Langdale and Keswick (Parkfields)

Updated 10 May 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

One inspector visited the home. A member of the CQC medicines team reviewed medicine records off site. An assistant inspector, along with the inspector, made telephone calls to speak with relatives, staff and other professionals that worked with the service.

Service and service type

Langdale and Keswick (Parkfields) is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Langdale and Keswick (Parkfields) is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced

What we did before inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We asked the local authority and Healthwatch for feedback about the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We made observations in communal areas of how staff interacted with people who used the service. We spoke with five relatives about their experience of the care provided.

We spoke with seven members of staff including care workers and senior care workers. We also spoke with the registered manager, a manager from another service who was working at the home temporarily, the maintenance manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included two people’s care records and seven people’s medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke in detail with four professionals who supported some people who used the service and had some email feedback from multiple other professionals.

Updated 10 May 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Langdale and Keswick (Parkfields) is residential care home made of two bungalows providing personal care to seven people at the time of the inspection. The service can support up to eight people with learning disabilities and/or autism.

People’s experience of using this service and what we found

Right Support

Lessons were not always learned when things went wrong as incidents were not always thoroughly reviewed to ensure practice could be improved. Medicines were generally managed safely, and feedback was acted upon when areas for improvements were identified during the inspection. People were protected from the risk of cross infection, where possible. Staff enabled people to access specialist health and social care support in the community, although some improvements were needed to ensure advice was promptly followed.

Right Care

Staff understood how to protect people from poor care and abuse, however incidents were not always reported. The service did not always have enough appropriately skilled staff to meet people’s needs and ensure they led a fulfilling life. However, staff were recruited safely. People who had individual ways of communicating, using body language, sounds, Makaton (a form of sign language) or objects of reference could not always interact comfortably with staff because staff did not always have the necessary skills to understand them. People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. People were supported to have food and drinks in line with their choices and needs.

Right culture

People did not always receive good quality care, support and treatment because staff did not always feel they had sufficient training to effectively support people. People were not always supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. There had been a recent increased staff turnover, which meant people did not always receive consistent care from staff who knew them well. Despite this, relatives were positive about the support their loved ones received. The provider and registered manager were responsive to feedback and open to discussions about our inspection findings.

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 good (published 4 April 2019).

Why we inspected

We undertook this inspection to assess that the service is applying the principles of ‘Right support, right care, right culture’. This was because we had received concerns about how people were being supported, so we wanted to check people’s care.

Enforcement and Recommendations

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 monitor the service and will take further action if needed.

We have identified breaches in relation to safeguarding, training of staff and quality assurance systems at this inspection. 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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.