CQC report explained · a residential care home
What the CQC found at Langley House Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found risks were assessed, staffing was sufficient and infection control arrangements were effective. Some 'as needed' medicine records initially lacked detail, but this was corrected immediately.
- Effective?
- Good
- People's needs and choices were assessed and reviewed. Staff were trained and supported, and people received suitable food and help to access health services. The home had improved its consent and capacity processes, although relatives' legal authority was not always recorded.
- Caring?
- Good
- This question was not inspected during this focused visit. The previous rating was carried forward to calculate the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused visit. The previous rating was carried forward to calculate the overall rating.
- Well-led?
- Good
- The provider and registered manager had clear oversight of the home. Audits were used to identify and act on improvements, and people, relatives, staff and professionals gave positive feedback.
What inspectors found, November 2022
Rated Good; inspectors found safe, effective and well-led care, with some records about decision-making needing clearer legal detail.
This was an unannounced focused inspection on 17 and 18 October 2022. Inspectors spoke with people, relatives, staff and visiting professionals. They observed care and reviewed care, medicine, staff and management records.
The home was rated Good overall and was rated Good for Safe, Effective and Well-led. Inspectors found enough staff, safe recruitment, suitable infection control, good support with food and health needs, and improved checks on quality and safety.
Some records did not clearly show relatives' legal authority to make decisions for people who could not make particular decisions themselves. Inspectors recommended reviewing this process. Some 'as needed' medicine records also initially lacked detail, but more information was added immediately.
The previous inspection rated the home Requires Improvement and found breaches relating to safe care, consent and governance. This inspection found enough improvement for the home to no longer be in breach. The Caring and Responsive questions were not inspected in this visit, so their earlier ratings were used for the overall rating.
Staffing and safety
Inspectors found enough staff to meet people's needs promptly. Staff were recruited safely and responded to risks and incidents.
“There were enough staff on duty to meet people's needs.” from the report
Improved management
Management checks had become more effective since the previous inspection. The home used audits and acted on identified improvements.
“The provider and the registered manager had clear and effective oversight of the service.” from the report
Food and health support
People had varied meals and could choose what they ate. The home made referrals and worked with health professionals when people needed extra support.
“People received balanced and varied meals. People told us they enjoyed the food and could choose what they ate.” from the report
Legal authority in records
needs fixingRelatives were involved in decisions, but records did not always show whether they had the legal authority to act. Inspectors recommended that the home review its capacity and best-interest assessment process.
“Relatives confirmed they were involved in care decisions, but their involvement or legal authority to act was not always recorded.” from the report
As-needed medicine records
needs fixingSome records did not explain clearly enough when an 'as needed' medicine should be given. The home added further detail immediately during the inspection.
“Some records for people who required medicines as and when needed lacked detail about how staff would recognise when these were required.” from the report
- 01How do you record whether a relative has legal authority to make decisions for a person?
- 02How do you carry out and record mental capacity and best-interest decisions?
- 03How do you decide when an 'as needed' medicine should be given, and how is this recorded?
- 04What changes were made after the previous inspection, and how do you check that they remain effective?
- 05Which current ratings were carried forward because Caring and Responsive were not inspected this time?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were used to calculate the overall rating. This explanation was written from the published report of 23 November 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 2021
Langley House Care Centre is rated Requires Improvement; inspectors found safety, consent and management weaknesses, although the new provider had started making changes.
This was a targeted inspection of infection prevention and control. Inspectors found concerns about recording people's capacity and consent for COVID-19 testing and vaccinations, so they widened the inspection to look at safe, effective and well-led care.
Inspectors visited on 2 and 5 March 2021. They spoke with staff, people and relatives, and reviewed care records, medicines records, recruitment files, policies, audits and other management records.
They found that risks were not always identified or monitored, consent and legal safeguards were not consistently recorded, and quality checks had missed important problems. There were enough staff, medicines were managed safely, and people generally said they felt safe and well cared for.
The overall rating is Requires Improvement. The ratings for Safe, Effective and Well-led all fell from Good at the previous inspection, published in February 2020. The provider had recently changed ownership and had started reviewing care plans, risk assessments, policies and audits, but the inspection could not show that these changes were complete or effective.
Staffing
Inspectors found enough staff to meet people's needs. Recruitment checks were completed safely.
“There were sufficient numbers of staff on duty to meet people's needs.” from the report
Medicines
Medicines were given as prescribed, recorded clearly and stored correctly. Staff understood when people needed medicines prescribed for occasional use.
“Medicines were managed safely and people received their medicines as prescribed.” from the report
Understanding people
People's preferences were recorded, and staff knew about their individual needs.
“People's likes, dislikes and preferences were recorded in their pre-admission assessments and care plans.” from the report
Person-centred culture
Inspectors found a culture focused on individuals. The manager was approachable and staff felt able to raise concerns.
“There was a person-centred culture at the home.” from the report
Risk records and monitoring
seriousRisks were not consistently identified or managed. Care plans and risk assessments were sometimes out of date, and some actions, such as repositioning, were not recorded.
“Safety concerns and risks to people were not consistently identified.” from the report
Consent and legal safeguards
seriousCapacity assessments, consent records, best-interest decisions and Deprivation of Liberty Safeguards were not always in place or renewed when needed.
“People's capacity and ability to consent to particular decisions was not always assessed or recorded.” from the report
Quality checks
seriousThe home's audits did not find the problems identified by inspectors. Records did not always show what action had been taken or what had been learned.
“The provider's internal audits had failed to identify the issues found during this inspection regarding assessing risk, monitoring safety, the requirements under the MCA, and governance records.” from the report
Professional referrals
needs fixingReferrals to relevant professionals and specialist services were not always made promptly. Records did not always show whether concerns had been followed up.
“The provider had not always made appropriate and timely referrals to relevant professionals and specialist services.” from the report
Feedback opportunities
needs fixingThere were limited opportunities for people, relatives and staff to give meaningful feedback about the service.
“There were limited opportunities for people, relatives and staff to provide meaningful feedback.” from the report
- 01Have all people's care plans and risk assessments now been reviewed, and how do you check that they stay up to date?
- 02How do you record capacity assessments, consent and best-interest decisions for COVID-19 testing, vaccinations and bed rails?
- 03How do you make sure Deprivation of Liberty Safeguards are applied for and renewed before they expire?
- 04What changes have been made to the audit system since inspectors found that important risks and record problems had been missed?
- 05How do you make sure referrals to doctors and specialist professionals are made promptly and followed up?
This began as a targeted inspection of infection prevention and control and was widened to a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not assessed in this inspection. This explanation was written from the published report of 10 April 2021 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 Langley House Care Centre
3 rated inspections over 3 years: the service has held its Good rating throughout.
- November 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2021Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- February 2020GoodSafe: GoodEffective: GoodWell-led: Good
- December 2018
Registered with the Care Quality Commission on 3 December 2018.
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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