This inspection took place on 19 and 24 September 2018. The first day was unannounced; the provider knew we were returning on the second day.

Langlea House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home provides nursing and personal care for up to 14 older people, some of whom may be living with dementia. Accommodation is provided on two floors with chair lift access between floors. There are communal areas on the ground floor, including a lounge, conservatory, dining room and visitors room. There were 10 people in the home when we inspected including one person who was in hospital.

The home has a registered manager. 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 our last inspection on 14 March 2016 we rated the service as ‘Good’ and there were no regulatory breaches. At this inspection, we have rated the service as ‘Requires Improvement’. Although we found some aspects of the service were good, we found others required improvement. This was in relation to recruitment processes, record keeping and quality assurance systems. We identified two breaches of regulation; Regulation 19 (Fit and Proper Persons Employed) and Regulation 17 (Good Governance).

Staff recruitment procedures were not robust as thorough checks had not always been completed before staff started working in the service. Staff received the induction, training and support they required to carry out their roles.

Staff had received training in safeguarding and understood the reporting systems. Safeguarding incidents were reported to the local authority safeguarding team. Staff were aware of how to manage risks to people, however this was not always fully reflected in risk assessments which required more detail.

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.

There were sufficient staff to meet people’s needs. People and relatives were happy with the service provided. They said staff were kind and caring and respected people’s privacy and dignity. People’s nutritional needs were met and people had access to healthcare services.

Activities were provided and opportunities to go out which people told us they enjoyed. Systems were in place to manage any complaints.

People received personalised care and staff were kept informed of any changes in people’s needs through handover at each shift change. However, people’s care records were not always up to date or accurate and there was not enough detail to guide staff about the care and support people required. Medicine management was safe, although some improvements were needed in relation to record keeping.

People, relatives and staff praised the management of the home. The registered manager had already identified improvements were needed and an action plan was in place. New care documentation had been developed and was due to be in place by December 2018. The quality audit systems and processes needed to improve to enable the provider to effectively assess, monitor and improve the service.

You can see what action we told the provider to take at the back of the full version of the report.

This inspection took place on 14 March 2016 and was unannounced. At the last inspection on 25 March 2014 we found the service was meeting the regulations.

Langlea House provides accommodation and personal care for up to 14 older people, some of who are living with dementia. There were nine people living at the home when we visited.

The accommodation consists of ten single bedrooms and two shared rooms, all of which have ensuite facilities. On the ground floor there is a lounge, conservatory, dining room, kitchen, laundry and a visitors/hairdressing room. There is a car park at the front and gardens to the rear of the property.

The home has a registered manager who has been in post since 2010. 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.

People told us they felt safe and we found risks were well managed. There were enough staff to meet people’s needs. Staffing levels were kept under review and increased accordingly if there were new admissions or people’s dependencies increased. Staff recruitment processes ensured staff were suitable and safe to work in the care home.

Staff had a good understanding of safeguarding and knew the reporting systems if any allegations of abuse were raised.

Medicines were managed safely and systems which ensured people received their medicines when they needed them.

Staff knew people well and supported people in accordance with their individual preferences and needs. Staff received the training and support they needed to carry out their roles.

The home was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and acting within the legal framework of the Mental Capacity Act (MCA).

The home was clean and well maintained. People told us they enjoyed the food and we saw a wide range of food and drinks were available. People’s weights were monitored to ensure they were getting enough to eat and drink. People had access to healthcare services such as GPs and district nurses.

People were comfortable and relaxed around staff. We saw staff treated people with respect and maintained their privacy and dignity. Staff were kind, caring and considerate and care was centred around people’s needs and preferences. People looked clean, well dressed and well groomed.

Relatives spoke highly of the care provided and praised the providers, registered manager and staff team. People’s views were listened to and acted upon. For example, new communal toilets with more space had been provided on the ground floor.

A range of activities were provided including Wii games, arts and crafts and going out for walks. Daily newspapers were available. We saw staff spent time sitting chatting with people and nothing was rushed as staff gave people time to do things at their own pace.

Langlea House is a family-run home and we saw the registered providers took an active role in the day to day running of the service and worked alongside the registered manager and staff team to ensure people received a quality service. The registered providers and registered manager led by example and provided support to the staff team. People, relatives and healthcare professionals gave positive feedback about the home and the care provided to people.

When we visited the home in July 2013 we found that suitable arrangements were not in place for the purposes of obtaining consent from people who lived at the home. We also found the provider did not have an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who lived at the home and others. We looked at the way records were maintained at the home and saw there were no clear index systems in place within staff records and care records. This meant they were difficult to follow. We also saw care records were not accurate and did not contain updated information which reflected changes in peoples care needs. We asked the provider to make improvements.

We went back on this inspection to check whether improvements had been made.

We looked at the care records of three people who lived at the home and found they all contained documentation to show each person had given their consent to the care and treatment they received at the home.

We looked at evidence which showed the manager had systems in place to regularly assess and monitor the quality of service people received.

We saw staff records, care records and other records relevant to the management of the services were accurate and fit for purpose.

We spoke with one person who lived at the home and they told us that it really felt like home. They told us they had lived at the home for 7 years and were very happy with the care provided. We were also told 'there are regular activities on offer and entertainment from time to time'. We spoke with the relative of another person who lived at the home who told us 'I have no complaints about the home. The staff are lovely and I am very happy with the care my relative receives'.

We spoke with five people who live at the home, two relatives, three members of staff and a visiting health care professional. These are some of the things they told us:

“I was in another home but I didn’t get the care I needed. I came and had a look around Langlea House and liked the atmosphere. Staff have been helpful and have arranged my room so I can have my television and computer. They have also put up extra shelves for my models. It was a good move coming here.”

“When I wasn’t well they got the doctor straight away.”

“The staff are kind and look after me.”

“I like some of the staff better than others.”

“I would tell the manager if I was unhappy about anything and she would sort it out. One day they served pasta for lunch that I don’t like. I told them and I haven’t had it again.”

“The home is kept clean, tidy and odour free.”

“I get a written report every now and again about my relatives’ progress and this is very helpful.”

“At Christmas people living at the home made their relatives a woven basket that contained photographs and other bits and pieces, this was very much appreciated.”

“When I visit I am made to feel welcome. I am always offered a drink and can have a meal here if I want to.”

“When I visit I can see that activities take place they do exercises, quizzes and staff talk to people.”