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Inspection on 19/05/05 for Laurel Court Nursing Home

Also see our care home review for Laurel Court Nursing Home for more information

This inspection was carried out on 19th May 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Residents said that they were treated as individuals with their dignity being maintained. As one resident said "staff always knock before entering my room. A good range of activities both in and outside the home are available with a very committed activities organiser who undertakes one to one activities with those residents who are unable to take part in communal activities. Residents were positive about the range of activities available.

What has improved since the last inspection?

Carpets in a number of bedrooms and on the corridor of one floor have been replaced. Other carpets have been steam cleaned. The number of carers with NVQ level 2 has increased from 3 to 11.

What the care home could do better:

Though some carpets have been cleaned or replaced, some carpets still remain marked or dirty. More attention to cleanliness in some areas is needed. Some lounge areas require more chairs to enable residents to choose which area to sit in and also provide seating for visitors. Lockable storage space in bedrooms must be provided along with all the required furniture unless this has been agreed with the resident. The home need to ensure that they have the required information kept on all staff, and that they do not have something in their past that does not make it inappropriate for them to work in the home.

CARE HOMES FOR OLDER PEOPLE Laurel Court Nursing Home 1A Candleford Road, off Palatine Road Didsbury Manchester M20 3JH Lead Inspector Leslie Hardy Unannounced 19 May 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 Court Nursing Home F55 F05 s21556 Laurel Court V227941 D190505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Laurel Court Nursing Home Address 1A Candleford Road, off Palatine Road Didsbury Manchester M20 3JH 0161 446 2844 0161 446 2873 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) Ashbourne Homes Limited Care home with nursing (N) 86 Category(ies) of Old age, not falling within any other category registration, with number (OP) (75) of places Physical disability (PD) (11) Laurel Court Nursing Home F55 F05 s21556 Laurel Court V227941 D190505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 The maximum number of service users requiring nursing care shall be 61. 2 The service users requiring nursing care by reason of physical disability shall be accommodated on the lower ground floor. The service users requiring nursing care by reason of old age shall be accommodated on the second and third floors. 3 The maximum number of service users requiring personal care only shall be 25, accommodated on the first floor. 4 Registration is subject to compliance with the minimum nursing staffing levels indicated in the Notice of Variation of Conditions of Registration dated 8th March 2005. 5 Personal care staffing levels will remain in line with those currently in place. 6 One named service user requiring personal care is accommodated within a nursing unit. This place will revert to nursing care once this service user no longer requires this accommodation. Date of last inspection 21 October 2004 Brief Description of the Service: Laurel Court is a care home providing nursing care, personal care and accommodation for 75 older people and nursing care for 11 adult service users who require care by reason of physical disability. The first floor care is used to provide care only to older adults, and the second and third floors care with nursing to older adults. The home was opened in 1994 and is purpose built consisting of accomodation on four floors. The ground floor has been adapted to residents requiring care by reason of physical disability. The home has extensive gardens that are well maintained and readily accessible for residents. Ample car paring is available at the side and rear of the home. Each floor is served by two passenger lifts. Laurel Court is operated by Ashbourne Homes Limited, a subsidiary company of Ashbourne Consolidated Group. The home is located in a residential area of Withington, South Manchester. Local amenities are available in Withington village and the area is served by an excellent bus network into the city centre. Laurel Court Nursing Home F55 F05 s21556 Laurel Court V227941 D190505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection, which was unannounced started at 6.45 am and was carried out by two inspectors who were in the home for 7 hours. The last full inspection was carried out in October 2004 but 2 smaller inspections have been carried out since as the home were proposing to reduce the number of trained nurses on the morning shift on the second and third floors from two to one, and replace with senior carers. This has subsequently been agreed by the Commission for Social Care Inspection. At the time of this inspection this change had not taken place but was scheduled for August. The short reports on the additional Inspections are available from CSCI. The reports were generally positive. During the inspection, 22 residents, 4 visitors and 14 staff were spoken with. Overall the home was found to be delivering a good standard of care with residents being treated as individuals. What the service does well: What has improved since the last inspection? Carpets in a number of bedrooms and on the corridor of one floor have been replaced. Other carpets have been steam cleaned. The number of carers with NVQ level 2 has increased from 3 to 11. Laurel Court Nursing Home F55 F05 s21556 Laurel Court V227941 D190505 Stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Laurel Court Nursing Home F55 F05 s21556 Laurel Court V227941 D190505 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 Court Nursing Home F55 F05 s21556 Laurel Court V227941 D190505 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) No standards in this section were assessed at this inspection. At least the key standards will be assessed at the next inspection EVIDENCE: Laurel Court Nursing Home F55 F05 s21556 Laurel Court V227941 D190505 Stage 4.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) 9and 10 Medicines were handled safely by the home. Residents were treated with respect by staff. EVIDENCE: Medicines were given by a member of staff trained to give them. Good record and storage systems were in place and regular checks of stock undertaken. Staff signed for medication when it was given, or if it was omitted a reason was stated on the Medicine Recording Sheet. Residents said that all personal care was given in private and staff knocked on bedroom doors before entering. Residents were very clear that they were treated with respect and their dignity usually upheld, though one resident reported that on a couple of occasions if staff were busy it had taken some time to answer the staff call. During the inspection these were heard to be speedily answered. Residents wore their own clothes, which were laundered on the premises, and these were clean and ironed if necessary. A telephone was readily available; some residents also rented their own line using the socket provided in each room. Post was delivered to residents unopened. Laurel Court Nursing Home F55 F05 s21556 Laurel Court V227941 D190505 Stage 4.doc Version 1.30 Page 10 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) 12and15 Residents were enabled to spend their day as they wished. Food was appropriate to the residents needs. EVIDENCE: Getting up and going to bed times in the home were arranged around each resident’s wishes. Residents said that they could spend the day as they wished. Some choose to spend most of their day in their bedroom, others preferred to spend a lot of the day in the lounge with others, but as one resident said “I can go and have a lie down after lunch, the staff take me when I ask them.” There is a good programme of activities, organised by an enthusiastic activities organiser, including craft activities in the home and at external venues. Trips out to tourist attractions were organised along with more local trips to cafes and pubs. The home now offered weekly yoga sessions that were said to be extremely popular. Residents were complementary about the activities on offer. The organiser also took time with residents who did not want to take part in organised activities. There were notices in the home giving a list of activities but it was noticed that this did not mention all available activities. One resident said she would like to be able to make herself a cup of tea. The Manager should give consideration to this after an appropriate risk assessment. Laurel Court Nursing Home F55 F05 s21556 Laurel Court V227941 D190505 Stage 4.doc Version 1.30 Page 11 Resident’s views of meals varied but on the whole they were fairly positive about the food. Discussion with the manager showed that she and the catering staff were trying to respond to resident’s’ needs, with a new menu introduced that week offering a better choice, in particular, of soft options. Breakfast could be tea and toast or a cooked breakfast as preferred by the individual resident. A lighter lunch was served, consisting on the day of the inspection of vegetable soup, sausage and mash, and a sweet. Other choices including sandwiches were available. A main meal was served in the evening, but residents confirmed that if they wanted this at lunchtime this was provided. Staff encouraged and helped residents with their meals in a very positive but relaxed way encouraging adequate intake. Laurel Court Nursing Home F55 F05 s21556 Laurel Court V227941 D190505 Stage 4.doc Version 1.30 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17 and 18 Concerns raised are listened to, and staff are aware of what to do if they see adult abuse. EVIDENCE: The home had a clear complaints policy and residents were aware how to complain formally but clearly knew that they could raise concerns informally and have them dealt with. A general election had taken place two weeks before the inspection and residents who had been in the home sometimes talked about voting by post. The home had an adult protection policy and a copy of the Manchester City Council Adult Protection Procedure. Staff did have a basic knowledge of what to do if they suspected adult abuse was occurring. The manager should ensure that the Ashbourne Homes commitment to ongoing training occurs regularly. Laurel Court Nursing Home F55 F05 s21556 Laurel Court V227941 D190505 Stage 4.doc Version 1.30 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 24, 25 and 26 The home, though modern in design is showing its age in the fabric of the building and the cleanliness of some carpets, curtains and surfaces require attention. EVIDENCE: Some work had been undertaken since the requirement was made in the last inspection report about cleaning or replacing carpets. Carpets had been replaced in a number of bedrooms on the 2nd and 3rd floors along with a new corridor carpet on the second floor. Deep cleaning had taken place on other carpets but some remained stained despite this. Other items such as curtains and some lounge furniture require cleaning or replacement. The manager must undertake an audit of carpets curtains and furniture and produce a schedule for cleaning, or replacement where cleaning is unsuccessful. A number of surfaces were also found to be dirty such as in satellite kitchens. There were also generally signs of wear and tear and a programme needs to be put in place to deal with this. Laurel Court Nursing Home F55 F05 s21556 Laurel Court V227941 D190505 Stage 4.doc Version 1.30 Page 14 The lounge for which a requirement was made in the last report for it to be provided with more chairs still only had three chairs. This is said to be because it only has limited use as a smoking lounge by a very small number of people. The manager must review the number of chairs available across the home and ensure there are sufficient and that residents who send time in wheelchairs do so because this is their wish. The requirements made in the last report for all bedrooms to have lockable storage space and for all residents to have had an assessment on their ability to use keys had not been complied with. This requirement is reiterated. The home was at a comfortable temperature and one resident commented “its always lovely and warm here.” Rooms were well lit but the home should look at placing lamps in the lounge for residents that want to read. The home was generally odour free except for a residual odour in the main lounge on the 1st floor. Laurel Court Nursing Home F55 F05 s21556 Laurel Court V227941 D190505 Stage 4.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 and 29 Residents needs were found to be met. The externally verified competency level of staff has improved. However the home is not ensuring that all staff who have been there for some time are fit to be employed. EVIDENCE: Planned staffing levels in the home were found to be to at least the minimum in the recently issued staffing notice. The manager was open about that fact that the home did not have its full establishment of staff despite frequent advertisements. She had agreed with her managers to increase the hourly rate of pay to recruit new staff. This rate would also be paid to the existing workforce. The manager was covering deficiencies in staffing with agency staff to maintain appropriate levels. By 2005 the standard is for homes to have 50 of carers with at least NVQ level 2. Since the last inspection when only 3 staff had this, 8 more staff have obtained NVQ level 2. This is still some way off 50 but another group of 11 staff are to commence shortly. The home and the parent company did appear to be committed to this. A review of staff files showed that not all staff including recent starters had proof of identity, including a recent photograph, or had evidence of 2 references being obtained. This must be done for all new starters. A requirement had been made in the last inspection report for the manager to take steps to ensure that all staff had a current Criminal Records Bureau (CRB). Laurel Court Nursing Home F55 F05 s21556 Laurel Court V227941 D190505 Stage 4.doc Version 1.30 Page 16 There were still staff employed who had not had a check and the new manager stated that this would be undertaken. The requirement is reiterated. Laurel Court Nursing Home F55 F05 s21556 Laurel Court V227941 D190505 Stage 4.doc Version 1.30 Page 17 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) No standards `from this section were assessed at this inspection. EVIDENCE: Laurel Court Nursing Home F55 F05 s21556 Laurel Court V227941 D190505 Stage 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x x x x x x x x Laurel Court Nursing Home F55 F05 s21556 Laurel Court V227941 D190505 Stage 4.doc Version 1.30 Page 19 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 19 Regulation 16,23 Requirement The Manager must undertake an audit of carpets curtains and furniture and produce a schedule for cleaning or replacement where cleaning is unsuccessful. The Manage must ensure that cleanliness of all work surfaces, ward fridges, and placemats is maintainedr The Manager must undertake an audit of required setting in all lounge areas to ensure that seating is available not only for all residents who wish to use the area, but also for visitors. This must be made available to the CSCSI All bedrooms must have a lockable storage space.(Previous requirement - timescale of 01/03/05 not met. All service users must have an assessment to determine ability to manage keys. ( timescale of 01/03/05 not met). All staff files must contain the information required by Schedule 2 of the Care Homes Regulations 2001 Timescale for action 01/09/05 2. 19 16,23 01/09/05 3. 19 16,23 01/09/05 4. 19 16,23 01/09/05 5. 19 16,23 01/09/05 6. 29 19 01/09/05 Laurel Court Nursing Home F55 F05 s21556 Laurel Court V227941 D190505 Stage 4.doc Version 1.30 Page 20 7. 29 19 8. 9. 29 16,23 The manager must take steps to ensure that all staff have a current CRB check.)timescale of 31/12/04 not met). A programme must be put in place to deal with general wear and tear. 01/08/05 01/09/05 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. 3. 4. Refer to Standard 12 19 25 28 Good Practice Recommendations The manager should look at the feasability, following risk assessment,of residents making drinks if they wish. Training on adult protection, should be ongoing. The Manager should look at providing lamps in lounges for residents that want to read. The Responsible Individual, should continue to take steps to that at least 50 of carers have at least NVQ level 2. Laurel Court Nursing Home F55 F05 s21556 Laurel Court V227941 D190505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 Court Nursing Home F55 F05 s21556 Laurel Court V227941 D190505 Stage 4.doc Version 1.30 Page 22 - 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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