Inspection on 31/08/05 for Laurel Care Home

This inspection was carried out on 31st August 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 12/04/05

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 Salisbury Road Totton Hampshire SO4 2RN Lead Inspector Annie Billings Unannounced 31.08.05 13:00 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 H54 S12376 Laurel Bank V245499 310805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Laurel Bank Address Salisbury Road Totton Hampshire SO4 2RN 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 DE(E) Dementia over 65 PD Physical disability registration, with number PD(E) Physical disability over 65 of places MD(E) Mental disorder over 65 MD Mental disorder OP Old age DE Demnetia Laurel Bank H54 S12376 Laurel Bank V245499 310805 stage 4.doc Version 1.40 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 12.04.05 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, four of which are doubles, and offers two spacious lounges, separate dining room and a conservatory sitting room which overlooks the spacious gardens. Accommodation is arranged on two floors, with a passenger lift providing easy access between floors. Laurel Bank H54 S12376 Laurel Bank V245499 310805 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 3.5 hours and was the second of the April 2005 to March 2006 inspection programme. Many of the standards were assessed on the first inspection, and should be read in conjunction with this report to obtain a full overview of the service. A partial tour of the premises took place, records were inspected and residents’ files were examined. Discussions were held with three members of staff, two visitors and nine residents, in addition to the registered manager. Planning approval has recently been granted for an extension to the existing building. This would provide an additional twelve beds, as well as extensive improvements to the existing building, which would address outstanding environmental issues identified during previous inspections. The expected date for the commencement of any work is likely to be early in 2006. What the service does well: What has improved since the last inspection? A system of daily record keeping has been developed, as recommended at the last inspection, to demonstrate that care plans are being delivered effectively, and changes in need identified at reviews are brought to the attention of staff, to ensure that all needs are met. The manager advised that she is currently preparing for an early review of their Investors in People Award, which will involve updating the staff and development programme for the future. This ensures that staff feel valued, and the home makes best use of its staff team skills. Laurel Bank H54 S12376 Laurel Bank V245499 310805 stage 4.doc Version 1.40 Page 6 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 H54 S12376 Laurel Bank V245499 310805 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 H54 S12376 Laurel Bank V245499 310805 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) These standards were not inspected, but were assessed as met at the last inspection. EVIDENCE: Laurel Bank H54 S12376 Laurel Bank V245499 310805 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, 9 Systems are in place ensuring that residents’ health, medication, personal and social care needs are well met. EVIDENCE: Three resident’s care plans were inspected that confirmed that an initial plan of care is developed from the initial assessment. These were in sufficient detail to ensure that staff have sufficient guidance to address all assessed needs. Changes in need are identified at regular reviews, and brought to the staff’s attention. Following a recommendation at the last inspection, a daily care record system is to be implemented in early September, to ensure that care given remains consistent. Residents commented that care, “couldn’t be better” and “we’re well looked after, quite content”. Visiting relatives said, “Care and health needs are well supported, they’re marvellous”. None of the current residents choose to self medicate. Stocks and medication administration records are well maintained, and closely audited by the manager on a monthly basis, and an annual audit by the pharmacist. Any omissions are fully investigated and documented. Staff undertaking Laurel Bank H54 S12376 Laurel Bank V245499 310805 stage 4.doc Version 1.40 Page 10 medication administration receive training from the manager, who is a registered nurse. From discussion with the manager, it was identified that GPs do not always confirm changes in medication. The manager has been encouraged to ensure that no medication is changed without written instructions from the prescribing GP or consultant. Laurel Bank H54 S12376 Laurel Bank V245499 310805 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) 14 Residents are encouraged to take control over their lives, and remain as independent as possible. EVIDENCE: Discussion with several residents confirmed that daily routines are flexible and they can choose when to get up and go to bed. One advised they can have breakfast in bed if they choose to. Residents were observed to move around the home freely, with some choosing to remain in their room while others went out with relatives or sat in the lounge sleeping or chatting. Other chose to participate in an exercise class in the afternoon or just to sit and watch. Two residents suggested that outings and more activities in the afternoon would be a good idea. This was discussed with the manager, who advised that an issue had been raised by the insurance company regarding trips out, and that outings have been put on hold until this matter is satisfactorily resolved. An assurance was given that residents would have the opportunity to discuss alternative activities at the next residents meeting. Laurel Bank H54 S12376 Laurel Bank V245499 310805 stage 4.doc Version 1.40 Page 12 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) These standards were not inspected, but were assessed as met at the last inspection. EVIDENCE: Laurel Bank H54 S12376 Laurel Bank V245499 310805 stage 4.doc Version 1.40 Page 13 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) These standards were not assessed. EVIDENCE: Laurel Bank H54 S12376 Laurel Bank V245499 310805 stage 4.doc Version 1.40 Page 14 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 Residents are well supported by a competent and skilled workforce. EVIDENCE: Residents and relatives spoken with praised both the staff and management, describing them as “marvellous”, “couldn’t be better” and they are always cheerful and smiling. From observation and examination of the staff rota, staff were available in sufficient numbers to adequately meet the needs of residents. Call bells were answered promptly, and staff were observed to be on hand, to provide guidance and support where necessary. The home benefits from a stable staff team, many of whom have worked in the home for a number of years. Staff members spoken with described the team as well supported and had a good understanding of residents needs. Staff said they meet regularly with the manager, who is always available for advice and support, and are kept fully informed and have opportunities to make suggestions and have an input in the running of the service. One member of staff had recently undertaken training in the awareness of dementia, and found it really useful. The manager advised that she is currently preparing for an early review of their Investors in People Award, which will involve updating the staff and development programme for the future. Laurel Bank H54 S12376 Laurel Bank V245499 310805 stage 4.doc Version 1.40 Page 15 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, 35, 38 The service is well managed and policies and procedures in the home protect residents’ health, safety, welfare and financial interests. EVIDENCE: The registered manager is a qualified nurse, has been at Laurel Bank since 1999 following a career in the NHS, and has recently completed an NVQ 4 in management in addition to a variety of other qualifications already achieved. Always keen to improve any area of the home, Ms Bache manages an efficient, well run service, with residents well being central to this objective. Residents described Janet as “marvellous” and “runs a tight ship”. Policies and procedures in the home ensure that residents rights and wellbeing are protected and promoted. Laurel Bank H54 S12376 Laurel Bank V245499 310805 stage 4.doc Version 1.40 Page 16 Residents are encouraged to manage their own finances with the support of their families. Personal allowances held by the home for safekeeping were sampled, and found to be accurate and well documented, with inventories of all personal possessions available in files inspected. A current risk assessment for the building and current certificates in respect of all equipment and services within the home were sampled. Records of monthly health and safety audits undertaken by the management were also available. Staff training records confirmed that all staff are appropriately trained and receive updated training on a regular basis. Laurel Bank H54 S12376 Laurel Bank V245499 310805 stage 4.doc Version 1.40 Page 17 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 x COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 x x x 3 x x 3 Laurel Bank H54 S12376 Laurel Bank V245499 310805 stage 4.doc Version 1.40 Page 18 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 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. Refer to Standard Good Practice Recommendations Laurel Bank H54 S12376 Laurel Bank V245499 310805 stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection 4th Floor Overline House 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. 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