.

At the previous inspection people's capacity was not always assessed, and this meant their liberty may have been compromised. During the current inspection we saw that people had mental capacity assessments completed to determine if they needed support to help make important decisions. This ensured people's rights were protected, and they were not deprived of their liberty. Information was shared with other professionals only on a need-to-know basis.

Staff were able to describe different types of abuse and what they would do if they suspected any abuse. They had regular knowledge checks and staff completed safeguarding refresher training annually. Staff and management knew when they needed to make a referral and notify relevant partners including the local authority and the Care Quality Commission (CQC).     

The provider did not always work with people to understand and manage risks. Staff did not always provide care that was safe and enabled people to do things they liked doing. Risks were not always managed effectively. The registered manager told us certain cupboards were kept locked to ensure peoples safety. This included two kitchen cupboards that housed dangerous items.

During an evening visit we observed a Control of Substances Hazardous to Health (COSHH) cupboard in the kitchen was found unlocked. Inside the cupboard were various substances likely to cause harm if ingested, or if it came into contact with skin or eyes. At the same time, we observed another cupboard was found to be unlocked which contained a large amount of carving knives and other sharp kitchen utensils likely to cause serious harm if they got into the wrong hands. People living in the service were placed at risk of harm due to inconsistent approaches to managing safety. Staff did not work closely with individuals to understand and respond to known risks, it limited their ability to provide safe, enabling care. Following the visit staff were reminded about the importance of ensuring the cupboards are kept always locked when not in use.

People were given information to help them make appropriate choices about what the risks were and how to minimise them to help keep themselves safe. For example, people who went out to events or participating in activities in the home had a full and robust risk assessment completed. This helped reduce the risk of harm to both the person using the service and staff members.  

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care. For example, the environment was not well maintained in relation to décor and flooring which was soiled in places. There was a risk of infection due to a lack of visible hand washing facilities. People had individual risk assessments completed. This was usually completed prior to people moving into Langley View. Risks were assessed in relation to the environment to help keep people safe.

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 care that met people’s individual needs.

People received care from a staff team that had been recruited using a safe recruitment process, to ensure their suitability for the role. Staff confirmed the recruitment process was thorough. All staff had a disclosure and barring check [DBS] completed. This is a background check that employers use to verify an applicant's criminal history. References were taken up from previous employers. All staff completed an induction which covered all mandatory training including moving and handling, the safe administration of medicines, safeguarding people and infection control. Staff were required to attend regular training updates.  

Most staff had completed specialist Oliver McGowan training. Two staff who had not yet completed the training were booked to complete the training. The registered manager was addressing this post assessment.

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading. For example, the cleanliness of the toilets and surrounding areas were visibly dirty. Food was left uncovered in the fridge which was not dated. Staff had completed infection prevention and control training However, as the risk was not effectively managed and refresher training was recommended. Staff were provided with personal protective equipment including gloves, aprons, hand sanitizer and face masks where required. In the kitchen we observed different coloured chopping boards for use with different food types. This practice promotes good food hygiene practices and helps prevent cross-contamination.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. People were supported to take their medication by staff who had completed training in the safe administration of medicines, to ensure medicines were managed and given safely.  Staff had competency checks completed and regular observations where they were shadowed when administering medication. Staff were aware of how to report any medication errors. Medication administration records were completed at the time of administering the medication and records were completed. The registered manager completed regular audits of medicines that showed people received their medication regularly. The registered manager told us that no one at the service were prescribed any medication for mood and or agitation.  People had regular medication reviews to help ensure they were not being over medicated or taking medication, they no longer required. [STOMP]. Stop over medicating people.