Inspection on 01/11/06 for Laurel Bank

This inspection was carried out on 1st November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Laurel Bank 31/01/06

Laurel Bank 09/09/05

Laurel Bank 01/03/05

Laurel Bank 29/09/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Laurel Bank Knott Lane Gee Cross Hyde Tameside SK14 5HZ Lead Inspector Janet Ranson Unannounced Inspection 1st November 2006 09:30 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Laurel Bank Address Knott Lane Gee Cross Hyde Tameside SK14 5HZ 0161 368 4719 0161 367 8950 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Laurel Bank Residential Care Home Limited Mrs Patricia Connell Care Home 41 Category(ies) of Dementia - over 65 years of age (41), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (3), Old age, not falling within any other category (41), Physical disability over 65 years of age (40), Sensory Impairment over 65 years of age (3) Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 41 service users to include: *up to 41 service users in the category OP (Old Age, not falling within any other category); *up to 3 service users in the category MD(E) (Mental Disorder, excluding learning disability or dementia over 65); *up to 40 service users in the category PD(E) (Physical Disability over 65 years of age); *up to 3 service users in the category SI(E) (Sensory Impairment over 65 years of age); *up to 41 service users in the category DE(E) (Dementia over 65 years of age). 31st January 2006 Date of last inspection Brief Description of the Service: Laurel Bank is a care home adapted to meet the needs of 41 older people. Previously a Victorian church school, the adaptations now provide accommodation on three floors. There are 35 single bedrooms, 15 of which have en-suite facilities, and three double en-suite rooms. The bedrooms are located on all three floors and there is a full passenger lift. There are a total of six day/quiet rooms on all floors. A conservatory has been built to provide additional lounge space. In addition, there are two dining rooms, one on the ground floor and a further one on the third floor. Adapted baths and toilets are also located and clearly signed throughout the home. There is a small secure garden available to the service users, at the side of the building. Car parking is available at the front of the building, in addition to planted areas. The home is situated in a residential area, close to the centre of Gee Cross. There is a small shopping area within walking distance. The market towns of Hyde and Stockport are accessible by public transport. The people who live at Laurel Bank have been assessed as requiring residential care. The Commission for Social Care Inspection has registered the home to provide care for older people who may have dementia and/or physical disability. The fees for accommodation and care at the home range from £450 to £384. Additional charges are also made for hairdressing and chiropody services, newspapers and personal toiletries. Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection, which included an unannounced site visit by one inspector and an ‘expert by experience’. The Commission for Social Care Inspection are trying to improve the way we engage with people who use services so we gain a real understanding of their views and experiences of social care services. We are currently testing a method of working where ‘experts by experience’ are an important part of the inspection team and help inspectors get a picture of what it is like to live in or use a social care service. The term ‘experts by experience’ used in this report describes people who have been appointed by Help the Aged, under the direction of the Commission for Social Care Inspection, to take part in the inspection of services for older people. The site visit took place on Wednesday, 1st November 2006 and covered a period of seven and a half hours from 9:30am until 5:00pm. Time was spent talking to residents, relatives and staff and observing the home’s routine and staff interaction with residents. A total of four residents’ identified needs were looked in detail. Individual details of their experiences and care were examined from the point of admission to their current care. Time was spent having a look round the home and looking at a selection of staff and residents’ records (records of care, medication records, employment and training records). The inspector checked that what the Commission asked the home to do at the previous inspection (31st January 2006) had been done. Questionnaires were left at the home for use by residents, their relatives and the staff to comment on the service. In addition to carers, the home employs teams of catering and domestic staff and a maintenance person. Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Some improvements have been made to the environment. A start has been made to redecorate the hall stairs and landing. Wallpaper was being stripped and the walls were being prepared to receive the new wallpaper. Some bedrooms have been decorated when they became vacant. The new carpet has improved the appearance of the dining room on the ground floor. Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (Standard 6 intermediate care is not provided at Laurel Bank) Quality in this outcome area is good. The home’s system of assessment reflected individual preferences and social requirements. This meant that the home could be certain they could meet the prospective resident’s diverse needs. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: A range of care records was examined. assessments. They all contained pre-admission Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 10 The manager explained she undertook her own assessment of all prospective residents prior to admission. This information was shared verbally with staff and the written assessment was placed on the resident’s care file. The assessments were well documented, giving details of personal preferences and social abilities. The manager stated the home would only admit people in a planned manner. That is with a full assessment from the social worker, a visit to the prospective resident’s current place and, wherever possible, for the person to spend some time at Laurel Bank. Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. The care planning process clearly identifies the residents’ individual health and social requirements. They provide the carers with action to be taken to provide appropriate care on a day-to-day basis enabling the residents to benefit from the individual care. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Four care plans were examined as part of the inspection process. They clearly set out the residents’ individual personal care needs. The care plans document the action to be taken by the carers to ensure all aspects of health, personal and social care are met and reviewed. Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 12 Where identified, the resident’s health is monitored and addressed by the appropriate health care professionals. The district nurses are involved on a regular basis as are the chiropodist, audiologist, optician and dietician. Specialist equipment was in evidence to prevent pressure sores. The home also works closely with the local authority’s mental health team who provide specialist advise and guidance. The residents’ representatives who spoke with the inspector stated they were kept informed of any changes in their relative’s health and felt they remained involved with their care. A carer noted in the comment survey: “The home is good at listening to carers’ opinions on the needs of the service users. If we (as carers) feel a particular need of a client has changed, the management team will listen to our opinion and, if valid, apply it to the care plan.” All senior staff responsible for the administration of medication have received the appropriate training. Records are retained to show changes to medications and medical interventions. There is a policy and procedure in place to ensure all medications are administered in the correct manner. All medication is stored and administered in the correct manner. Two other visitors said, “the staff are brilliant. We don’t have to worry now about the phone call in the night (referring to the situation when the resident was in the community)”. It was reported by the resident’s close family that she had previously been in “at least five other homes, this comes out as the best.” Due to the residents’ high level of dementia it was not always possible to discover the residents’ true feelings of life at Laurel Bank. However, based on observation, it was apparent that the staff respected the residents’ privacy by knocking and waiting before entering rooms. The carers demonstrated tact and understanding in their interactions with the residents and the expert by experience noted, “the staff are courteous and respectful to residents and relatives.” Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. The choices offered to the residents meet with their requirements and needs and enable them to exercise elements of control over their lives. The ad hoc nature of the activities provided does not fully provide for a stimulating environment for most of the residents. Visitors are made to feel welcome and remain in contact with their relatives’ care. The contents of the menu appeared nutritious and well balanced, with a choice provided at each mealtime. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Laurel Bank has a good system of recording the residents’ previous lifestyles and social histories. This information serves to provide the carers with a better understanding of some residents’ reactions, particularly those residents with dementia. Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 14 There is no regular planned programme of activities. A resident told the expert by experience “the afternoons are really boring, as there is nothing to do other than wait for tea time.” And another resident said, “all that happens in the afternoon is more sitting around.” When asked what type of activities they would like, a resident told the expert by experience “I would love to visit the theatre.” This issue was discussed with a team leader, who confirmed that carers do provide some activities but only if and when they have the time. One carer described to the inspector that she had recently managed to arrange an impromptu sing-along which was enjoyed, but agreed this was only as a result of finishing her other duties. The home was decorated for Halloween and a social event had been arranged for the weekend. The residents’ families and friends are invited to all the parties. Entertainers also visit the home on a regular basis. Based on direct observation, the residents benefit from relaxed informal contact with the staff. A visitor said she valued the manner in which the staff kept her involved with the care of her relative. The main meal of the day at Laurel Bank is served at 5:00pm; breakfast is flexible, as and when the residents get up. The choice for the day was displayed in the dining room, although the residents who spoke with the inspector were unable to remember what they had chosen for their next meal. The expert by experience took her lunch with the residents in the main lounge. The expert by experience reported: “The menus show a well balanced choice of options, all residents are given assistance to choose from the menu. All the residents and relatives I spoke to said the food was great. One resident said “where else would you get food as good as this?” A visitor told the inspector that her relative, who had been refusing to eat whilst in the community, had put on weight since she had gone to live at Laurel Bank. Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. The home has a satisfactory complaints system with evidence that residents feel that their views are listened to and acted upon. Staff knowledge and understanding of adult protection issues provides a safe environment to protect residents from abuse. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The complaints procedure was available in the service user guide; it is also clearly displayed within the home. Two of the residents’ relatives were aware of the complaints process and were confident that the manager took their concerns seriously. The manager retains records of complaints. One relative however remained dissatisfied with her concerns that she regularly brought to the attention of the senior staff. This situation, which was described to the expert by experience, was brought to the attention of the senior staff during the inspection for their further consideration. The Commission For Social Care Inspection has not received any complaints about the service since the last inspection. Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 16 The home has a policy and procedure to respond to allegations of abuse. The senior carers have received formal training in the Protection of Vulnerable Adults (POVA) as required. This training enables them to “cascade” this to the other carers. The carers who spoke with the inspector confirmed they had received the POVA training and demonstrated their understanding of their responsibilities. The care worker surveys also confirmed they had received this form of training. Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. Improvements to the communal areas of the home provide the residents and their visitors with a pleasant warm and welcoming environment. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: At previous inspections there have been requirements to make improvements to the environment within the home. This was specifically with regard to the communal areas and the residents’ bedrooms. Work has started to redecorate the main hallway, staircase and landings. It was anticipated that the decoration would be completed before Christmas. A further improvement was the carpet in the dining room. This area had also been redecorated, creating a very pleasant room. Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 18 The manager stated that when a bedroom became vacant, it would be redecorated by the handyman, and there was evidence that this was the case. The décor in some of the double rooms remains very shabby, as does some of the bedroom furniture. There was evidence that the residents and their families had been encouraged to personalise their rooms. The home in general appeared to be clean, although some areas on the first floor smelled of stale urine. Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. The residents receive care from welltrained staff that responds to the residents and visitors in a respectful manner. The home’s recruitment policy and procedure provides protection to the residents from potential abuse. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: From observation during the inspection the numbers of staff on duty met with the residents’ assessed needs. The duty rota was not assessed at this visit. The carers were attentive and responded to the residents and their visitors in a respectful manner. A team leader has responsibility for the delivery of some mandatory training. This person has the required training to do this. A carer responded in the survey: the manager “has been instrumental in me attending any course I have asked to be sent on, funds permitting.” A further comment from a carer, “the company has provided lots of opportunity for interesting, useful and appropriate training.” Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 20 There continues to be a commitment to the National Vocational Qualification training scheme with carers achieving levels 2 and 3 in care practices. The home operates an effective recruitment and selection procedure. There is a small turnover of staff. Those staff who spoke with the inspector said they enjoyed working at Laurel Bank. This situation provides a stable workforce that can only serve to benefit the residents by the consistency. A small number of staff files were examined. They contained the required documentation and there was evidence of references, including satisfactory checks with the Criminal Record Bureau. Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. The manager of the home has the skills, experience and qualifications to run the establishment. The residents’ financial interests are safeguarded. Systems are in place to protect the residents, their visitors and the staff’s health and safety. This judgement has been made using available evidence, including a visit to this service. Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 22 EVIDENCE: The registered manager has the appropriate skills and experience to manage Laurel Bank. She has achieved National Vocational Qualification level 4 (registered manager’s award) as required by the standards. The staff surveys document that they are well supported and enjoy working at the home. One carer wrote “The home’s manager and her “officers in charge” are all very approachable if I have any problems.” The staff are enabled to carry out their roles in a relaxed and informed manner. Relatives who spoke with the inspector spoke warmly of the staff. Small amounts of monies are retained for safekeeping by the registered provider. All records of expenditure are retained for inspection, along with the receipts. The records are appropriately maintained in order that the interests of the residents were safeguarded. The staff at all levels benefit from an established formal supervision process. The supervision takes place every eight weeks, in addition to team meetings. All staff have received the mandatory training concerning health and safety, fire awareness, first aid, moving and handling, and food hygiene. All appliances and equipment are maintained in working order under contract. Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP12 OP19 Good Practice Recommendations The residents would benefit from a structured activities programme. The registered person must ensure that a programme of redecoration and refurbishment is arranged and implemented. Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Laurel Bank DS0000005574.V317881.R01.S.doc Version 5.2 Page 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. 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