CQC report explained · a residential care home
What the CQC found at Langdale and Keswick (Parkfields)
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Some safeguarding referrals were not made, and incidents were not always recorded and reviewed properly. Medicines were generally managed safely, but some guidance was out of date and one expired medicine was not identified by checks.
- Effective?
- Requires improvement
- Staff did not always have suitable training in supporting distress or communicating with people who used methods other than speech. People received support with food, healthcare and choices, but some professional advice was not followed promptly.
- Caring?
- Good
- No separate rating was given for Caring in this report. Inspectors said people received kind and compassionate care and that their privacy and dignity were protected.
- Responsive?
- Good
- No separate rating was given for Responsive in this report. Inspectors found that limited staffing reduced people's opportunities for meaningful activities and community access.
- Well-led?
- Requires improvement
- The culture, communication and staff morale were not consistently positive. Quality checks did not reliably identify problems, and some required notifications were not submitted.
What inspectors found, May 2022
Rated Requires Improvement; inspectors found kind care, but safeguarding, staff training and management checks were not reliable enough.
The inspection was unannounced and took place on 15 February 2022. One inspector visited the home. Medicines records were reviewed separately, and relatives, staff and other professionals were contacted.
Inspectors found that people were treated kindly and supported with food, drinks, healthcare and infection control. Medicines were generally managed safely, and staff recruitment checks were completed properly.
There were important weaknesses. Some safeguarding concerns were not reported. Staff did not always have the training or communication skills needed, and staffing levels limited people's access to activities and the community. Records and checks did not always identify or learn from problems.
The overall rating is Requires Improvement. Safe, Effective and Well-led were all rated Requires Improvement. These ratings had fallen from Good at the previous inspection, published on 4 April 2019. The provider must send an action plan, and the CQC will monitor progress.
Kind and respectful care
Inspectors found that people received compassionate care and that staff protected their privacy and dignity.
“People received kind and compassionate care. Staff protected and respected people's privacy and dignity.” from the report
Food and drink
People were supported to eat and drink enough, in line with their needs and choices. People were weighed regularly.
“People received support to eat and drink enough to maintain a balanced diet, in line with their needs.” from the report
Recruitment checks
The home completed checks on staff suitability, including employment history, references and criminal records checks.
“Staff were recruited safely. Checks were made on their suitability to work with people who used the service” from the report
Infection control
Inspectors were assured that the home had arrangements for preventing and managing infection, including safe use of protective equipment.
“We were assured that the provider was using PPE effectively and safely.” from the report
Safeguarding referrals
seriousSome incidents that should have been referred to the local safeguarding authority were not reported. This was a breach of Regulation 13.
“Safeguarding referrals had not always been made to the local safeguarding authority.” from the report
Staff training and communication
seriousSome staff lacked training in supporting distress, physical intervention and communication methods such as signs or picture cards. This affected people's safety, support and access to the community. This was a breach of Regulation 18.
“People were not always supported by staff who had received relevant and good quality training in evidence-based practice.” from the report
Weak management checks
seriousQuality checks did not reliably identify problems with medicines, records, incidents or notifications. This was a breach of Regulation 17.
“The above concerns show quality assurance systems had not been fully effective at ensuring the quality and safety of the service was monitored and improved.” from the report
Limited activities and community access
needs fixingStaffing levels did not allow people to regularly take part in meaningful activities they liked, including going out into the community.
“However, the staffing levels did not enable people to regularly engage in meaningful activities they liked, such as accessing the community.” from the report
- 01How do you now make sure every safeguarding concern is reported to the local safeguarding authority?
- 02What training have staff completed on supporting distress, physical intervention and non-verbal communication?
- 03How many staff and trained drivers are available for each shift, and how often can residents now take part in community activities?
- 04How do managers check medicines, care records and incident reports, and what happens when a problem is found?
- 05How are professional recommendations, including equipment and medicines reviews, followed up without delay?
This inspection focused on how the home applied the Right support, right care, right culture principles and rated Safe, Effective and Well-led; Caring and Responsive were not separately rated in the report. This explanation was written from the published report of 10 May 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, April 2019
Langdale and Keswick (Parkfields) was rated Good; inspectors found safe, kind and personalised care, with all five areas rated Good.
This was an announced comprehensive inspection on 2 March 2019. The report also refers to 3 March 2019 in its summary. One inspector observed people and staff, spoke with the provider, manager and four staff, checked care, medicine and staffing records, and gathered feedback from three relatives.
The home supports up to eight people with learning disabilities in two bungalows. All eight places were occupied during the inspection. Inspectors found enough staff, safe recruitment, suitable risk assessments and safe medicines management. Staff understood people's communication, health and support needs.
People were described as receiving kind, respectful and personalised care. Inspectors also found good leadership, training, monitoring and support for people's choices and legal rights. The overall rating stayed Good, as did the ratings for Safe, Effective, Caring, Responsive and Well-led.
Staff knew people well
Staff understood people's verbal and non-verbal communication and could recognise when people were happy, sad, anxious or needed reassurance.
“Staff knew people well and understood people's verbal or nonverbal communication.” from the report
Kind and respectful care
People appeared relaxed and comfortable. Staff were patient, attentive and compassionate, and respected privacy and dignity.
“People were supported by staff who were both kind and caring and we observed staff treated people with patience and compassion.” from the report
Personalised support
Care plans recorded people's history, preferences, routines, communication needs and support goals. Staff used pictures and other methods to help people make choices.
“The plans were personalised and detailed how the person needed and preferred care and support to be delivered.” from the report
Positive leadership and monitoring
Inspectors found approachable leadership and systems to check quality and safety, including reviews of accidents, the environment, care plans and nutrition.
“The provider provided clear leadership and governance; ensuring the service was overseen to maintain quality.” from the report
Making complaints accessible
minorSome people might not fully understand the complaints procedure because of their learning disability. The provider said it would review the policy to make sure it met people's communication needs.
“Some people currently living in the service would not fully understand the procedure due to the level of their learning disability.” from the report
- 01How do you help each person raise a complaint if they cannot use the written complaints procedure?
- 02How do you check that staff still understand each person's communication methods, including signs, pictures and body language?
- 03How do you review medicine competency and the instructions for medicines given only when needed?
- 04How are changes in a person's health, behaviour or support needs recorded and shared with relatives and health professionals?
- 05What activities and family contact are currently available, and how are people's individual choices supported?
This was an announced comprehensive inspection covering all five CQC questions; the previous inspection in December 2016 was also rated Good. This explanation was written from the published report of 4 April 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Langdale and Keswick (Parkfields)
3 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- May 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Langdale and Keswick (Parkfields) →
- April 2019Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
Read what inspectors found at Langdale and Keswick (Parkfields) →
- December 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 11 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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