Langfield Nursing and Residential Home is situated in its own grounds. The accommodation is divided over two floors. The service is registered to provide nursing care, accommodation and personal care for up to 54 older people. At the time of our inspection the service had decided not to provide nursing care and did not employ nursing staff. There were 50 people living at the home. The service had not been inspected since the home had changed ownership.This was an unannounced inspection which took place on the 28 February 2017.
The service is required to have a registered manager in place. There was a registered manager in place at Langfield Nursing and Residential Home. A registered manager is a person who has registered with the CQC 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. The registered manager was present during this inspection.
People told us they felt safe at Langfield Nursing and Residential Home. Staff had received training in safeguarding adults. They were aware of the correct action to take if they witnessed or suspected any abuse. Staff were aware of the whistleblowing (reporting poor practice) policy in place in the service. They told us they were certain any concerns they raised would be taken seriously by the managers in the service.
Robust recruitment procedures were in place which ensured staff had been safely recruited. Staff received the training, support and supervision they needed to carry out their roles effectively.
All the people we spoke with were positive about the support they received and felt staff were very respectful, friendly, caring and kind. We saw staff instigated and encouraged conversation and found staff to be vigilant and caring. The registered manager and all the staff we spoke with were able to tell us about the people who used the service. Staff spoke with compassion about people who lived at the home.
People who used the service we spoke with indicated they experienced no restrictions accessing choices. People who used the service and their relatives told us the service was responsive and staff were flexible in meeting their needs.
People’s support needs were assessed before they moved into Langfield Nursing and Residential Home. Care records were written in a person centred way and contained sufficient information to guide staff about people’s support needs, likes and dislikes, preferences and routines. Risk assessments were in place for people who used the service and staff. Care records we saw had been reviewed regularly and had been updated when people’s support needs had changed. People and their relatives had been involved in planning and reviewing the care provided.
The administration of medicines was safe. Staff had been trained in the administration of medicines and had up to date policies and procedures to follow to ensure people received medicines as prescribed.
The service had an infection control policy; this gave staff guidance on preventing, detecting and controlling the spread of infection and staff received training in infection prevention and control. Staff were trained in infection control and provided with the necessary equipment and hand washing facilities to help protect their health and welfare.
The home was clean, well-kept, smelling fresh and was brightly lit and well decorated. People’s bedrooms were personalised and contained personal objects and photographs. The home had recently had improvements to the decoration, flooring and furnishings in communal areas and some bedrooms. The first floor had been designed to support people living with dementia orientate themselves. This included differently coloured bedroom doors, big pictures on the walls and memory boxes on individual doors. This helped people identify where their bedroom was, and other areas of the home, and so promote their independence.
Accidents and incidents were appropriately recorded. Health and safety checks had been carried out and equipment was maintained and serviced appropriately.
People had their health needs met and had access to a range of health care professionals. People at risk of poor nutrition and hydration had their needs regularly assessed and monitored. The food within the service was nutritionally balanced and plentiful. All the people we spoke with told us the food was good. One person we spoke with said, “I like my food, there is always choice and options with lots of snacks.”
We saw that appropriate arrangements were in place to assess whether people were able to consent to their care and treatment. The registered manager was meeting their responsibility under the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure that people's rights were considered and protected. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.
During our inspection we saw lots of visitors coming and going. Visitors we spoke with said they were made to feel very welcome.
There was a range of activities available for people to reduce social isolation and encourage people to be active. One person told us, “I like to mix with others, have a laugh, I enjoy sing-alongs.”
We saw there was a system for gathering people’s views about the service. There was a system in place to record complaints and the service’s responses to them. People we spoke with were aware of the company complaints policy and were very positive about the way the service responded to their concerns.
There was a good system of weekly, monthly and annual quality monitoring and auditing in place to help improve the quality of the service provided.
Everyone we spoke with was positive about the service and the way it was managed. People told us the home had improved, was well managed and that the management and staff were very approachable. Everyone we spoke with was positive about the registered manager. During our inspection we found the registered manager to be open, caring and committed to providing a good quality, caring service.
Staff told us they liked working at Langfield Nursing and Residential Home and felt supported in their work.
The service had notified CQC of any DoLS authorisations, accidents, serious incidents and safeguarding allegations as they are required to do.