Inspection on 23/06/05 for Laurel Bank Nursing Home

This inspection was carried out on 23rd 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Laurel Bank Nursing Home 02/07/07

Laurel Bank Nursing Home 07/07/06

Laurel Bank Nursing Home 15/11/05

Laurel Bank Nursing Home 17/03/05

Laurel Bank Nursing Home 01/09/04

Laurel Bank Nursing Home 23/07/04

Laurel Bank Nursing Home 04/05/04

Laurel Bank Nursing Home 10/03/04

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 Holdsworth Road Holmfield Halifax HX2 9TJ Lead Inspector Paula McCloy Unannounced 23 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 J52J01_s1062_Laurel Bank_v230948_230605.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Laurel Bank Address Holdsworth Road Holmfield Halifax HX2 9TJ 01422 244123 01422 247212 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) Mr Christopher Bolland Mrs P Linda Parker CRH - Care Home 37 Category(ies) of N - Nursing, OP - Old People over 65 37 places registration, with number of places Laurel Bank Nursing Home J52J01_s1062_Laurel Bank_v230948_230605.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 17 March 2005 Brief Description of the Service: Laurel Bank is situated in Holmfield, Halifax. It is close to the High School and there are some small local shops and two pubs nearby. It is set in its own very attractive, well maintained grounds with parking facilities to the front of the building. Laurel Bank is a care home with nursing. It is a large house, which has been extended to provide accommodation for 37 older people. The accommodation is arranged over 4 floors. There are single and double bedrooms, some of which have en suite toilets. There are four lounges and a dining room. Laurel Bank Nursing Home J52J01_s1062_Laurel Bank_v230948_230605.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over 7.75 hours. Thirteen residents, two relatives, six members of staff and the visiting McMillan nurse were spoken to. Residents records, duty rotas and staff records were inspected. What the service does well: Any prospective resident and/or their relative is invited to visit the home so they can make an informed decision about whether or not they feel the home is suitable. Written information is also available that gives details about what the home provides and its facilities. Staff from the home make their own assessment of any prospective residents needs to make sure that the home can look after them properly. Each resident has an individual care plan that sets out what care and support they require from staff. Staff are vigilant and care plans are updated as peoples needs change. Staff are also quick to involve Doctors and other specialists for advice. Residents look well cared for. All residents spoke well of staff and they felt that they were kind and caring. One resident said that ‘they never make you feel as if you are a trouble.’ Residents can follow their own routines and relatives and friends are welcome to visit at any time. Meals at the home are good. If residents and/or relatives are not happy about the service they are getting the home has a complaints procedure. Complaints that the manager has received have been dealt with and resolved. The staff are friendly and well trained. Staff enjoy working at the home and feel they work well as a team. Laurel Bank Nursing Home J52J01_s1062_Laurel Bank_v230948_230605.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 J52J01_s1062_Laurel Bank_v230948_230605.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 J52J01_s1062_Laurel Bank_v230948_230605.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) 1,2,3,4 & 5 The home’s statement of purpose and service user guide provide service users and prospective service users with details of the services the home provides. Prospective service users and/or their representatives are also encouraged to visit the home so they can make an informed decision about admission to the home. All prospective service users are assessed by staff from the home before admission to make sure that the home can meet their needs. Service users are given a written contract/ terms and conditions of residence document which details fees, room to be occupied etc. EVIDENCE: The home’s statement of purpose and service user guide are available from the home. The nurses assess any prospective service user prior to admission. The assessments for the three most recently admitted service users were seen. These were well completed and service users needs had been identified. Service users are issued with a contract/terms and conditions of residence document. Copies of these were available. These documents are kept in a separate file from the care plans. It would be helpful if a note was made on the front sheet of the care plan of the date service users were issued with their contract. Laurel Bank Nursing Home J52J01_s1062_Laurel Bank_v230948_230605.doc Version 1.30 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 There is a good care planning system in place that gives staff the information they require to meet service users needs. The health needs of service users are well met with evidence of good multidisciplinary working taking place on a regular basis. The medication system is well managed and service users get their medication at the prescribed times. Personal support in this home is given in a way that promotes and protects service users privacy and dignity. EVIDENCE: Five care plans were examined in detail. Care plans are well organised and it is easy to find relevant information quickly. The care plans set out in detail what action needs to be taken to ensure that service users needs are met. There was evidence of service users and relatives being involved in developing their care plans. Staff are vigilant and new care plans are developed as people’s needs change. There was also evidence that staff are identifying service users social needs and are trying to meet these. For example a table has been provided for one service user so they can pursue their interest in stamp collecting. It was noted that not all of the care plans have been fully completed. For example some social care information is missing and some nutritional assessments were not in place. An audit of service users’ care plans Laurel Bank Nursing Home J52J01_s1062_Laurel Bank_v230948_230605.doc Version 1.30 Page 10 does need to take place to ensure that all of the relevant information has been documented and that all of necessary assessments have been completed. Generally care plans are being reviewed on a monthly basis, however, some have been overlooked and therefore were not up to date. It was also disappointing that the very informative monthly summaries, which gave a holistic account of service users life at the home were not up to date. This was discussed during the inspection. Whilst the nursing staff clearly have to review the nursing care plans there may be a role for care staff to be involved with the reviewing process in getting service users views about meals, activities and general care. Service users health care needs are being identified and met. Staff are vigilant and GP’s and other health care professionals are being involved as necessary. The McMillan nurse felt that the staff were making referrals to her promptly and appropriately and were following the advice she gave. The personal hygiene needs of service users are clearly documented in their care plans. Staff need to make sure that peoples oral health care needs are also included in the care plans. The medication system is well managed. Service users are receiving their medication at the prescribed times and records are well maintained. Service users looked smart and well cared for. All service users spoke well of staff and they all felt they were kind and caring. One service user said that ‘they never make you feel as if you are being a trouble.’ The staff induction programme covers treating service users with respect. Staff were able to give a good account of the care given to service users when they are dying. There accounts confirm that service users are treated with dignity and respect. One service users wife, who also lived sat the home has died. Records show the additional support that staff have offered him following his loss. Care plans do not contain information about service users’ wishes regarding the care and support they want during illness and following death. This needs to be addressed. Laurel Bank Nursing Home J52J01_s1062_Laurel Bank_v230948_230605.doc Version 1.30 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 Service users preferences’ in relation to the routines of daily living are respected. Relatives and friends fell welcome to visit at any time. The meals at the home are good but meal times need to be better organised and service users consulted about the choice of meal available. EVIDENCE: Service users preferences’ in relation to the times they want to get up and go to bed are respected by staff. It was noted that service users were getting up at varying times during the morning. Care staff organise activities in the afternoons, and outside entertainers are booked regularly. Service users talked about a singer that had been at the home the day before the inspection and that they had enjoyed the ‘sing song.’ There is a notice board in one of the lounges that gives details of the activities on offer. It was also noted that staff were taking service users out for a walk in the grounds, an activity that was clearly enjoyed. Some of the care plans examined stated that an activity that individuals enjoyed was talking to staff. Staff confirmed that the afternoons are the times that they can sit and talk to service users. Currently there is very little recorded in care plans about the activities people have participated in. This is an area that care staff could be more involved in and contribute to the written records. Laurel Bank Nursing Home J52J01_s1062_Laurel Bank_v230948_230605.doc Version 1.30 Page 12 Relatives confirmed that they can visit at any time and that they are made to feel welcome. Visits take place in the communal areas or in service users bedrooms if they want to be private. Service users stated that the food was good. Service users have their meals in a number of different rooms. At lunchtime the process of delivering meals to service users was poor. For example four service users were sitting at the same table. Two received a meal and two had to wait for theirs to arrive. In the same room two service users were given puddings that they needed assistance with to cut up the pears. No staff were directly supervising this area to assist. At lunchtime there is one main meal detailed on the menu board and an alternative is offered if service users refuse this. In order to give service users a planned choice it would be better if people were consulted in the mornings about their preference for the lunchtime meal. Laurel Bank Nursing Home J52J01_s1062_Laurel Bank_v230948_230605.doc Version 1.30 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 home has a satisfactory complaints system and complaints that have been made have be resolved. Staff have a good understanding of adult protection issues which protect service users from abuse. EVIDENCE: There has been one complaint since the last inspection from a relative. The registered manager has recorded the complaint and suitable action was taken to resolve the complaint. Service users and relatives felt that if they had any concerns that they would feel able to raise these with the registered manager. Staff have attended adult protection training and the local adult protection procedures are available. All staff spoken to were able to detail exactly what they would do if they felt any practices in the home were not in the best interest of the service user. Laurel Bank Nursing Home J52J01_s1062_Laurel Bank_v230948_230605.doc Version 1.30 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) These standards were not assess on this inspection. EVIDENCE: Laurel Bank Nursing Home J52J01_s1062_Laurel Bank_v230948_230605.doc Version 1.30 Page 15 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, 28, 29 & 30 Staff moral is good resulting in an enthusiastic workforce that work positively to improve service users quality of life. Staff are receiving appropriate training to meet service users needs. Any new staff are thoroughly checked to ensure that they are suitable to work with older people. EVIDENCE: All staff spoken to felt that they were working well as a team and that they enjoyed coming to work. New members of care staff said that they had been made to feel welcome and were enjoying working at the home. Although agency staff are having to be used for some shifts, these tend to be staff who are familiar with the home. There is a vacancy for a tea time kitchen assistant. The registered manager needs to ensure that if care staff are needed to wash up that there are sufficient staff available to meet service users needs. There are 43 of the care staff qualified to NVQ level 2 or 3. Staff have also completed moving and handling, adult protection, MRSA and infection control training. Recruitment procedures at the home are robust. Staff files confirmed that the necessary checks are being completed to ensure the suitability of new staff. Laurel Bank Nursing Home J52J01_s1062_Laurel Bank_v230948_230605.doc Version 1.30 Page 16 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) These standards were not inspected. EVIDENCE: Laurel Bank Nursing Home J52J01_s1062_Laurel Bank_v230948_230605.doc Version 1.30 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 1 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x x Laurel Bank Nursing Home J52J01_s1062_Laurel Bank_v230948_230605.doc Version 1.30 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 11 Regulation 12 Requirement Service users wishes about how they wish to be cared for during illness and following death must be recorded. Timescale for action 31 July 2005 and thereafter 2. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 2 7 Good Practice Recommendations A note should be made on residents care plans that a contract or terms and conditions of residence document has been issued and signed. An audit of individual care plans needs to take place to ensure that all of the relevant information has been documented and all of the assessments have been completed. The holistic monthly summaries need to be brought up to date. Care staff should contribute to these by discussing sevice users views about their general care, activities and meals with them. Care staff should contribute to individual service users records regarding their social care e.g. activities people have participated in. Meal times need to be better organised so service users receive their meal in a timely way and that staff are J52J01_s1062_Laurel Bank_v230948_230605.doc Version 1.30 Page 19 3. 7 4. 5. 12 15 Laurel Bank Nursing Home 6. 15 available to assit when necessary. Service users should be consulted in the mornings about their preference for the lunchtime meal. Laurel Bank Nursing Home J52J01_s1062_Laurel Bank_v230948_230605.doc Version 1.30 Page 20 Commission for Social Care Inspection Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 J52J01_s1062_Laurel Bank_v230948_230605.doc Version 1.30 Page 21 - 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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