Inspection on 02/06/05 for Laurel Bank Nursing Home

This inspection was carried out on 2nd June 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 Nursing Home 23/08/07

Laurel Bank Nursing Home 07/09/06

Laurel Bank Nursing Home 10/11/05

Laurel Bank Nursing Home 07/12/04

Laurel Bank Nursing Home 20/07/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Laurel Bank Nursing Home Main Street Wilsden Bradford D15 0JH Lead Inspector Kathleen Firth Unannounced 11.15am 2nd June 2005 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 Nursing Home J52 S19861 Laurel Bank V229549 020605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Laurel Bank Nursing Home Address Main Street, Wilsden, Bradford, West Yorkshire, BD15 0JH 01535 274774 01535 274035 Joanneewalkden@AOL.com Victorguard Care plc 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) Mrs Sarah Rose Knott Care Home 40 Category(ies) of Physical disability over 65 years of age (40) registration, with number of places Laurel Bank Nursing Home J52 S19861 Laurel Bank V229549 020605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 07.12.04 Brief Description of the Service: The home is situated in a rural location and has ties with all aspects of the local community. It is close to the Post Office, Pharmacy, village hall and churches. There are Dentist, opticians and pubs within easy reach. It is on a bus route and there is parking for visitors cars. Entry to the home is ramped for easy access. There are three lounge areas with one being used for people who choose to smoke. The dining areas offer comfortable and congenial settings for the residents. There are gardens to the front of the home, which the residents have been involved in developing. They are well maintained and complement the overall appearance of the home. There are twenty six single rooms, ten with en-suite facilities and seven double rooms , two with ensuite facilities. The rooms are over three floors but are easily accessed by the passenger lift and internal ramp. Laurel Bank Nursing Home J52 S19861 Laurel Bank V229549 020605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on Thursday June 2nd over 5.5 hours by one inspector. The inspector toured the building, spoke with residents, staff, owner, management and visitors, examined residents’ records, including care plans, menus, staff rosters and the Home’s brochure. The owner, manager, staff, residents and visitors were very helpful throughout the inspection and were happy to join in the process. Twelve residents, one relative, three visitors and six staff were spoken to during the inspection. What the service does well: Each resident has a very comprehensive care plan in place with their needs clearly identified along with how these needs should be met. Clear instructions are given and risk assessments with coping strategies are in place where needed. Communication within the home is excellent and staff showed a good awareness of the needs of the residents. Regular staff meetings and supervision sessions are held. Residents have chosen not to have their own meetings. The activity programme within the home is excellent with everyone been involved including families if they wish. Residents spoken to confirmed that they are able to go to bed/get up at the times they choose, are able to go out with family or have them visit with no restrictions. All of the residents spoken to said that they feel respected by staff and that they are well looked after. Everyone said that they feel happy to speak to the manager or staff if they have any concerns/worries. Some of the residents who are in a shared room are keen to move into a single one when one becomes available. The home operates a waiting list for this. Residents are happy with the meals stating that the sponge cakes are like the ones they used to make at home. Alternatives are offered when there is something on the menu that someone does not like. Everyone spoken to confirmed that they are happy with the activity programme and feel that staff work hard but still have time to spend with them. There is a commitment to training and the staff confirmed that they have access to relevant courses. Most of the care staff are involved in NVQ and at least 50 should be qualified by the end of the year. Laurel Bank Nursing Home J52 S19861 Laurel Bank V229549 020605 Stage 4.doc Version 1.30 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 Nursing Home J52 S19861 Laurel Bank V229549 020605 Stage 4.doc Version 1.30 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 Nursing Home J52 S19861 Laurel Bank V229549 020605 Stage 4.doc Version 1.30 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) 1, 3, 5 People are able to make an informed choice about the home from the written information they receive and what they see when they visit the home. EVIDENCE: A copy of the home’s brochure given to all prospective residents was seen and found to be very comprehensive, containing sufficient information to enable the person to make an informed decision about the home. The pre and admission assessments were in the residents’ files and were seen to be very comprehensive. They contained sufficient information for staff to know what the needs of the people are and if these needs can be met at the home. Social work assessments were present in some files alongside appropriate risk assessments. Some of the residents spoken to remembered the manager coming from the home to see them at their home or in hospital. All prospective residents are invited to visit the home and most of the ones spoken to said that they had done so. Relatives had visited on behalf of one Laurel Bank Nursing Home J52 S19861 Laurel Bank V229549 020605 Stage 4.doc Version 1.30 Page 9 resident spoken to and another said she had made her decision based on the information she had received and a recommendation from a friend. Laurel Bank Nursing Home J52 S19861 Laurel Bank V229549 020605 Stage 4.doc Version 1.30 Page 10 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 Staff are aware of the residents’ needs and there is good communication amongst the staff group. Residents are treated with dignity and their privacy is maintained at all times. EVIDENCE: Care plans looked at contained the needs of the residents and what tasks are required to be done in order to meet these needs. The plans are clear, concise, easily understood and contain healthcare, social and religious needs. Where required risk assessments alongside the necessary coping strategies are in place. Evidence was seen that the plans are reviewed and updated on a regular basis. The home pays a retainer to a local GP practice and the home has excellent support from them. District nurses come to the home to treat the residential residents and other specialist services can be accessed, e.g. Tissue viability nurse, dietician. There was evidence that plans are in place for chiropodists, opticians and dentists to visit or residents to be taken to them. Any health professional visits are recorded in one place with any necessary actions needed and are easily accessed. Relatives are informed of any GP visits and given appropriate feedback. Laurel Bank Nursing Home J52 S19861 Laurel Bank V229549 020605 Stage 4.doc Version 1.30 Page 11 Two residents look after their own analgesia and one man takes responsibility for his eye creams. This has been agreed following the appropriate risk assessments. No one looks after their own medication and the home has a comprehensive policy and procedure to manage this for them. Medication was seen to be stored correctly and all records appropriately maintained. Individual bottles rather than the pre-set up blister packs are used at the home and is administered by the registered nurse on duty. This was seen to be done in a safe and correct way. Residents are treated with respect and evidence was seen of this throughout the inspection. People spoken to said that staff treat them with respect and maintain their dignity at all times and again this was evident. One lady said that staff offer personal care in a very sensitive way and that she feels well looked after. Staff were seen to knock on bedroom doors before entering and to deal with residents in a caring manner. Laurel Bank Nursing Home J52 S19861 Laurel Bank V229549 020605 Stage 4.doc Version 1.30 Page 12 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 Residents are encouraged to be part of the decision making process and make choices about their lifestyle. They are supported in maintaining contact with family and friends and visitors are made welcome at the home. A good, nutritious and varied diet taking into account individual choices is provided at the home. EVIDENCE: There are many and varied activities happening at the home that take into account individual abilities and tastes. Evidence of these activities are displayed around the home including paintings, flower displays, glass painting and many others. All of the residents spoken to said that they really enjoy the activities and that the organiser is excellent and cannot do enough for them. She also provides a resident “shop” and brings things in for the residents to purchase. Evidence of the enjoyment this brings was seen. Outings are also organised on a regular basis. The staff and residents enjoy special theme nights where the home is decorated to reflect a particular subject. These themes range from Valentines night or French and Italian nights. Family and friends are free to join in any of these events. Choirs both local and from the city visit to entertain the residents. Religious ministers visit the home and are made welcomed. Laurel Bank Nursing Home J52 S19861 Laurel Bank V229549 020605 Stage 4.doc Version 1.30 Page 13 An interdenominational service is held on a monthly basis and well attended. Some people go out with family and friends where this has been agreed in their care plan. Residents spoken to confirmed that the meals at the home are very good and that they enjoy them. The chef has recently been changing the menus and has liaised with the residents when doing this. Residents confirmed that they had been involved in this. People can eat meals either in the dining areas or their rooms. The meal served at the time of the inspection was seen to be nicely presented and nutritious in content. The main meal of the day is served in the evening. Two residents said that the sponges served after lunch; were just like at home. Staff were seen to be offering appropriate support to residents to ensure they could eat their meal. Regular weight checks are carried out and staff can call on the help of the dietician for advice if required. A few of the residents complained about being rushed at mealtimes but said that they are not afraid to speak to staff about this happening. Relatives and residents all said that they feel able to approach the staff and manager if they have any concerns or worries. Everyone spoken to said that the care is excellent at the home and that they are kept informed of what is happening Laurel Bank Nursing Home J52 S19861 Laurel Bank V229549 020605 Stage 4.doc Version 1.30 Page 14 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 Residents and their relatives have their views listened to, taken seriously and action is taken to resolve issues. Residents have their rights protected and are protected from abuse. EVIDENCE: The appropriate policies and procedures were seen to be in place and the senior nurse confirmed that staff have had Adult Protection training. All staff know what they need to do if they suspect any abuse. Staff understand the complaints policy and will assist residents or relatives to make a complaint if they wish to do so. Residents and relatives spoken to all said that they are happy to approach the manager if they have any concerns or worries. They feel that she will deal with them in a correct way and resolve them. No complaints have been received in the last year. Residents confirmed that they had been able to vote in the recent election. Where people had used the postal system, staff offered appropriate help to complete the forms. People who wished to go to the polling station were taken there. Residents and relatives are aware that they can have access to their records. All resident and staff records are stored in line with Data Protection policy. Laurel Bank Nursing Home J52 S19861 Laurel Bank V229549 020605 Stage 4.doc Version 1.30 Page 15 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, 21, 24, 26 The home provides a safe, well-maintained environment for the residents and provides appropriate bathing and toilet facilities. EVIDENCE: The home is decorated and furnished to a very high standard throughout and evidence was seen of a regular maintenance programme in place. There is a call system in all areas of the home for residents to summon help. Residents are able to easily access the parts of the home they need to. The bedrooms are large enough for residents to be able to follow their own lifestyles and offer comfort and safety. Residents all had plenty of their own possessions around them including family photographs and pictures, thus making their rooms very personal. Everyone spoken to said that the staff knock on the doors before entering. The rooms all have a pleasant outlook and where two people are sharing a privacy curtain is in place. There are various toilets throughout the home but there appears to be a problem in one area where residents have to wait. Laurel Bank Nursing Home J52 S19861 Laurel Bank V229549 020605 Stage 4.doc Version 1.30 Page 16 They are offered alternative toilet facilities but most prefer to stand and queue. Assisted bathing facilities are provided. Commodes are put in the rooms at night if this is felt to be appropriate and facilities are in place for the cleaning of these. There is a freedom from infection policy in place and staff are aware of this. Laundry is done in the home and this is all done to meet regulations. In the recent questionnaire getting the wrong clothes back was a negative comment, although no one mentioned it at the inspection. The home is extremely clean and tidy throughout and little recesses are built in for the storage of wheelchairs and mobility aids. Nothing was seen that could cause hazard to residents, staff or visitors. There were no offensive smells present at the time of the inspection. Laurel Bank Nursing Home J52 S19861 Laurel Bank V229549 020605 Stage 4.doc Version 1.30 Page 17 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 Residents are supported and protected by recruitment procedures in place. Staffing numbers and skills ensure that residents’ needs can be met. EVIDENCE: There were sufficient staff members on duty at the time of the inspection and everyone confirmed that this is mostly the case. The senior nurse said that sick leave is normally be covered by other staff unless it is too short notice. Staff and residents spoken to confirmed that this is usual practice. There is a mixture of nursing and care staff working on each shift and rosters seen confirmed this. Recruitment is carried out to comply with equal opportunities; two written references, CRB checks and professional qualifications checks are done before any member of staff can start work at the home. Work permits and visas are also examined where it is deemed to be appropriate. Training is felt to be very important at the home and all new staff undergo an induction period when they work as a super-nummary member of the team. Qualified staff are able to keep up their PREP in order to retain their qualification at the correct status. Other staff are working to-wards NVQ. Staff confirmed that they have easy access to training. Training in-house is divided up with different nurses being responsible for different subjects, thus ensuring continuity. A movement and handling update was taking place at the time of the inspection and staff were seen to be using correct techniques. Staff confirmed that they were aware of what to do if they suspected abuse Laurel Bank Nursing Home J52 S19861 Laurel Bank V229549 020605 Stage 4.doc Version 1.30 Page 18 was taking place at the home. There is an excellent communication system in place including written handovers at the end of each shift. All staff showed a high awareness of the needs of the residents. They said that they receive good support from the manager and that the staff team is supportive of each other. Staff feel able to approach the manager or owner if they have any concerns or worries and say that they are sure that they will be listened to. Laurel Bank Nursing Home J52 S19861 Laurel Bank V229549 020605 Stage 4.doc Version 1.30 Page 19 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, 33, 35, 38 The home is well managed, the interests of the residents are seen as very important to the manager and staff and are safeguarded at all times. EVIDENCE: The manager is experienced and qualified for her position at the home. Her approach towards residents, visitors, and staff demonstrated that she has a good professional rapport with them. Regular staff meetings are held but the manager’s offer of residents meetings has been declined. The manager is open to ideas and suggestions and residents, staff and visitors all confirmed that they are able to speak to her and express any concerns/worries. She in turn stated that she receives excellent support from the owner of the home. Evidence of this was seen, as the owner was present at the inspection. The home does not take responsibility for residents’ monies but anything that the resident requires that necessitates payment is recorded and relatives Laurel Bank Nursing Home J52 S19861 Laurel Bank V229549 020605 Stage 4.doc Version 1.30 Page 20 billed. This policy is well documented in the information booklet issued to prospective residents. Records were all up to date. There is an awareness of health and safety in the home and staff are trained in this area. Hoists and moving equipment are available and are positioned throughout the home where staff can access them quickly in the case of emergency. The recent quality assurance exercise carried out produced some very positive answers and comments. Receiving the wrong laundry was the only negative comment that was repeated by several residents. Individual negative comments had been discussed where possible and the problem sorted out. Twenty-three out of forty questionnaires were sent back. Laurel Bank Nursing Home J52 S19861 Laurel Bank V229549 020605 Stage 4.doc Version 1.30 Page 21 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 3 x 3 x 3 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 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION 3 x 3 x x 4 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 3 3 3 x 3 x 3 x x 3 Laurel Bank Nursing Home J52 S19861 Laurel Bank V229549 020605 Stage 4.doc Version 1.30 Page 22 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 OP 28 Regulation 18 Requirement The registered provider must ensure a minimum ratio of 50 trained members of care staff (NVQ Level 2 or equivalent) is achieved by 2005, excluding the registered manager, and in care homes providing nursing, excluding those members of the care staff who are registered nurses.(previous timescale of April 2005 not met) Timescale for action October 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 Good Practice Recommendations There are no recommendations from this inspection. Laurel Bank Nursing Home J52 S19861 Laurel Bank V229549 020605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Aire House Town Street Rodley Leeds, LS13 1HP 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 Nursing Home J52 S19861 Laurel Bank V229549 020605 Stage 4.doc Version 1.30 Page 24 - 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. 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