Inspection on 13/05/09 for Lauren Court Residential Care Home

This is the latest available inspection report for this service, carried out on 13th May 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Extracts from inspection reports are licensed from CQC, this page was updated on 20/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Lauren Court Residential Care Home Shelley Road Blacon Chester Cheshire CH1 5US     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: Paul Ramsden     Date: 1 3 0 5 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 26 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 26 Information about the care home Name of care home: Address: Lauren Court Residential Care Home Shelley Road Blacon Chester Cheshire CH1 5US 01244373761 01244374237 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Meridian Healthcare Ltd Name of registered manager (if applicable) Mrs Deborah Wilson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following categories of service only. Care home only - code PC, to people of the following gender:- Either. Whose primary care needs on admission to the home are within the following categories: - Old age not falling within any other category - Code OP. The maximum number of people who can be accommodated is: 48 Date of last inspection Brief description of the care home Lauren Court is a two-storey care home; access between floors is via the shaft lift or the stairs. The home is owned by Meridian Healthcare Limited and is located in the Blacon area of Chester, close to the local shops and other community facilities. There is a garden with sitting areas available for the residents to use; this was accessible and well maintained. There are adequate car parking facilities available. Residents accommodation consists of 47 single bedrooms all of which have en-suite Care Homes for Older People Page 4 of 26 care home 48 Over 65 48 0 Brief description of the care home facilities. A variety of lounge and dining areas are provided for residents. Lauren Court has a variety of bathing facilities for people to choose from. Aids to help independence are in evidence throughout the home; these include bath hoists, grab rails and an emergency call bell system. The current fee range for the home is £376.73 - £441 per week. Further information regarding fees are available from the manager. A copy of this inspection report can be made available upon request to the home or via the new Care Quality Commission [CQC] website [This is the new name for CSCI from 1st April 2009] Care Homes for Older People Page 5 of 26 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: This unannounced visit took place on the 13 May 2009 and lasted for a total of seven hours and forty minutes. Paul Ramsden, Inspector, undertook the visit on behalf of the Care Quality Commission [The replacement body for the Commission for Social Care Inspection, CSCI, since 1 April 2009]. Any references to we or us in the report refer to the Commission. All of the key standards for older people were looked at. Feedback on the findings of the inspection was given to the home manager as the inspection progressed. This visit was just one part of the inspection. Prior to the visit the home manager was asked to complete an Annual Quality Assurance Assessment [AQAA] to provide up to date information about the service provided in the home. This is a very detailed Care Homes for Older People Page 6 of 26 questionnaire that provides us with a lot of information about the service before the visit. We looked at the Annual Service Review [ASR] that was carried out last year [This is a review of good and excellent services that takes place between key inspections, good services only have an inspection every two years and excellent services every three years]. Following the completion of the review we found no evidence to suggest that our quality rating had changed or that we needed to bring the inspection forward. During the visit various records and the premises were looked at. When looking at the documents relating to the type of care each person needs [assessments and care plans]we use a system called case tracking. This is a method that allows us to follow or track a particular situation in order to ensure it was dealt with appropriately. A number of residents, family members and staff were spoken with; they gave their views about the home and the service provided. Some of these comments have been quoted in the report. A new manager has recently been appointed; she is currently undergoing registration with the Commission. What the care home does well: What has improved since the last inspection? What they could do better: 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 8 of 26 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 9 of 26 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. Information and opportunities to visit before moving in are available and residents are assessed before moving in to ensure their needs can be met at the home. Evidence: The home provides a range of information to prospective residents; these are presented in a Service User Guide and the Statement of Purpose. In addition to these documents Meridian has also produced a brochure that gives people some general information about Lauren Court and what people can expect. These documents contain all of the information required and they should provide sufficient information for anybody who is thinking of moving into the home. Pre-admission assessments demonstrating that the residents individual needs had been assessed in an accurate and consistent way had been carried out for the residents whose files were looked at. The manager or deputy will usually carry out the Care Homes for Older People Page 10 of 26 Evidence: assessments and will visit people in their own home, another care home or hospital to gather the necessary information before admitting someone. This provides an opportunity to make sure the home can accommodate the person and their individual needs. Where applicable copies of information provided by the Local Authority is also obtained prior to admission. Intermediate care is not provided at Lauren Court. Care Homes for Older People Page 11 of 26 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. The care planning system is in need of some improvement in order to ensure that the continuing health and welfare needs of the residents are met. Evidence: The deputy manager and senior carers are responsible for drawing up a residents plan of care. Since the previous inspection visit the people managing the home have made recommendations/introduced systems regarding the care planning system and as a result the staff have to record information in a variety of places; for example, carers or seniors may record that something is required in their respective communication books, this is acted upon but the action taken may not be recorded on the residents actual care plan. Over time this information is lost and the care plan will not therefore fully reflect the care needs of the individual concerned. This system is very difficult for the staff members to use so it is to their credit that we did not find any evidence to indicate that any problems had occurred in the care of those residents whose plans we looked at. This was discussed at length with the new manager who had already identified the issue and was taking the appropriate action to sort things. Care Homes for Older People Page 12 of 26 Evidence: Risk assessments are being completed as and when needed. Staff members spoken with had a good understanding of the people they were supporting and they were able to meet their diverse needs. Care staff work to a good standard in order to ensure that residents receive the care they need. They monitor a residents health and emotional needs daily and there was evidence to show that people were receiving the appropriate support from district nurses, GPs, opticians etc. Those residents that were asked confirmed this. A key worker system is in place [This is a system used in the majority of homes and involves particular staff members working more closely with certain residents]. The changing needs of individuals are discussed as and when required. We were able to see this in practice during the visit when information about individual residents was passed between staff members. During a conversation with one of the carers she said that the staff team worked well together and that the quality of care being provided was good. This was confirmed by residents and visitors spoken with during the inspection. It was seen throughout the visit that residents were being treated with courtesy, respect and good humour by staff. They were seen to be interacting with individuals in an appropriate way, knocking on bedroom doors before entering and addressing people according to their wishes. All personal care is carried out in the privacy of a residents bedroom or one of the bathrooms. Policies and procedures in relation to medication are in place. Medicines are administered using a blister pack system provided by a local pharmacist. The arrangements for the administration of medicines were looked at during this visit; they were considered to be good and the residents were being given their medication as prescribed. All senior staff members have regular medication training. Care Homes for Older People Page 13 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents using the service are able to maintain contact with family and friends and those spoken with were positive about the home and the support they received. Evidence: Residents were able to move freely around the home and a choice of sitting areas was available. It was seen that routines within the home were flexible and that residents were able to make choices in many areas of daily living; for example, times of rising and retiring, whether or not to join in with planned activities and where to spend time and with whom. The residents and family members spoken with made a number of positive comments during the inspection. These included: The staff are very good, The next best thing to home. Although the home did not have an activities co-ordinator the manager explained that someone was due to start this job in June. This role is to work with individuals both on an individual basis or in groups and to organise social and other activities for people to participate in if they want to. Various religious denominations conduct services in the home and residents are free to Care Homes for Older People Page 14 of 26 Evidence: attend if they wish to do so. A hairdresser visits the home on a regular basis and residents were seen to be using this service on the day of the visit. Links with the local community are maintained and people are able to go out with their families whenever they like. A visiting relative said; We are always made to feel welcome. Meals can be taken in the main dining room, one of the lounge/diners or in the privacy of a residents own room. The menu has the flexibility to meet individual needs and choices and special diets can be prepared if needed. The kitchen area was seen to be clean and well organised. We received varied comments about the food being provided, some people really enjoyed it and others were not as positive, these comments were passed onto the manager for her to deal with. Care Homes for Older People Page 15 of 26 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. Residents and relatives are able to complain/make suggestions and action would be taken to respond to their concerns. Evidence: There is a written complaints procedure for the home; this is on display in the entrance area and in each bedroom [The manager has confirmed that this could be made available in a different format if needed]. Information about complaints is also included in the Service User Guide and Statement of Purpose. Those residents and family members that commented said they would inform the manager or another senior staff member of any issues. The complaints record and the AQAA shows that two complaints have been made in the previous 12 months, these have been addressed. A comments and suggestions book and comment cards are also available in the entrance area should anyone wish to use them. The home has an adult protection procedure that complies with all of the relevant legislation and good practice guidelines. This is designed to ensure that any possible problems that arise are dealt with openly and people are protected from possible harm. Staff members undertake training in this area. The new manager who is currently undergoing registration with the CQC is in the process of undertaking an audit of all staff training and will address any shortfalls as soon as possible. Care Homes for Older People Page 16 of 26 Care Homes for Older People Page 17 of 26 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 facilities and accommodation is of a very good standard; this means that residents live in a homely, comfortable environment. Evidence: A tour of the premises was undertaken; this included communal [lounges/dining room]areas and a number of bedrooms. Lauren Court provides an environment that can fully meet the needs of the residents that live there. It is, both externally and internally being maintained to a good standard and the levels of hygiene and cleanliness are very high. The manager explained that as part of a general improvement plan new furniture has been provided for the lounges. All bedrooms seen during the visit were personalised, comfortable, well furnished and contained items of furniture belonging to the resident. A visiting relative told us that their family members bedroom had been completely redecorated prior to moving in and that they had been encouraged to personalise the room. Aids to help maintain independence, for example bathing aids have been provided. There are fully accessible garden areas available for residents to use. Care Homes for Older People Page 18 of 26 Evidence: The laundry within the home is well equipped and good systems are in place for the care of peoples clothes. Care Homes for Older People Page 19 of 26 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. Staff members work positively with residents and families to improve the quality of life of residents living in the home. Evidence: Care staff on duty and rotas seen demonstrated that staffing levels and the skill mix of staff was able to meet the needs of the residents within the home. The staff members were cheerful and friendly and the residents spoken with were complimentary about their attitude and competence. The manager and separate ancillary staff such as kitchen and laundry staff members are in addition to the care staff members on duty at any one time. The deputy manager who currently works on the floor is going to have a number of supernumerary hours in the immediate future; this will enable her to spend time on improving some of the systems in place, for example, the care plans. According to the AQAA 18 of the 24 care staff members are qualified to National Vocational Qualification [NVQ] level 2 or 3 in care, a recognised qualification for people working in the care profession. The two staff files seen contained all of the required information and a thorough Care Homes for Older People Page 20 of 26 Evidence: recruitment procedure was in place for the protection of residents. The homes manager confirmed that all new staff are checked against the POVA list and that a satisfactory CRB disclosure must be obtained before employment commences. New staff members undertake an in-house induction followed by a thorough induction training programme, including adult protection. This meets the Skills for Care Induction Standards. A new staff member confirmed this. Although Lauren Court provides a range of training courses for staff members and this was confirmed by them the new manager was unable to confirm whether all of the required mandatory training was up to date. She has started to address this already and has now accessed a variety of distance learning courses. Enrollment session; medication for seniors, equality and diversity and dementia for all staff members was taking place on the day of the visit. Other courses such as first aid and nutrition are planned. It was agreed that she would undertake an audit of all training and address any shortfalls as quickly as possible. As she has already identified this problem and had started to address it a requirement has not been made. Care Homes for Older People Page 21 of 26 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 being well run and managed on a day to day basis, this helps to ensure that the needs of the residents are met and that there are appropriate procedures in place to maintain their safety. Evidence: Since the previous inspection visit the home has had a number of management changes; we have been kept informed of this. A new manager has recently been appointed and she is currently undergoing registration with the Commission. She is very experienced and can show a clear sense of direction and best practice. She regularly attends courses/training in order to keep her practice up to date and to fulfill her management responsibilities. She has her Registered Managers Award and can clearly demonstrate an awareness of the needs of the residents living in the home and how to manage the staff team. A deputy and senior staff members support the manager. The residents, family members and staff that commented spoke positively about her appointment. An open day so that people could meet the manager was Care Homes for Older People Page 22 of 26 Evidence: held when she started, we think this was a good idea because it gave people the opportunity to meet her in an informal and relaxed situation. Lauren Court has a quality assurance system in place in order to ascertain whether residents and families are happy with the standards of care being provided. This is an ongoing process and comment cards are available for people to complete if they wish to do so. The home keeps some personal allowances for the residents. There are efficient systems in place to ensure people are safeguarded and the management of peoples monies, including record keeping is of a good standard. A random sample of these monies were checked, each had a correct balance and were being well managed. All records seen were being kept securely. All staff members are supervised on a continuous basis; they are not however currently receiving formal supervision. This will be looked at as part of the training audit that is being carried out. Any accidents are recorded and the home manager or deputy regularly audits these in order to ensure that any trends, for example, a resident having a number of falls are identified and addressed. The home has a comprehensive range of policies and procedures to promote and protect both residents and staff members health and safety. The maintenance records seen demonstrated that the appropriate service contracts were in place. These included, the bathing aids, the fire alarm system and the gas and electrical installations. The fire safety log book showed that the tests on the system and emergency lighting were being carried out at the recommended intervals and that drills and training were also up to date. Care Homes for Older People Page 23 of 26 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 24 of 26 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 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 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 26 of 26 - 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!