CQC report explained · a residential care home
What the CQC found at Langdales
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Risk assessments, equipment checks, recruitment checks, medicines systems and infection control were generally in place, although some as-required medicine instructions were unclear.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its previous rating was carried forward into the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its previous rating was carried forward into the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its previous rating was carried forward into the overall rating.
- Well-led?
- Good
- The management team had strengthened oversight and records were generally good quality. Some formal audits had not yet been fully introduced, but there was a timetable for completing them.
What inspectors found, February 2023
Rated Good; inspectors found people felt safe and improvements had been made, but some medicine, training and audit records still needed attention.
This was an unannounced focused inspection on the first day and an announced inspection on the second day. Inspectors visited on 09 February 2023 and 21 February 2023. They spoke with people living in the home, relatives, staff and outside professionals, and reviewed care records, recruitment records and management documents.
People said they felt safe and staff responded quickly. Inspectors found safe moving and handling, suitable risk assessments, safe medicines management overall, appropriate staff checks and effective infection control. The home was working within the Mental Capacity Act principles.
The home had improved since the previous inspection, when it was rated Requires Improvement and was in breach of Regulation 17. The breach had been resolved. However, some formal audits were not fully in place, two newer staff had not completed mandatory training, and instructions for some as-required medicines were unclear.
The overall rating is Good. Safe and Well-led were rated Good. This was a focused inspection of those areas only, so the other ratings were carried over from the previous inspection rather than reassessed.
People felt safe
People and relatives told inspectors they felt safe and that staff responded when help was needed.
“People told us they felt safe and they were supported by staff who helped them quickly if they needed this.” from the report
Safe care systems
Inspectors found risk assessments, equipment checks, recruitment checks and infection control arrangements. Staff used safe moving and handling practices.
“Staff completed and reviewed risk assessments to help ensure risks were mitigated.” from the report
Improvement since the last inspection
The home had acted on the previous breach relating to governance. Inspectors found it was no longer in breach.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulations.” from the report
Good management support
The management team had added audit support, and the latest audit had identified improvements that the manager had acted on.
“We viewed the last audit and saw this had identified areas of improvement and these had been actioned by the manager.” from the report
As-required medicine instructions
needs fixingInstructions did not always say whether one or two prescribed medicines should be given. Inspectors said this could mean someone received the wrong amount.
“This did not always instruct if one or two of a prescribed medicine should be administered and could result in a person not receiving the correct amount of medicine.” from the report
Mandatory training
needs fixingTwo recently recruited staff had not completed their mandatory training at the time of the inspection. The provider said this was being monitored.
“We noted two staff who had recently joined the service had not completed their mandatory training.” from the report
Audits still being introduced
minorThe manager had started documenting audits, but not all formal audits were fully in place during the inspection.
“We found not all formal audits had been fully introduced by the current manager but there was a timetable to ensure these were completed.” from the report
No registered manager yet
minorThere was no registered manager in post. A new manager had been in post for four months and was applying to register with the CQC.
“The service did not have a registered manager. The provider had recruited a manager who was in the process of registering with the Care Quality Commission.” from the report
- 01What has been done to make sure instructions for all as-required medicines clearly state the correct amount to give?
- 02Have all newer staff now completed their mandatory training, and how is this tracked?
- 03Which formal audits were not fully in place at the inspection, and have they now been completed?
- 04What is the current progress of the manager's application to register with the CQC?
- 05How are referrals to health professionals recorded and checked, after two occasions were found where referrals had not been recorded?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried over from the previous inspection. This explanation was written from the published report of 25 February 2023 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, May 2022
Rated Requires Improvement; inspectors found unsafe medicines management, poor records and weak oversight, although the provider acted quickly during the inspection.
This was an unannounced focused inspection on 14 and 21 February 2022. Inspectors looked only at Safe and Well-led. They spoke with seven people and nine staff, observed care, checked the building and reviewed care, staff, medicines and management records.
The home was not always safe. Medicines had not been managed properly, risks were not always assessed or reviewed, and the provider had not used accidents and incidents to learn. Weekend staffing was difficult for staff, although people said they felt safe and could get help when they needed it.
Management and record keeping were also not reliable. Care plans and risk assessments were not consistently reviewed, audits had not found important problems, and some records were missing or inaccurate. The provider made improvements during the inspection, but these needed to continue.
The overall rating fell from Good at the previous inspection, published in June 2019, to Requires Improvement. Safe and Well-led were both rated Requires Improvement. The report does not give new ratings for Effective, Caring or Responsive because they were not inspected.
People felt safe
People told inspectors they felt safe and described staff as kind and caring.
“People told us they felt safe and described staff in positive terms.” from the report
Protection from abuse
Staff knew how to recognise and report abuse, including to outside agencies if needed.
“Staff were trained to identify and report abuse.” from the report
Recruitment checks
The provider checked criminal records and references before employing staff.
“The provider carried out checks to ensure staff were of good character before they were employed.” from the report
Quick response to feedback
The provider acted during the inspection to improve medicines, care records and staff organisation.
“The management team and the nominated individual were receptive to our feedback and that from other professionals.” from the report
Medicines were not managed safely
seriousAn audit found medicines had not been managed safely or properly. The provider made changes during the inspection, but this was a serious shortfall.
“Medicines had not been managed safely and properly.” from the report
Risk management was inconsistent
seriousRisk assessments were not always completed or reviewed without prompting from outside professionals. This increased the risk that people's needs might not be managed safely.
“Risks to people's health and safety were inconsistently assessed and managed.” from the report
Poor learning from incidents
needs fixingThe provider could not show that accidents and incidents had been reviewed to find patterns and prevent repeat problems.
“There had been no analysis carried out to identify any trends or themes in accidents or incident, to try to reduce the risk of recurrence.” from the report
Weak records and oversight
seriousCare records and management records were sometimes missing, inaccurate or lacking detail. Audits had not identified or corrected several of the problems inspectors found.
“Records lacked detail, were inaccurate or were absent.” from the report
Weekend staffing pressures
needs fixingStaff said reduced weekend staffing made it difficult to clean, cook and care for people. The provider reviewed rotas and staff deployment during the inspection.
“Staff told us they found this difficult as they had to try to clean, cook and care for people.” from the report
- 01What changes have you made to medicines checks since the inspection, and how do you now make sure medicines are accounted for and records are accurate?
- 02How are each resident's risks and care plans reviewed now, and how quickly is professional advice added to their written care plan?
- 03What staffing levels are in place at weekends, and how do you check that staff can complete care, cleaning and cooking safely?
- 04What audits are now carried out on care plans, risk assessments, medicines and infection control, and who checks that problems are fixed?
- 05How do you review accidents and incidents for patterns, and how do you share the lessons with staff?
This was a focused inspection of Safe and Well-led only; the other key-question ratings were not inspected and the previous overall rating was from the 2019 inspection. This explanation was written from the published report of 7 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.
Every inspection of Langdales
4 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- February 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2022Requires improvementSafe: Requires improvementWell-led: Requires improvement
- May 2021Inspected but not ratedSafe: GoodWell-led: Good
- June 2019Goodup from Requires improvementSafe: GoodWell-led: Good
- June 2018Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2017Inspected but not ratedSafe: GoodWell-led: Good
- April 2017
Registered with the Care Quality Commission on 13 April 2017.
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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32 live-in carers within about an hour of Blackpool
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,250 a week. 31 can care for a couple. 12 years' experience on average.
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
“He developed a close affinity with Terence, spending time talking with him before he retired to bed and looking after his needs during the night.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.