Inspection on 07/07/06 for Laurel Bank Nursing Home

This inspection was carried out on 7th July 2006.

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 15/11/05

Laurel Bank Nursing Home 23/06/05

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 West Yorkshire HX2 9TJ Lead Inspector Paula McCloy Unannounced Inspection 7th July 2006 10:00 X10015.doc Version 1.40 Page 1 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 Laurel Bank Nursing Home DS0000001062.V292171.R01.S.doc Version 5.2 Page 2 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 DS0000001062.V292171.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Laurel Bank Nursing Home Address Holdsworth Road Holmfield Halifax West Yorkshire HX2 9TJ 01422 244123 01422 247212 Telephone number Fax number Email address Provider Web 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 Catherine Bolland Mrs P Linda Parker Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places Laurel Bank Nursing Home DS0000001062.V292171.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Can provide accommodation and care for three named service users under 65 years of age - category PD Can provide accommodation and care for one named service user aged under 65 years 15th November 2005 Date of last inspection 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. The current charges at the home range from £380 - £420 for residential care and £440 - £480 for nursing care. The fees do not include chiropody or hairdressing. Laurel Bank Nursing Home DS0000001062.V292171.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In April 2006 the Commission for Social Care Inspection (CSCI) made some changes to the way in which care services are inspected. Care services are now judged against outcome groups. The inspection report is divided into separate sections for each outcome group for example Choice of Home. An overall judgement is made for each outcome group based on the findings of the inspection. The judgements reflect how well the service delivers outcomes to the people using the service. The judgements categories are “excellent”, “good”, “adequate” and “poor”. The judgements are recorded within the main body of this report. More detailed information about these changes is available on our website – www.csci.org.uk Since April 2005 the home has received one additional inspection in response to a complaint about care practice. The complaint was not upheld. This inspection was carried out to assess the home against a pre-determined selection of the National Minimum Standards for Older People and to check what progress had been made on meeting the requirements from the previous inspection visits. One inspector carried out the inspection over 2 days and spent approximately 8 hours in the home. The methods used in this inspection included discussions with 7 residents, 3 relatives, 5 members of staff, management a care co-ordinator, a reviewing officer, observation of care practice, examination of records, and a partial tour of the home. A pre-inspection questionnaire was sent to the home prior to this inspection visit asking for information. This questionnaire was returned to the Commission for Social Care Inspection and the information provided has been used in this report. Comment cards were sent and left at the home for residents and relatives; these cards provide an opportunity for people to share their views of the service with the CSCI. Comments received in this way are shared with the provider without revealing the identity of those completing them. Five residents and two relatives wrote to the inspectors with their comments Laurel Bank Nursing Home DS0000001062.V292171.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? The results of the quality assurance survey have been published in the homes newsletter. This tells people what residents thought was good about the home Laurel Bank Nursing Home DS0000001062.V292171.R01.S.doc Version 5.2 Page 7 and what they thought could be improved. It also gives residents information about what the home is going to do to improve the service to them. 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 DS0000001062.V292171.R01.S.doc Version 5.2 Page 8 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 Outcomes Statutory Requirements Identified During the Inspection Laurel Bank Nursing Home DS0000001062.V292171.R01.S.doc Version 5.2 Page 9 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 the following standard(s): 1, 2 3 & 5 (Standard 6 does not apply) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. 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 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. A social worker said that she has a copy of the service users guide Laurel Bank Nursing Home DS0000001062.V292171.R01.S.doc Version 5.2 Page 10 which, she shows to prospective residents before they go to the home. One resident said that they had been to look around the home before they decided to move in. Five residents said that they had received enough information about the home before they decided to go and live there. The nurses assess any prospective residents prior to admission. The assessments for the three most recently admitted residents were seen. These were well completed and residents needs had been identified. Residents are issued with a contract/terms and conditions of residence document when they move into the home. Copies of these documents were available and were seen. Four residents confirmed that they had received a contract. The home does not provide intermediate care. Laurel Bank Nursing Home DS0000001062.V292171.R01.S.doc Version 5.2 Page 11 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 the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. There is a good care planning system in place that gives staff the information they require to meet residents individual needs. The health care needs of residents are well met with good multidisciplinary working taking place on a regular basis. The medication system is well managed and residents get their medication at the prescribed times. Personal support in this home is given in a way that promotes and protects residents privacy and dignity. EVIDENCE: Four 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 residents needs are met. There was some evidence of residents and relatives being involved in developing and Laurel Bank Nursing Home DS0000001062.V292171.R01.S.doc Version 5.2 Page 12 reviewing their care plans. For example one resident does not want assistance with personal care, her wishes have been documented, and staff respect her right to refuse assistance. Staff are vigilant and new care plans are developed as resident’s needs change. Staff are also identifying any potential risks to residents and making sure that the necessary risk assessments are in place. For example one resident is at risk if they leave the building unaccompanied, this has been addressed through the risk assessment process. Some care plans contained social care plans but some did not. This is any area that needs to develop, to make sure that residents are offered suitable and stimulating activities that interest them. Care plans are being reviewed monthly and brief monthly summaries completed that give an overview of how each resident has been for that month. The monthly summaries give staff an ideal opportunity to talk to residents about their care and support and involve them in the care planning process. This is an area that should be pursued. A reviewing officer for the health authority said that the manager is always well prepared for formal reviews and knows the residents well. Residents health care needs are being identified and met. Staff are vigilant and health care professionals are being involved as necessary. There was clear evidence of GP’s, speech and language therapist, community psychiatric nurses, dieticians, dentists, opticians etc., being involved in the ongoing care of individual residents. Two residents confirmed that they receive the care and medical support they need. One relative said that “we are constantly kept up to date about our relatives condition.” The medication system is well managed. Residents get their medication at the prescribed times and the records are well maintained. Residents looked smart and well cared for. All residents spoke well of staff and they all felt they were kind and caring. This view was also shared by two relatives. One resident said “Staff will do anything you ask” and another said “staff are very helpful”. From observation staff carried out any personal care in a discreet and respectful way. The home take residents for respite stays. One of the Care Co-ordinators from Calderdale said that she has placed a number of residents at the home, and all of them have enjoyed their stay and some have not wanted to return home. Laurel Bank Nursing Home DS0000001062.V292171.R01.S.doc Version 5.2 Page 13 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 the following standard(s): 12, 13, 14 7 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users preferences’ in relation to the routines of daily living are respected. Relatives and friends feel welcome to visit at any time. The meals at the home are good and residents are 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. One of the domestic staff said that residents get up when they want and said they never go into one residents room until after 10am, because he doesn’t get up until then. Care staff organise some activities in the afternoons, and outside entertainers are booked regularly. Residents enjoyed the singer that performed in the home during the inspection visit. Residents also said that they liked the exercise class that takes place on a Saturday. There is a notice board in one of the lounges that gives details of the activities on offer. Staff confirmed that the afternoons are the times that they can sit and talk to service users. The home need to Laurel Bank Nursing Home DS0000001062.V292171.R01.S.doc Version 5.2 Page 14 develop their activities programme for both group and individual activities to keep residents stimulated. 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. One resident goes out every Sunday to church, the home also has a Methodist service in the home and a visiting Catholic sister. Relatives confirmed that they can visit at any time and that they are made to feel welcome. Visits take place in the communal areas, the visitors lounge or in service users bedrooms if they want to be private. Service users stated that the food was good. The menu for the day is displayed in one of the lounges. The current 2 weekly menu is also on the notice board. There is a choice available for every meal. Service users have their meals in a number of different rooms. The delivery of meals at lunchtime has improved. From observation staff were available to supervise and assist residents in the lounge and dining areas. One of the cooks has recently revised the menus. She has talked to residents and asked them about the meals they would like. As a result prawns and salmon have been included in the summer menus. There were jugs of juice in each of the lounges and residents were offered extra drinks throughout the day. Laurel Bank Nursing Home DS0000001062.V292171.R01.S.doc Version 5.2 Page 15 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 the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home has a satisfactory complaints system and complaints that have been made have been resolved. Staff have a good understanding of adult protection issues which protect service users from abuse. EVIDENCE: The complaints procedure is well publicised. It is in the service user guide and on display in the home. 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 said that if they had any concerns that they would feel able to raise these with the registered manager and that they felt any problems would be sorted out. 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 DS0000001062.V292171.R01.S.doc Version 5.2 Page 16 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 the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents live in a clean, safe, comfortable, well maintained home. EVIDENCE: Laurel Bank is situated in Holmfield, Halifax. It is a large property, which is set in its own extensive, well kept grounds. There is car parking to the front of the building. There is seating available outside which service users enjoy using in fine weather. A lawned area has been created at the side of the home, which has a water feature and bird table. This is a very pleasant area that service users can use. There are some local shops and two public houses within walking distance. The fire authority and environmental health have both carried out inspections of the home this year. The owner confirmed that the work that both these agencies required has been completed. Laurel Bank Nursing Home DS0000001062.V292171.R01.S.doc Version 5.2 Page 17 There is a redecoration and refurbishment programme in place. Recently two bedrooms have been redecorated and a new hall and stair carpet fitted in the front entrance. The owners are also gradually replacing beds in the home with specialist ‘profiling beds’ that will meet the long term needs of residents who need nursing care. The home currently has fifteen of these beds. The home was clean and tidy on the day of the inspection. Four residents and a relative said that the home is always fresh and clean. There are infection control procedures in place. There have been no infection control issues at the home since the last inspection. The laundry is well equipped, clean and tidy. The required ‘non return’ valves are in place on the washing machines. Laurel Bank Nursing Home DS0000001062.V292171.R01.S.doc Version 5.2 Page 18 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Staff morale 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: The duty rotas were examined. These show that during the day there is one nurse on duty with six care assistants in the mornings and one nurse and three care assistants on duty in the evenings. At night there is one nurse and two care assistants on duty. There is cook, domestic and kitchen assistant cover during the day. The laundry assistant works seven mornings per week. Staff said that at the current time the numbers of staff on duty were adequate to meet residents needs. The manager is aware that she needs to keep the staffing levels under review as residents needs change and the number of residents in the home increase. All staff spoken to felt that they were working well as a team and that they enjoyed coming to work. New members of staff said that they had been made to feel welcome and were enjoying working at the home. Although agency Laurel Bank Nursing Home DS0000001062.V292171.R01.S.doc Version 5.2 Page 19 staff have been used to cover some shifts, these tend to be staff who are familiar with the home. There are 52 of the care staff qualified to NVQ level 2 or 3. All staff have recently completed moving and handling training. Some staff are in the process of completing dementia care 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 DS0000001062.V292171.R01.S.doc Version 5.2 Page 20 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is well managed and run in the best interests of residents. Practices in the home promote the health, safety and welfare of the residents. EVIDENCE: The registered manager is a registered nurse and has completed her NVQ level 4 training. She is well liked by residents. One resident said “Matron is great, she makes sure you get what you want.” Residents are consulted about the running of the home the annual quality assurance questionnaires. The results of the last survey were included in the Laurel Bank Nursing Home DS0000001062.V292171.R01.S.doc Version 5.2 Page 21 homes newsletter in March 2006. The issues residents highlighted that they felt the home could do better, have been addressed. For example, meals are now being served more quickly. The registered manager is also trying to set up a ‘Friends of Laurel Bank’ group that will meet and give feedback to the home about care issues etc. The first meeting is scheduled to take place on 17 July 2006. This will provide a way for the home to get views from relatives and friends on the service. The manager does hold money on behalf of residents. The records examined were well maintained and accurate. The service users guide gives information about residents accessing the records that are held in the home. There is a policy in place regarding service users seeing the records that are held on them. Records at the home were readily available and well maintained. There is a written Health and Safety policy. Staff receive moving and handling, food hygiene, fire safety, first aid and infection control training. The fire alarms are tested weekly and fire drills/practices are held. The passenger lift and moving and handling equipment service records were all seen and were up to date. Risk assessments regarding safe working practices for staff need to be completed and implemented. Laurel Bank Nursing Home DS0000001062.V292171.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 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 3 X 3 X 3 X X 3 Laurel Bank Nursing Home DS0000001062.V292171.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 2 Standard OP7 OP8 Regulation 15 16 Requirement Residents must be involved in the development and monthly reviews of their care plans. Residents must be consulted about activities they would like to participate in. The home then needs to look at how they will meet residents individual needs and add this information to their care plans. Timescale for action 31/08/06 31/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Laurel Bank Nursing Home DS0000001062.V292171.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Brighouse Area Office 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 DS0000001062.V292171.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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