Archived: 55 Langaton Lane

Updated 12 December 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The inspection was undertaken by one inspector on 24 November 2018 and was unannounced.

Before the inspection we reviewed information, we held about the service. We reviewed notifications of incidents the provider had sent to us since the last inspection. A notification is information about important events, which the service is required to send us by law.

We used information the provider sent us in the Provider Information Return (PIR). This is information we require providers to send us at least annually to give some key information about the service, what the service does well and improvements they plan to make.

People living at 55 Langaton Lane had limited communication. Therefore, they were unable to tell us about all their experiences of the services. During our inspection we spent time with people observing daily routines and interactions between people and staff supporting them. This helped us gain a better understanding of people and the care they received at the service.

We spoke to six members of staff and we looked at records relating to people’s care and the running of the home. These included four peoples’ care and support plans and records relating to medicine administration and finance records. We also looked at quality monitoring of the service.

Following the inspection, we received feedback from two professionals and one relative. We asked them about their views and experiences of the service. Their feedback can be found throughout the inspection report.

Updated 12 December 2018

We carried out an unannounced comprehensive inspection on 24 November 2018.

55 Langaton Lane provides care and accommodation for up to four people. On the day of our inspection there were four people living at the service. The home provides residential care for people with a learning disability.

People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

We checked the service was working in line with ‘Registering the right support’, which makes sure services for people with a learning disability and/or autism receive services are developed in line with national policy - including the national plan, Building the right support - and best practice. For example, how the service ensured care was personalised, discharge if needed, people’s independence and links with their community.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the last inspection on the 13 and 14 April 2016, the service was rated Good. However, it was rated Requires Improvement in Well led. The service has now improved to Good in Well Led. At this inspection we found the evidence continued to support the overall rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated Good:

People were not able to verbalise their views therefore they were not able to tell us verbally about their experience of living there. Therefore, we spent time with people seeing how they spent their day and observing the interactions between people and the staff supporting them. This helped us gain a better understanding of people and the care they received at the service.

People remained safe at the service. People were protected from abuse as staff understood what action they needed to take if they suspected anyone was being abused, mistreated or neglected. Staff were recruited safely and checks carried out with the Disclosure and Barring Service (DBS) ensured they were suitable to work with vulnerable adults. Staff agreed that there were sufficient numbers of staff to meet people’s needs and help to keep them safe.

People had their risks assessed, monitored and managed by staff to help ensure they remained safe. Staff assessed and understood risks associated with people’s care and lifestyle. Risks were managed effectively to keep people safe whilst maintaining people’s rights and independence.

People had their medicines managed safely. People continued to receive their medicines in a way they preferred. Staff completed regular training and competency checks to ensure their knowledge and their skills in relation to medicines, were up to date and in line with best practice.

People were supported by staff who had received training to meet their needs effectively. Staff said meetings, one to one supervision of staff practice, and appraisals of performance were regular completed. Staff, new to care, completed the Care Certificate (a nationally recognised training course for staff new to care). Staff confirmed the Care Certificate training looked at and discussed the equality and diversity and the human right needs of people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People's health and wellbeing was monitored by the staff and they had access to a variety of healthcare professionals. The registered manager worked closely with external health and social care professionals to help ensure a coordinate approach to people’s care.

People’s care and support was based on legislation and best practice guidelines; helping to ensure the best outcomes for people. People’s legal rights were up held and consent to care was sought as much as possible. Care records were person centred and held full details on how people liked their needs to be met; taking into account people’s preferences and wishes. Overall, people’s individual equality and diversity preferences were known and respected. Information recorded included people’s previous medical and social history and people’s cultural, religious and spiritual needs.

People were treated with kindness and compassion by the staff who valued them. Staff had built strong relationships with people who lived there. Staff respected people’s privacy. People, or their representatives, were involved in decisions about the care and support people received.

The service remained responsive to people's individual needs and provided personalised care and support. People’s communication needs were known by staff. Staff had received training in how to support people with different communication needs. The registered manager had taken account of and acted on the Accessible Information Standard (AIS). The AIS is a requirement to help ensure people with a disability or sensory loss are given information they can understand, and the communication support they need.

Staff adapted their communication methods dependent upon people’s needs, for example using simple questions, pictures and objects. Information for people could have information available about the service in an easy read version or other appropriate format as needed.

People could make choices about their day to day lives. The provider had a complaints policy in place and that was also available in an easy read version. People currently living in the service were unable to make complaints. However, staff knew people well and used this knowledge to gauge how people were feeling. They would then act to ensure people’s concerns were addressed.

The service improved to well led. People lived in a service where the provider’s values and vision were embedded into the service, staff and culture. Staff told us the registered manager, appointed six months ago, was approachable and made themselves available. The provider had monitoring systems which enabled them to identify good practices and areas of improvement.

People lived in a service which had been designed and adapted to meet their needs. The service was monitored by the provider to help ensure its ongoing quality and safety. The provider’s governance framework, helped monitor the management and leadership of the service, as well as the ongoing quality and safety of the care people were receiving.

Further information is in the detailed findings below