CQC report explained · a residential care home
What the CQC found at Langley View Residential Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, April 2021
Inspected but not rated; the previous Requires Improvement rating remained, with inspectors finding inappropriate restrictions and poor oversight.
This was an unannounced targeted inspection on 25 February and 5 March 2021. Inspectors looked mainly at people's rights, the Mental Capacity Act, DNACPR decisions and infection control. They spoke with people, staff and a professional, and reviewed care records, policies and quality records.
Inspectors found that locked food cupboards and a locked front door limited people's choice and independence. These restrictions had not always been properly assessed or authorised. Staff and managers also did not understand the Mental Capacity Act or DNACPR decisions well enough.
The home had some positive infection control measures and staff offered choices about food and activities. However, staff were often task-focused, people did not always have meaningful conversations or activities, and quality checks were not strong enough. The inspection did not give new ratings. The previous overall rating of Requires Improvement remained.
Infection control measures
Inspectors were assured about several infection control arrangements, including PPE, testing, social distancing and the home's ability to manage outbreaks.
“We were assured that the provider was using PPE effectively and safely.” from the report
Some everyday choices
Staff gave people choices about food and activities. Pictures were used to help people who could not communicate verbally.
“Staff gave people choices about what food they would like and activities they wanted to do in the day.” from the report
Staff teamwork
Staff said they felt supported by management and worked well together.
“Staff said they felt supported by the management and they felt the team worked well together.” from the report
Restrictions on choice and movement
seriousFood cupboards were locked without following the Mental Capacity Act properly. The locked front door also meant people could not leave freely.
“Where people had capacity to make decisions about their care, this was not taken into consideration.” from the report
Poor understanding of legal decisions
seriousStaff and managers did not understand the correct use of DNACPR decisions. Inspectors also found that not all restrictions had been considered as a deprivation of liberty.
“The management team and staff were not clear on the correct use of a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR).” from the report
Limited meaningful interaction
needs fixingPeople said there were not many meaningful conversations, and staff were observed to be focused on tasks. Views about activities during lockdown were mixed.
“People spoke about how they did not have many meaningful conversations with staff as they were busy doing tasks around the home.” from the report
Weak quality monitoring
needs fixingThe provider had not carried out enough quality checks or audits to identify and address the problems found by inspectors.
“The provider had not completed any quality assurance checks or audits which meant they did not have oversight of the service, and improvements needed.” from the report
Training gaps
needs fixingStaff had not completed training about individual support needs, including learning disability, autism and diabetes.
“Staff had not completed specific training relating to people's individual support needs.” from the report
- 01What has changed so that people can access food independently, where they have the capacity to decide this?
- 02How do you now assess and legally authorise restrictions such as locked doors or cupboards?
- 03What training have staff completed on the Mental Capacity Act, DNACPR decisions, learning disability, autism and diabetes?
- 04How do you record each person's wishes, consent and preferred activities in their care plan?
- 05What quality checks are now carried out, and what improvements have resulted from the action plan?
This was a targeted inspection of specific concerns about the Mental Capacity Act, DNACPR decisions, human rights and infection control; it did not fully assess the key questions, so the previous ratings carried over. This explanation was written from the published report of 27 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.
What inspectors found, October 2019
Rated Requires Improvement; inspectors found people were safe and treated kindly, but care effectiveness and leadership were inconsistent.
This was an unannounced inspection on 4 September 2019. Two inspectors spoke with people, staff, relatives and a professional. They observed care and reviewed care plans, medicines records, staff files and management records.
The home was rated Good for Safe, Caring and Responsive. People felt safe, medicines were managed safely, staff were kind and respectful, and care plans reflected people's preferences. Staff supported people with health appointments, activities and developing independence.
The home was rated Requires Improvement for Effective and Well-led. Inspectors found that least restrictive and best-interest decisions were not always clearly recorded. They also found limited interaction with some people who had communication needs, worn decoration and musty smells, and mixed experiences among relatives about communication and responses to concerns.
The overall rating fell from Good at the previous inspection, published in March 2017, to Requires Improvement. The CQC said it would continue monitoring the home and return under its re-inspection programme.
People felt safe
There were enough staff, recruitment checks were completed and risks were assessed. Medicines were stored and given safely.
“People felt safe at the service and there were enough staff to meet people's support needs.” from the report
Kind and respectful staff
Inspectors saw caring support and staff who understood people's preferences. Privacy and dignity were promoted.
“Staff spoke warmly about people living at the home.” from the report
Personalised support
Care records included people's likes and dislikes and were reviewed regularly. People were offered choices and activities suited to their interests.
“People's care records were personalised and there was clear information about people's likes and dislikes.” from the report
Support for independence
People were encouraged to learn skills and make choices, including shopping for their own food and making a hot drink with support.
“People's independence was encouraged.” from the report
Good partnership with health professionals
The home supported people to attend health appointments and made referrals when needed. Staff worked with other agencies during end of life care.
“People were supported to attend appointments with health care professionals to maintain good health.” from the report
Least restrictive decisions were not always clear
needs fixingSome best-interest decisions did not show that less restrictive options had been properly considered. Some consent forms were signed by relatives or the manager without evidence of the legal authority to do so.
“However, it was not always clear if the service had considered the 'least restrictive' option when making these decisions.” from the report
Limited interaction for some people
needs fixingInspectors saw limited interaction with two people who had communication needs. The home was asked to seek guidance on meaningful engagement.
“However, over a lunch period we observed limited interaction between staff and two people with communication needs.” from the report
Worn environment
needs fixingThe decoration was very worn and inspectors noticed a musty smell. A six-month plan for redecoration was agreed after the inspection.
“The decoration was very worn, and we observed the service to smell musty.” from the report
Relatives' concerns were not always handled consistently
needs fixingSome relatives said communication and responses to concerns had worsened or depended on which staff member they spoke to. The manager showed inspectors records of responses to complaints.
“Relatives told us they did not consistently feel listened to and their concerns were not always responded to appropriately.” from the report
Some cleaning needed improvement
minorCleaning arrangements were in place, but inspectors saw areas, including toilets, where cleaning could be better.
“However, we observed some instances where cleaning could be improved, such as in the toilets.” from the report
- 01What has been done since the inspection to make sure best-interest decisions clearly consider the least restrictive option?
- 02How do you now check that consent is given by someone with the proper legal authority?
- 03What changes have been made to provide meaningful interaction for people with communication needs?
- 04Has the planned redecoration been completed, and what has been done about the musty smell?
- 05How are relatives' concerns recorded, answered and checked to make sure responses are consistent?
This was an unannounced inspection covering all five CQC questions; the previous rating was Good, but Effective and Well-led fell to Requires Improvement. This explanation was written from the published report of 24 October 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 Langley View Residential Home
3 rated inspections over 4 years: the service has slipped, from Good to Requires improvement.
- April 2021Inspected but not ratedcurrent ratingSafe: Inspected but not ratedEffective: Inspected but not ratedWell-led: Inspected but not rated
Read what inspectors found at Langley View Residential Home →
- October 2019Requires improvementdown from GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Langley View Residential Home →
- March 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2014
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- March 2012
Registered with the Care Quality Commission on 30 March 2012.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
At least 100 live-in carers within about an hour of Hertfordshire
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 £1,300 a week. 82 can care for a couple. 12 years' experience on average.
“She handled the new situation in front of her with such professionalism and I felt I could trust her 100%.”
“She was v competent and confident and we felt our mum was safe in her care. She supported us through a difficult time.”
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.