Kisharon Langdon - Edgware

Updated 13 March 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 was planned to check 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.

This inspection took place on 18 and 26 January 2018. It was carried out by one adult social care inspector. The first visit was unannounced.

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

Before the inspection, we checked for any notifications made to us by the provider and the information we held on our database about the service and provider. Statutory notifications are about important events which took place at the service, such as safeguarding incidents, which the provider is required to send to us by law. We also contacted the local authority and other community professionals involved in the service for their views, receiving one reply.

The inspection site visit activity took place on both of our visit days. It included visits to two supported living schemes, to meet people living at those schemes, staff working with them, and to check records kept at the schemes. We also observed people's interactions with staff and how they were supported.

We also visited the office location on both days, to meet the registered manager and office staff, and to review records relating to the management of the service. The first day also included a visit to the provider’s local human resources department, to check staff personnel records in respect of recruitment, training and supervision.

There were nine people receiving a personal care service in their home at the time of this inspection. During the inspection, we spoke with seven of these people, four people’s relatives, four support staff, two scheme managers, a team manager, the human resources manager, the service's social worker, the registered manager and the CEO for the provider.

During our visits we looked at four people’s support plans along with other records about people’s care and treatment including medicines and care delivery records. We looked at the personnel files of four staff members and records about the management of the service such as safeguarding and complaint records. We also requested further specific information about the management of the service from the registered manager in-between and after our visits.

Updated 13 March 2018

This service provides care and support within a Jewish framework to adults with learning disabilities and autism living in their own houses and flats in the community and in three ‘supported living’ schemes, so that they can live in their own homes as independently as possible. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for supported living; this unannounced inspection looked at people’s personal care and support.

Not everyone using ‘Langdon Community – Edgware’ receives regulated activity. CQC only inspects the service being received by people provided with ‘personal care’, meaning help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. There were nine people using the service in this respect.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service had a registered manager. This 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 of this service, in March 2017, we found three breaches of legal requirements. These were in respect of safeguarding people using the service from abuse, staff support and training and effective governance including for medicines management. The service was rated ‘Requires Improvement.’ The provider sent us an action plan in respect of the addressing the breaches. We undertook this inspection to check that the action plan had addressed the breaches. This was also a comprehensive inspection, to make sure the service was providing care that is safe, caring, effective, responsive to people's needs and well-led.

We found the required improvements had been made. Allegations of abuse were being properly addressed and monitored, minimising the risk of concerns being repeated. There had also been good work to raise awareness of amongst people using the service and staff of hate crimes, discrimination and bullying.

Increased monitoring and further staff training and competency checks had helped to ensure that people were consistently supported to take prescribed medicines. Records of this were now being accurately kept.

Improvements had been made to systems for ensuring staff received appropriate training, regular developmental supervisions and annual appraisal which helped to ensure staff had the knowledge and skills needed for supporting people. We found weaknesses with ensuring new staff completed induction training and probation periods in a timely manner. However, the management team were starting to develop systems to address this.

The service was now demonstrating better overall governance, as systems for scrutinising service delivery risks and the quality of care had been reviewed and improved on. There was an accountable structure in place and there were processes in place to support continuous learning and improvement.

People we spoke with all praised the service. Comments included, “I think Langdon is the best” and “It’s a fantastic service.” Most relatives told us they recommended the service to others, and a community professional told us the service worked well with them in meeting people’s needs.

The service promoted people’s independence well. It continued to support most people to gain paid or voluntary employment. It promoted social inclusion and provided many recreational opportunities through which people using the service developed friendships. This enhanced people's quality of life.

Staff at the service were kind, caring and emotionally supportive. There were enough staff to provide people with their required support. This was usually through the same small team of staff, which helped positive and trusting relationships to develop and enabled people’s needs and preferences to be better understood and addressed.

People received personalised care that was responsive to their needs. There were systems in place to ensure people were supported to have choice and control of their lives and for support to be provided in the least restrictive way possible. There were a number of avenues by which people using the service and their relatives were involved in the development of the service.

The service paid attention to people’s safety. Risks were assessed and managed, to balance people’s safety with their freedom.

The service supported people with health and nutritional needs, including accessing healthcare professional advice and following it.

The service supported people’s individual communication needs. It had an extensive range of easy-to-read documents, used to help some people’s understanding of specific matters.

The service promoted a positive and inclusive culture that achieved good outcomes for people, particularly for social inclusion. The management team were approachable and supportive of people and the staff working with them. There were effective links with other agencies to support care provision and development.

The service listened and responded to people’s concerns and complaints. However, we have made a recommendation to improve the overall monitoring of matters raised in this area, to help ensure opportunities to improve the service are followed.