Inspection on 12/04/05 for Laurel Care Home

This inspection was carried out on 12th April 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 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 Care Home 04/11/08

Laurel Care Home 07/11/06

Laurel Care Home 31/08/05

Laurel Care Home 27/10/04

Laurel Care Home 04/05/04

Similar services:

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

St Vincents

The Cotswold Home

Newbeech House

Winton House

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

CARE HOMES FOR OLDER PEOPLE Laurel Bank Care Home Salisbury Road Totton Hampshire SO4 2RW Lead Inspector Annie Billings Unannounced 12.04.05 10:30 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 Care Home Version 1.10 Page 3 SERVICE INFORMATION Name of service Laurel Bank Care Home Address Salisbury Road Totton Hampshire SO4 2RW 02380 869861 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 Care Home Limited Ms Janet Bache CRH 36 Category(ies) of Dementia (36), Dementia - over 65 years of age registration, with number (36), Mental disorder, excluding learning of places disability or dementia (36), Mental Disorder, excluding learning disability or dementia - over 65 years of age (36), Old age, not falling within any other category (36), Physical disability (10), Physical disability over 65 years of age (10) Laurel Bank Care Home Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents in the categories MD and PD are not to be admitted under the age of 55 years. 2. Not more than 10 residents in PD and PD(E) categories to be accomodated at one time. Date of last inspection 27.10.05 Brief Description of the Service: Laurel Bank is a spacious, detached residence, which stands in two acres of ground, on the eastern edge of the New Forest. The home is situated one mile from the centre of the town of Totton, and is easily accessible with junction 2 of the M27 nearby. Laurel Bank is a family run business, managed by Janet Bache to provide comfortable, friendly accommodation to meet the needs of up to 36 service users who fall into the category of older persons, mental disorder (excluding learning disability), physical disability or sensory impairment. The home has 32 bedrooms, three of which are doubles, and offers two spacious lounges, separate dining room and a conservatory sitting room which overlooks the well maintained gardens. Accommodation is arranged on two floors, with a passenger lift providing easy access between floors. Laurel Bank Care Home Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 6.5 hours as part of the normal inspection and regulation programme, and to confirm that one previous requirement has been met. A partial tour of the premises took place and residents’ files were examined. Five staff on duty, two visitors and thirteen residents were spoken to. Lunch was seen being served and a well attended Holy Communion service was observed. Plans for a proposed extension have been re-submitted to the planning office for consideration in May. If the planning application were successful, this would involve changes to the existing premises, and general refurbishment. This being the case, any major issues relating to the environment identified during previous inspections have not been addressed by requirements. However, these areas will be re-visited at future inspections pending the outcome of the application. What the service does well: The home benefits from a stable well-trained and supervised group of staff that have worked at the home for a long time. Service user and visitor feedback reflects the good relationships built with, and excellent care and support given by staff and management. Twelve of thirteen residents spoken with confirmed they or their family had been encouraged to visit the home prior to moving in. Meals are varied, well balanced and attractively presented, providing a good choice based on resident’s likes and dislikes. Specialist diets can be catered for. Residents spoken with confirmed their satisfaction with and variety of activities and entertainment provided. Regular trips are organised, particularly in the summer months. Good opportunities are available for staff, residents and relatives to participate in the running of the home. Laurel Bank Care Home Version 1.10 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Laurel Bank Care Home Version 1.10 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 Care Home Version 1.10 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, 6 All new prospective residents have their needs assessed prior to moving into the home, to ensure their needs can be met. Prospective residents and their families are encouraged to visit the home before making a decision to move in. The home does not offer an intermediate care service. EVIDENCE: Three resident’s files inspected contained a pre-admission assessment undertaken prior to admission. Once admitted to the home, these needs assessments are kept under regular monthly review. Twelve of thirteen service users spoken with confirmed either they or their families had visited the home to check if the home was appropriate for their needs. One could not remember. No intermediate care service is offered by the home, although short stay residents are accepted if there is a vacant room. Residents are assessed under the same process as long stay residents. Laurel Bank Care Home Version 1.10 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, 10 Systems are in place to ensure that residents’ health, personal and social care needs are well met, but plans need to be updated to reflect changes identified. EVIDENCE: Three resident’s care plans were inspected that confirmed that an initial plan of care is developed from the initial assessment. Evidence of monthly reviews identifies changes in need, although the care plans have not been updated to reflect this. One review identifies the service user as difficult to stand and transfer. A risk assessment is in place confirming a moderate risk, but moving and handling instructions to staff are not given on the care plan. Another review identifies behavioural problems with another resident. This has not been reflected within the care plan to give staff instruction on how to manage this behaviour. This care planning approach relies on the close relationships built between staff and residents, and knowledge of the good communication systems in the home. A recommendation was made to the manager, to update care plans and provide more detailed information, to ensure that all needs are addressed on the care plan. Laurel Bank Care Home Version 1.10 Page 10 The development of daily care records would better demonstrate that care plans are being delivered effectively and consistently. This was discussed with the manager who agreed to discuss and consult with colleagues to develop recording systems. Health care records are detailed, and evidence prompt referral to and consultation with other agencies where a need is identified. Referrals to community psychiatric nurse, psychiatrist and the rehabilitation team were seen in the files sampled. One resident had recently deteriorated, and following a number of falls was promptly referred for a nursing assessment. All service users spoken with confirmed they are well supported, treated with dignity and respect, and receive a high quality, consistent level of care. One service user advised, “I am looked after wonderfully well”. Residents were seen to choose whether to join in activities or to relax in their rooms. Staff were seen to uphold residents’ privacy, by knocking on doors before entering. Laurel Bank Care Home Version 1.10 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, 15 Activities and menus are well planned in consultation with service users, and provide an interesting and varied choice based on likes and dislikes. Visitors are welcomed into the home, and contact with family and friends is encouraged. EVIDENCE: A notice board provides information to residents advising of activities available in the home. These include church services twice per month, joint mobility classes two or three times per month, various trips out in the community and events organised for the next month. Several residents advised of a country and western event planned, following discussion at the January resident’s meeting. A Holy Communion service was held on the day of inspection. This was observed to be well attended, with several residents advising they “enjoyed the singing”. Two relatives visiting the home confirmed that staff are always welcoming and supportive. One advised: “communication with the home is good. I am kept well informed”. All the service users spoken with commented on their satisfaction with the food provided. One resident commented that: “the food is excellent”. New menus were implemented in November following consultation with residents regarding their likes and dislikes, which provide a good variety and choice. The meal served was hot, attractively presented and plentiful, with staff available to offer support if Laurel Bank Care Home Version 1.10 Page 12 required. Several service users preferred to receive lunch on a tray in their room, rather than eat in the dining room. Laurel Bank Care Home Version 1.10 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, 17, 18 Service users and relatives are aware of how to complain, and are confident their views will be listened to. Appropriate arrangements are in place for people to exercise their legal rights. Staff have a good knowledge and understanding of adult protection issues, which protect service users from abuse. EVIDENCE: Discussion with residents stated they find the manager very approachable, and know if they had a problem, were confident it would be listened to and acted upon. One resident stated they knew who to complain to but “have nothing to complain about, it’s excellent”. A copy of the complaints procedure is available within the service user’s guide. One relative confirmed they know who to complain to but had no complaints. The manager has made arrangements for a postal vote for those who wish to vote in the forthcoming general election, although residents had not yet been made aware of this. Appropriate policies and procedures are available to protect service users from abuse. Discussion with three staff members confirmed their awareness of the reporting procedures in the event of abuse. Laurel Bank Care Home Version 1.10 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, 20, 23, 24, 25, 26 Communal areas and bedrooms viewed are clean, well decorated, comfortable, homely and reasonably maintained, although some areas in need of refurbishment have been delayed until the outcome of a planning application is known. EVIDENCE: Generally, the home presents as a clean, comfortable and welcoming environment. Since the last inspection the home has continued with the programme of redecoration and two bedrooms have been completed with a further one underway. The dining room has been further enhanced, and new artwork has been commissioned for display throughout the home, following consultation with service users. Communal areas have benefited from new, more appropriate seating. One sofa is particularly low, but was seen to be a favourite of some residents, although plans are in place to replace this. Bedrooms viewed were personalised and organised to suit the service user’s needs. All those spoken to confirmed they were happy with their rooms. Laurel Bank Care Home Version 1.10 Page 15 Other areas of the home are in need of refurbishment, but this has been delayed, awaiting the outcome of a planning application, which would affect the areas of refurbishment. Risk assessments have been undertaken in respect of any area of potential risk to staff or residents. Requirements have not been made until the outcome of the current planning permission is known. In particular these areas include some exterior window frames, uncovered hot water pipes, several internal doors require redecoration and the laundry facility needs a total redevelopment. Although residents confirmed they were happy with the service provided, this area does not offer staff an ideal working environment. Following a requirement at the last inspection, conservatory windows have received attention although the manager advised that one window requires further attention. A repairs and maintenance log displayed in the staff area confirmed that minor issues of maintenance are dealt with promptly. The external grounds to the property are well maintained, and provide a pleasant outlook from many of the service user’s rooms. Laurel Bank Care Home Version 1.10 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) 28, 29, 30 The home’s recruitment policy and procedures are robust in the protection of service users, and the needs of residents are well met by a trained and skilled staff group. EVIDENCE: Staff morale is high, and those spoken to confirm they work well as a team, are very supportive of each other and are well supported by the management. The home continues to support the Investor’s in People Award, and with eleven of fifteen care staff qualified to NVQ2 reflects the priority given to provide a well-trained workforce. Staff files of the most recently employed staff indicate that all the appropriate checks have been undertaken to support the protection of residents. Residents advised that staff are kind, cheerful and very supportive. Evidence of induction training was available in the files viewed. The staff members spoken with were aware of their roles and responsibilities, and felt they received appropriate training to support resident’s needs. Training needs are addressed regularly at supervision. Programmes of staff training were displayed in the staff area and confirmed that regular mandatory and dementia awareness training was organised for the next two months. Laurel Bank Care Home Version 1.10 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, 32, 33 The home presents as a well managed, efficient home with an effective leadership. The systems for consultation are good, with a variety of evidence that views are sought and acted upon. EVIDENCE: The home presents as a well managed, efficient home with an effective leadership. The development plan for the home has been discussed with residents, relatives and staff. The registered manager is a qualified RGN and has been at Laurel Bank since 1999. Currently undertaking NVQ4 qualification, the manager is well supported by the directors of the company, who involve themselves in the day-to-day running of the home. Care staff and residents confirmed they are encouraged to voice their opinions and to approach the manager about any issues. Two members of staff spoken Laurel Bank Care Home Version 1.10 Page 18 with confirmed they feel well supported by both the manager and their colleagues. Minutes of regular resident and relative’s meetings are displayed on the notice board, which confirm that they are fully involved in all aspects of the home. Minutes of the latest staff meeting were displayed on the staff notice board. This included discussion around policies and procedures relating to manual handling and COSHH, shift patterns and an opportunity to discuss staff comments. Staff advised of their enjoyment of recent “away days”, which they felt improved staff morale, team spirit and greater understanding of management’s vision for the future. Despite the reminder at the last staff meeting, a bottle of bleach was found in the kitchen, and left unattended. The manager has agreed to deal with this issue immediately. Laurel Bank Care Home Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 3 x x 3 3 3 3 STAFFING Standard No Score 27 x 28 3 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 3 3 3 3 3 x x x x x Laurel Bank Care Home Version 1.10 Page 20 No 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 7 Regulation 15[2]b Requirement Changes in need identified at reviews must be reflected within the care plan, to ensure staff have clear guidelines to support those needs. Timescale for action 31st July 2005 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 7 Good Practice Recommendations Daily care records should be kept to demonstrate that care plans are followed consistently. Laurel Bank Care Home Version 1.10 Page 21 Commission for Social Care Inspection 4th Floor Blechynden Terrace Southampton SO15 1GW 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 Care Home Version 1.10 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. 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!