Inspection on 09/09/05 for Laurel Bank

This inspection was carried out on 9th September 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Laurel Bank 01/11/06

Laurel Bank 31/01/06

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 SK14 5HZ Lead Inspector Janet Ranson Unannounced 8 & 9 September 2005 th th 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 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 F54 F04 s5574 Laurel Bank v248433 080905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Laurel Bank Address Knott Lane, Gee Cross, Hyde, Tameside, SK14 5HZ 0161 368 4719 Telephone number Fax number Email 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, Laurel Bank, Knott Lane, Gee Cross, Hyde, Cheshire, SK14 4HZ Mrs Patricia Connell CRH Care Home 41 Category(ies) of DE(E) Dementia - over 65 - 41 registration, with number MD(E) Mental Disorder -over 65 - 3 of places OP Old Age - 41 PD(E) Physical Disability - over 65 - 40 SI(E) Sensory Impairment over 65 - 3 Laurel Bank F54 F04 s5574 Laurel Bank v248433 080905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 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 years of age). up to 41 service users in the category DE(E) (Dementia over 65 years of age). Date of last inspection 1st March 2005 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. Laurel Bank F54 F04 s5574 Laurel Bank v248433 080905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out over two days a total of ten and half hours. Laurel Bank residential care home is registered with the Commission for Social Care Inspection (CSCI) to provide personal care for up to 41 people over 65 years of age. It is privately owned. The manager is registered with CSCI and was present throughout the inspection. In addition to teams of carers the organisation employs domestic, catering and laundry staff. Individual case files and care plans of five residents were examined as part of the inspection process. They concerned people who had lived at the home for a long time, were newly admitted and whose needs were changing. Wherever possible the residents were invited to talk to the inspector of their experiences and expectations. Team leaders, carers and the chef were interviewed and three resident’s relations assisted the inspector with their comments. A further relative spoke to the inspector over the telephone. Certain records were examined and observations of staff practice were also carried out. The inspector left comment cards with the manager for completion by the residents and their relatives. The comments will form part of the next unannounced inspection. It was disappointing to note that little work had been carried out to improve the environment and comply with the requirements from the previous inspections. What the service does well: Laurel Bank provides a good service for vulnerable residents in a pleasant and secure environment. The home cares for the resident’s families and encourages them to remain involved in their relative’s care. There is a stable staff group that works well as a team. The carers are respectful towards the residents, their families and also towards each other. There are good systems and procedures in place. Laurel Bank F54 F04 s5574 Laurel Bank v248433 080905 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? 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. Laurel Bank F54 F04 s5574 Laurel Bank v248433 080905 Stage 4.doc Version 1.40 Page 7 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 Standards Statutory Requirements Identified During the Inspection Laurel Bank F54 F04 s5574 Laurel Bank v248433 080905 Stage 4.doc Version 1.40 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 & 5 Systems are in place to ensure the residents needs can be fully identified and met by the home. Prospective resident’s and their representatives are able to visit the home in order that they can assess the service for themselves. EVIDENCE: Care needs assessments were contained within the five care files examined as part of the inspection. The system of assessing the potential resident’s needs that is carried out by a senior member of staff. By completing such an assessment the home can ascertain individual needs and ensure they can be met. A resident’s representative stated that she had visited the home with the potential service user to see for themselves the vacant room and other communal areas. She said that the friendly welcome they received from the staff during their visit, and the interaction she observed assured her that her relative would be safe and feel at home at Laurel Bank. Laurel Bank F54 F04 s5574 Laurel Bank v248433 080905 Stage 4.doc Version 1.40 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 & 11 Resident’s personal care health and welfare needs are fully documented and reviewed. The resident’s identified health needs are fully met by the various healthcare professionals. The home has policies and procedures in place to ensure medications are administered in the approved manner. The residents are treated with respect and their privacy is maintained at all times. Families are treated sensitively and encouraged to remain with their relative during their last hours. EVIDENCE: Five care plans were examined as part of the inspection process. They clearly set out the resident’s 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. Four relatives who spoke with the inspector were aware of the care planning process. Laurel Bank F54 F04 s5574 Laurel Bank v248433 080905 Stage 4.doc Version 1.40 Page 10 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 and optician. Specialist equipment was in evidence to prevent pressure sores. The home also works closely with the local authorities mental health team who provide specialist advise and guidance. Four resident’s representatives who spoke with the inspector stated they were kept informed of any changes in their relatives’ health and felt they remained involved with their care. 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 in the correct manner and the administration was observed to be safely carried out. The inspector observed the staff respecting the resident’s privacy by knocking and waiting before entering the room. The carers demonstrated tact and understanding in their interactions with the residents. The relatives who spoke with the inspector visit the home on a regular basis. The visitor said she valued the manner in which the staff kept her involved with the care of her father. The inspector also spoke with a relative by telephone. She described the recent death of her relative at the home. In particular she described how both she and her mother were encouraged to remain with their relative in her final hours. Meals were offered and the carers kept them informed through out. All the people involved at this time appreciated the sensitivity and respect provided by the staff. Laurel Bank F54 F04 s5574 Laurel Bank v248433 080905 Stage 4.doc Version 1.40 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 & 15 The choices offered to the residents meet with their requirements and needs and enable them to exercise elements of control over their lives. 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. EVIDENCE: Laurel Bank has a good system of recording the resident’s previous life style and social histories. This information serves to provide an understanding of behaviours for those who are caring for them. There is no regular planned programme of activities. A recent trip on the canal had been enjoyed by a small group of residents. Music was playing during the inspection and visitors could be seen taking residents out of the home for short trips. Entertainers also visit the home on a regular basis. Laurel Bank F54 F04 s5574 Laurel Bank v248433 080905 Stage 4.doc Version 1.40 Page 12 Based on direct observation the resident’s benefit from relaxed informal contact with the staff. The main meal of the day at Laurel Bank is served at five pm; breakfast is flexible as and when the residents get up. The choice for the day was displayed in the dining room although the resident’s who spoke with the inspector were unable to remember what they had chosen for their next meal. It was noted that a member of staff was supporting a resident in an unhurried manner to eat her meal whilst remaining in a lounge. The menu planning had been changed since the last inspection. The format now shows options for any special diets. Two residents confirmed in general the food is good. Laurel Bank F54 F04 s5574 Laurel Bank v248433 080905 Stage 4.doc Version 1.40 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 &18 The resident’s and their visitors were confident any complaints would be ct and acted upon. Policies and procedures are in place to protect the residents from potential abuse. EVIDENCE: The complaints procedure was available in the service users guide it is also clearly displayed. The resident’s who spoke with the inspector were unable to recall having seen the complaints procedure but were able to tell the inspector how and to whom they would voice their concerns, either to family members or staff. Two of the resident’s relatives were aware of the complaints process and were confident that the managers took their concerns seriously. The manager retains records of complaints. 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. Laurel Bank F54 F04 s5574 Laurel Bank v248433 080905 Stage 4.doc Version 1.40 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,24 & 26 Failure to provide maintenance, a programme of redecoration and furniture replacement in the home creates a poor impression. Laurel Bank is maintained in a clean and hygienic state. Laurel Bank F54 F04 s5574 Laurel Bank v248433 080905 Stage 4.doc Version 1.40 Page 15 EVIDENCE: At the previous inspection there was a requirement that the registered person ensure a programme of redecoration was arranged and implemented. This specifically concerned the communal and private accommodation for service users. During this inspection the inspector noted that a few bedrooms had been redecorated but the communal areas had not been touched. There was evidence of water penetration that may point to a problem with the roof, and damp patches on the wallpaper. In some areas the wallpaper was ripped or peeling off. The paintwork on doorways were heavily damaged from the over enthusiastic use of wheelchairs. Some bedroom furniture was looking tired and shabby. The manager had completed an audit of rooms that required attention but was unable to confirm when or if the works were to be carried out. Some residents had brought their own furniture and personalised their rooms with photos, pictures and ornaments. A team of housekeepers are employed to maintain a good standard of cleanliness and hygiene throughout the home. Laurel Bank F54 F04 s5574 Laurel Bank v248433 080905 Stage 4.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 & 30 The residents receive care from well-trained staff who respond to the residents and visitors in a respectful manner. The homes recruitment policy and procedure provides protection to the residents from potential abuse. EVIDENCE: From observation during the inspection the numbers of staff on duty met with the resident’s 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. The manager continues to seek out specialist training for the staff. There continues to be a commitment to the National Vocational Qualification training scheme with carers achieving levels two and three in care practices. The home operates an effective recruitment and selection procedure. There is a small turnover of staff. This situation provides a stable workforce that can only serve to benefit the resident’s by the consistency. Staff files were not examined at this inspection but the manager demonstrated her understanding of the requirement to obtain clearances through the Criminal Records Bureau. Laurel Bank F54 F04 s5574 Laurel Bank v248433 080905 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,37 & 38 The manager of the home has the skills, experience and qualifications to run the establishment. The resident’s financial interests are safeguarded. The health, safety and welfare of the residents, visitors and staff are promoted and protected. EVIDENCE: The registered manager has the appropriate skills and experience to manage Laurel Bank. She has achieved National Vocational Qualification level four (registered managers award) as required by the standard. The staff state they Laurel Bank F54 F04 s5574 Laurel Bank v248433 080905 Stage 4.doc Version 1.40 Page 18 are well supported and enjoy working at the home. They are enabled to carry out their roles in a relaxed and informed manner. A relative specifically named the manager and a team leader for their compassion and caring abilities. Small amounts of monies are retained for safe keeping by the registered provider. All records of expenditure are retained for inspection, along with the receipts. The records were 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 is maintained in working order under contract. Laurel Bank F54 F04 s5574 Laurel Bank v248433 080905 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 1 x x x x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x x x x 3 3 Laurel Bank F54 F04 s5574 Laurel Bank v248433 080905 Stage 4.doc Version 1.40 Page 20 yes Are there any outstanding requirements from the last inspection? 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. 1. Standard 19 Regulation 23(2)(d) Requirement The registered person must ensure that a programme of redecoration and refurbishment is arranged and implemented. Previous timescales (01/01/05 & 01/06/05) not met. Timescale for action 01/02/06 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. Refer to Standard Good Practice Recommendations Laurel Bank F54 F04 s5574 Laurel Bank v248433 080905 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 2nd Floor, Heritage Wharf, Portland Place Ashton under Lyne OL7 0QD National Enquiry Line: 0845 015 0120 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 F54 F04 s5574 Laurel Bank v248433 080905 Stage 4.doc Version 1.40 Page 22 - 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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