Random inspection report
Care homes for older people
Name: Address: Laurel Court Laurel Court Brockway Nailsea North Somerset BS48 1BZ three star excellent service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Sue Fuller Date: 1 0 1 1 2 0 0 9 Information about the care home
Name of care home: Address: Laurel Court Laurel Court Brockway Nailsea North Somerset BS48 1BZ 01275859556 01275859557 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Southern Cross Healthcare (Kent) Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 62 Number of places (if applicable): Under 65 Over 65 62 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is 62 The registered person may provide the following category of service only: Care home with nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Laurel Court provides nursing care for up to 31 residents, and personal care for a further 31 residents. The home was purpose built and is owned by the Southern Cross
Care Homes for Older People Page 2 of 8 Brief description of the care home Healthcare group. It is situated in a suburban position, close to shops and leisure facilities. The home is fully wheelchair accessible. All accommodation is in single rooms with en suite facilities. The accommodation is arranged over two floors. Residents who require nursing care are accommodated on the ground floor; those requiring personal care are accommodated on the first floor. Communal space on the ground floor is provided in a large dining room, with adjoining seating area, and two separate lounges. On the first floor there is a similar dining room, separate sitting room, and small lounge. In addition there is a small private dining room. A passenger lift provides easy access to all areas of the home. There is a pleasant enclosed garden to the rear of the building. An activities co-ordinator arranges a weekly programme of social events. The provider makes information available through a company leaflet and service specific booklet about the home. CSCI reports, Statement of Purpose and Service User guide are displayed in the entrance to the home and available for all to read. The current fees charged range form #586 - #695 per week with additional charges being made for hairdressing, chiropody, newspapers, and toiletries. This information was provided in December 2007. Care Homes for Older People Page 3 of 8 What we found:
Some people on one unit look after their own inhalers and eye drops but staff look after and give all the other medicines. There is a self-administration policy, including a risk assessment, available for staff to make sure that people are safe looking after their own medicines. Staff need to ensure that this policy is followed. We (the Care Quality Commission) saw some morning medicines being given in both nursing and non-nursing units. Medicines were given safely and records completed as the medicines were given. We saw people being asked if they needed medicines for pain relief, which had been prescribed to be given when required. People living in Laurel Court are registered with one of two local doctors practices. medicines are supplied by the pharmacy using a monthly blister pack system. The pharmacy also provides monthly medicines administration record sheets for staff to complete when medicines are given. Copies of the homes medicine policy are available on each unit to provide information for staff. We saw that some medicines had been prescribed without clear dosage instructions for example one medicine was labelled One as directed, when necessary and another One or Two as directed. This means that staff do not have clear information to allow them to always give these medicines correctly. Staff told us that they knew how the medicines should be given and had asked the doctors to provide clear dosage instruction on the prescription. The pharmacy provides printed medicines administration record sheets for staff to complete each month. Any handwritten additions made by staff had been signed and dated and checked by a second member of staff. This is good practice to reduce the risk of mistakes being made. We saw three peoples records which included a medicine that needs to be regularly monitored, each person had written confirmation of the the current dose to be taken. This is good practice to make sure that the correct dose is given. Record sheets showed that medicines had been given as prescribed. Blister packs showed that medicines had been given as recorded. Systems are in place that would allow staff to check that medicines supplied in bottles and boxes have been given as recorded. Records are kept of the receipt of medicines into the home. Suitable records are also kept of the disposal of unwanted medicines. Staff told us that the doctors review peoples medicines every six months. We looked at two peoples care files, one person had their medicines reviewed in January 2009 but a care plan for a particular condition had not been reviewed to include the use of a recent prescription for emergency treatment. There was no information about what medicines they had been taking when they moved to Laurel Court. Another persons record showed that a medicine had been reviewed in November 2006 and the dose was reduced but there was no record of any medicine review since then. Secure storage is available for medicines on each floor. Medicine trolleys are used to transport medicines safely around the home. Each floor has a medicine fridge and temperature records showed that these are safe for storing medicines. Suitable storage is
Care Homes for Older People Page 4 of 8 available for controlled drugs, which need more secure storage. Staff carry out regular checks of these medicines. We saw two discrepancies in the records for one unit, where transfer of medicines had not been recorded. Care is needed to make sure that the records in the controlled drugs register are always complete. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 5 of 8 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 30 18.1 (c) The registered person must 21/02/2008 ensure that staff receive training appropriate to the work they are to perform and evidence that this is provided through records. The registered person must ensure that all staff receive fire training (6 monthly for day staff and 3 monthly for night staff) to ensure they have the skills and knowledge to protect residents in the event of a fire 28/02/2008 2 38 23.4(d) Care Homes for Older People Page 6 of 8 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 9 It is recommended that further action be taken to ensure that medicines have full dosage instructions so that they are given appropriately. It is recommended that records be made of peoples medicine reviews to make sure these are done at suitable intervals. 2 9 Care Homes for Older People Page 7 of 8 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 8 of 8 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
