Inspection on 23/06/09 for Laurel Bank Nursing Home

This is the latest available inspection report for this service, carried out on 23rd June 2009.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Laurel Bank Nursing Home 07/07/06

Laurel Bank Nursing Home 15/11/05

Laurel Bank Nursing Home 23/06/05

Laurel Bank Nursing Home 17/03/05

Laurel Bank Nursing Home 01/09/04

Laurel Bank Nursing Home 23/07/04

Laurel Bank Nursing Home 04/05/04

Laurel Bank Nursing Home 10/03/04

Similar services:

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Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Laurel Bank Nursing Home Holdsworth Road Holmfield Halifax West Yorkshire HX2 9TJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Paula McCloy     Date: 2 3 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Laurel Bank Nursing Home Holdsworth Road Holmfield Halifax West Yorkshire HX2 9TJ 01422244123 01422247212 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Christopher Bolland,Mrs Catherine Bolland care home 37 Number of places (if applicable): Under 65 Over 65 37 old age, not falling within any other category Additional conditions: 0 Can provide accommodation and care for one named service user aged under 65 years Can provide accommodation and care for three named service users under 65 years of age - category PD Date of last inspection Brief description of the care home Laurel Bank is situated in Holmfield, Halifax. It is close to the High School and there are some small local shops and two pubs nearby. It is set in its own very attractive, well maintained grounds with parking facilities to the front of the building. Laurel Bank is a care home with nursing. It is a large house, which has been extended to provide accommodation for 37 older people. The accommodation is arranged over 4 floors. There are single and double bedrooms, some of which have en suite toilets. There are four lounges and a dining room. Care Homes for Older People Page 4 of 28 Brief description of the care home Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This inspection was carried out to assess the quality of care provided to people living at Care Homes for Older People Page 6 of 28 the home. The inspection process included looking at the information we have received about the home since the last key inspection as well as a visit to the home, which lasted approximately 7 hours. During the visit we spoke to 6 people living in the home, 9 members of staff, a visiting social worker, the manager and 4 relatives. We also observed staff delivering care, looked at various records and looked around the home. Surveys were sent to 10 people living in the home, 10 staff and 5 health care professionals; these cards provide an opportunity for people to share their views of the service with us. Information received in this way is shared with the home without identifying who has provided it. Six people using the service or their relatives on their behalf, eight members of staff and one GP wrote to us with their comments. Their comments have been used in this report. What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Older People Page 8 of 28 Make sure that they are a range of individual and group activities arranged to keep people stimulated. Make a plan for redecoration and refurbishment that will be completed over the next 12 months. This will make sure the accommodation is maintained to a good standard. Make sure that the manager gets enough support so that she can make sure all of her management tasks are completed and up to date. Make sure that the manager gets copies of the monthly reports about the conduct and management of the home so that she can deal with any issues that may arise from those visits. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can visit the home to see for themselves if they think it is suitable. No one moves into the home unless staff are sure they can meet their needs. Evidence: A member of staff from Laurel Bank will go and assess anyone thinking of moving into the home. There is an assessment document that staff complete, which means that peoples needs are identified and that staff are sure they can meet those needs before people move in. We looked at the files for three people and found all of the assessment information we would expect, together with a care plan for each. We spoke to two relatives who told us that they had visited the home, unannounced, to have a look around and to find out about the service. They told us that staff had shown them around and had been very helpful. In the surveys people told us that they had received enough information about the home before they moved in. Care Homes for Older People Page 11 of 28 Evidence: Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are being met. Evidence: We looked at three care plans because we wanted to see what individual needs had been identified and what action staff have to take to meet these needs. We found that the care plans were detailed and easy to follow. All of the necessary risk assessments have been completed and staff are writing down the action they need to take to reduce or eliminate that risk. For example one person had been identified as being at risk of developing pressure sores. There was a clear plan in place regarding the specialist equipment that was in place and how frequently they needed to be repositioned. Peoples health care needs are being identified and met. Staff are vigilant and GPs and other health care professionals are being involved as necessary. Details of any visits by health care professionals are clearly documented in the residents care plan, Care Homes for Older People Page 13 of 28 Evidence: together with the advice that has been given. People told us that they get the medical support they need. People told us that the staff notice if there is anything wrong and always get a doctor or nurse. We could see from the care plans that staff were following instructions. For example peoples blood sugar levels were being monitored and recorded and peoples wound dressings changed as directed. On GP told us they keep on top of peoples medical needs, care for the patients and liase sensibly with local GPs. People looked well cared for and we saw that men had been shaved, peoples hair brushed or combed, spectacles were clean and peoples personal and oral hygiene was well maintained. In the surveys people told us that they get the care and support they need and that staff listen and act upon what they say. The medication system is well managed. We watched part of a medication round. The nurse spent time with each individual, offering encouragement when needed. People are receiving their medication at the prescribed times and records are well maintained. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a lack of activities provision in the home to make sure people are kept stimulated. Evidence: People told us that the routines of the home are flexible and if they want to stay in bed in the mornings they can do. We saw that people were getting up throughout the morning. As people come dowstairs the kitchen assistant takes their order for breakfast and serves a drink of their choice. People who want to have their meals in their bedroom can do so. The provision of activities in the home to keep people stimulated is poor. At our last visit an activities co ordinator had been recruited. This person was not at the home long and this position has not been filled. Everyone we spoke to thought that there needed to be more activities on offer. Whilst staff do their best to provide some stimulation this is very limited. It is important that both group and individual activities are provided that meet individuals preferences. There were lots of relatives visiting. They told us that they are made to feel welcome Care Homes for Older People Page 15 of 28 Evidence: and that staff are available to answer any questions they may have. At lunchtime there is a set meal, but there are a range of alternatives on offer if people do not like the dish of the day. We observed a meal time. People received a well presented meal, condiments were available and people who needed assistance from staff received appropriate support. Peoples views about the meals were mixed. It is important that staff find out what people think of the food so that they can make changes to the menu so that people get what they like to eat. In the surveys one person suggested making fruit bowls available in the lounges so that people can help themselves. It was a very hot day when we visited. People were given lots of drinks and everyone had a glass of water at all times. This means that people are kept well hydrated. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints and adult protection issues are being dealt with properly. This means that staff are listening to people and keeping them safe. Evidence: The homes complaints procedure is on display. People told us that the know who to talk to if they are unhappy or if they want to make a complaint. Staff told us that if anyone made a complaint or raised a concern they would report it to the manager or nurse in charge. People we spoke to told us that they would be able to raise any concerns with the manager and were confident that any issues would be sorted out. We looked at the complaints log and could see that details of complaints that have been made have been recorded together with the action taken and outcome. This showed that complaints have been dealt with properly. The staff we spoke to were able to tell us what they would do if they felt there were any practices in the home that werent in the best interest of the people living there. They also said that their National Vocational Training (NVQ) in care had covered adult protection issues. The manager told us that most of the staff have completed adult protection training. This means that staff are fully aware of all of the different types of abuse and about the reporting procedures. Care Homes for Older People Page 17 of 28 Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is comfortable, clean, tidy and generally well maintained. Evidence: Laurel Bank is situated in Holmfield, Halifax. It is a large property, which is set in its own extensive, well maintained grounds. There is car parking to the front of the building. There is seating available outside, which people use in fine weather. There is also a lawned area to the side of the home, with a water feature and bird table. This area is fenced off so that people can use it safely without wandering into the car park. There are some local shops and pubs within walking distance. The lounges and communal areas are well decorated and comfortable. Since our last visit the conservatory has been refurbished. In the surveys people told us that some of the bedrooms were in need of some redecoration and refurbishment. Currently there is no written redecoration and refurbishment plan for the home. This needs to be done so that everyone is clear about the improvements that are planned and people living in the home and there relatives can be kept informed. The home was very clean and there were no unpleasant odours. Everyone that Care Homes for Older People Page 19 of 28 Evidence: completed a survey said that the home is always clean and fresh. The laundry is well equipped, clean and tidy. Infection control procedures are in place. There have been no infection control issues at the home since the last visit. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough staff on duty to meet peoples needs. Staff are well trained and competent to do their job. Staff are properly checked before they start working in the home to make sure they are suitable and safe to work with older people. Evidence: There is a qualified nurse on duty throughout the day and night. There are four or five care assistants on duty during the day and two care assistants on duty at night. The care staff team are well supported by cooks, domestics and a laundry assistant. Staff told us they felt there were enough staff on duty to meet peoples needs at the current time. The manager is aware that she needs to keep the staffing levels under review as peoples needs change or as more people move into the home. Recruitment procedures at the home are good. Staff told us that criminal records bureau checks and references had been obtained before they started working at the home. Staff files confirmed that the necessary checks are being completed to ensure the suitability of new staff. This means that staff are safe to work with older people. There are 78 of the care staff team who have completed their National Vocational Training (NVQ) at level 2 or 3 in caring for older people. This means that they are qualified and competent to do their job. Care Homes for Older People Page 21 of 28 Evidence: We asked staff about their induction training when they first started working at the home. They all said that their induction had been good and covered everything they needed to know. We asked staff if they are being offered training. Staff told us that they are given training that is relevant to their role and keeps them up to date with new ways of working. Staff told us they feel well supported by the manager and feel that they have enough experience and knowledge to do their job. The manager has looked at every ones training needs and people have been booked on relevant courses to make sure their training is up to date. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and run in the best interests of the people living there. Practices in the home promote the health, safety and welfare of the people living there and staff. Evidence: The registered manager is a registered nurse who has also completed the registered manager award. Although she is supposed to have four days per week to work supernumerary to the rota this does not always happen as she covers the rota when other nurses are off duty. It is important that the registered manager gets this time consistently in order to carry out all of her management duties. She is very approachable and well liked by people living at the home. She works in a very hands on way and clearly has a good relationship with people. We talked to the manager about this. She enjoys working with people and wants to continue supporting people on a day to day basis as this also gives her the opportunity to see how staff are Care Homes for Older People Page 23 of 28 Evidence: working and to talk to people living in the home to see if there are any problems or concerns. She agreed that it would be possible for her to continue working in this way but she could do with help with the administration and someone to answer the telephone. She agreed to discuss this with the owner. The manager talks to people living in the home and relatives on a daily basis. There are no formal meetings being held at the current time. One relative thought that these would be a good idea. We talked to the manager about this and she agreed to start holding these meetings again. We wanted to look at the monthly reports that the provider has to write about the conduct and management of the home. These were not available, although one was faxed through for us to see. It is important that the manager gets a copy of these reports every month so she knows if there are any issues that she needs to deal with. The manager does not hold money on behalf of people living there. People or their representative are invoice for any additional charges for example hairdressing and chiropody. There is a written Health and Safety policy. Staff receive moving and handling, health and safety, food hygiene, fire safety, first aid and infection control training. The fire alarms are tested weekly. The service reports for the passenger lift and hoists were seen and were all up to date. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 12 16 A programme of individual and group activites must be in place. This will make sure that people are kept stimulated. 31/07/2009 2 24 16 A programme of redecoration and refurbishment should be drawn up to show what areas of the home will be included in the next 12 months. This will give people information about forthcoming improvements. 28/08/2009 3 33 26 The manager must be sent copies of the monthly reports on the home. This will make sure that she can pick up and deal with any issues that are raised. 28/08/2009 Recommendations These recommendations are taken from the best practice described in the National Care Homes for Older People Page 26 of 28 Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 15 People living in the home should be consulted about the food that is being served and menus adjusted accordingly. This will make sure people get the food that they want. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!