25 February 2021
During an inspection looking at part of the service
Langley View Residential Home provides accommodation and personal care for up to six people with mental health concerns, learning disabilities and/or autism. At the time of our inspection there were four people who were living at the service.
People’s experience of using this service and what we found
People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. People did not always have control and independence. For example, restrictions were in place which prevented people from accessing food independently.
The service didn’t consistently apply the principles of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people did not fully reflect the principles and values of Registering the Right Support for the following reasons lack of choice and control, limited independence and limited inclusion. For example, people did not have control and independence to get food when wanted or needed as cupboards were locked.
The management team did not provide clear guidance and training for staff to be understand the right attitudes and behaviours for their role, staff were observed to be task focused and people said there was limited meaningful conversation.
The quality assurance systems where not robust enough to recognise improvements were needed to meet best practice guidance and legislation.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 21 October 2019).
Why we inspected
We undertook this targeted inspection to check on a specific concern we had as to how the service was working within the principles of the Mental Capacity Act (MCA), inappropriate use of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) and how the provider ensured that peoples basic human rights was at the centre of their care. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to the lack of adherence to the principles of the MCA and the use of inappropriate restrictions.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.