Inspection on 07/07/05 for Laurel Lodge Care Home

This inspection was carried out on 7th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Lodge Care Home 08/02/07

Laurel Lodge Care Home 22/11/05

Laurel Lodge Care Home 14/02/05

Laurel Lodge Care Home 15/07/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Laurel Lodge Care Home 19 Ipswich Road Norwich Norfolk NR2 2LN Lead Inspector Marilyn Fellingham Announced 7 July 2005 9.30am 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 Lodge Care Home I55 S44217 Laurel Lodge V230141 070705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Laurel Lodge Care Home Address 19 Ipswich Road Norwich Norfolk NR2 2LN 01603 502371 01603 502371 brian.jones733@ntlworld.com Mr Brian Jones Mrs Linda Jones Mr Brian Jones Care Home 20 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) Category(ies) of Old Age (20) registration, with number of places Laurel Lodge Care Home I55 S44217 Laurel Lodge V230141 070705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The home is registered to accommodate up to 20 older people whose needs are only associated with their age. Date of last inspection 14 February 2005 Brief Description of the Service: Laurel Lodge is located in a residential area close to Norwich city centre. Formerly a large period residence, the premises have been adapted and extended to provide accommodation to a maximum of 20 older people. There are 14 single and 3 double rooms, all having en suite facilities. The care home has one spacious TV lounge and a second quiet lounge. There is a conservatory that grants access to a large garden and a private car park at the front of the premises. Laurel Lodge Care Home I55 S44217 Laurel Lodge V230141 070705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took place over six and a quarter hours. Twelve comment cards were received from relatives, service users and stake holders prior to the inspection; all commented on the improvements made since the new providers had taken over the home. Many of the comments from the relatives and residents commended the care and the dedication of the staff, one relative commented that they were thankful for having found such “a dream home” for her mother. Many changes have been taking place since the last inspection, one of the Providers has also taken on the responsibility of Manager and many areas have been addressed in order for the home to comply with regulations. The Manager is very aware that there are still more changes needed to bring the home up to scratch and a number of requirements and recommendations are made. Much refurbishment has taken place and the garden was being re vamped at the time if inspection. Plans are in place for total refurbishment and the main corridor was being decorated. The Manager/Provider and his wife also a Provider were present for the inspection process. A tour of the home took place, care and staff records were inspected. Four members of staff were spoken with including the chef; the Inspector spoke with five service users and two relatives. All those residents that the Inspector spoke with could not praise the home highly enough and were most appreciative of the work that the providers had already carried out to provide a suitable home for them to live in. The staff were most courteous throughout the inspection process and were very keen to assist the Inspector in the inspection process. Laurel Lodge Care Home I55 S44217 Laurel Lodge V230141 070705 Stage 4.doc Version 1.30 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Care planning needs to be improved to ensure that the service user’s health, personal and social needs are set out in an individual plan that meets all assessed needs of individuals. Residents could be at risk of not having their health needs met if they are not recorded and care prescribed accordingly. The home could keep better records, however the Manager /Provider is aware of this. Laurel Lodge Care Home I55 S44217 Laurel Lodge V230141 070705 Stage 4.doc Version 1.30 Page 7 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 Lodge Care Home I55 S44217 Laurel Lodge V230141 070705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Laurel Lodge Care Home I55 S44217 Laurel Lodge V230141 070705 Stage 4.doc Version 1.30 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 standard(s) 1,2,4,5 Prospective service users are assessed well before admission. Each service user has their own statement of terms/contract that contains all appropriate information needed on admission to the home. Prospective service users and their relatives are given the opportunity to visit the home prior to admission and are given sufficient information about the home before their admission so that they are able to make an informed choice. Some paperwork needs attention to bring it up to date. Laurel Lodge Care Home I55 S44217 Laurel Lodge V230141 070705 Stage 4.doc Version 1.30 Page 10 EVIDENCE: The statement of purpose needs to be amended to indicate recent changes in management. The Inspector examined individual records that related to service user contracts and statement of terms and conditions. Those records contained all the appropriate information and included a description of the accommodation that was to be occupied by the individual: a brief description of the services offered terms of conditions of occupancy, fees are also included in this information. Two residents who had recently been admitted to the home confirmed that they had been given sufficient information before admission and felt confident that the home could meet their needs. The residents also confirmed that they had been issued with a statement of terms and conditions on point of entry to the home. The two recent admissions also confirmed that they had been given this information; the Inspector also noted that the latest inspection report and service users guide was available in the main foyer of the home. The two most recent admissions also told the Inspector that they had been given the opportunity to spend time in the home before making their final decision. Laurel Lodge Care Home I55 S44217 Laurel Lodge V230141 070705 Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10,11 Arrangements need to be in place to improve the care planning system and thus ensure that the health needs of residents are identified and met. The handling of medication is on the whole managed well. The service users are treated with respect. EVIDENCE: Care plans are in place and these were examined by the inspector; they were very basic and not clear in relation to the assessed needs and care required. Discussion with the staff and residents suggested that needs were being met although there was a lack a clear care planning: this approach can lead to residents not having their needs met. The inspector also noted that the care plans had no records of skin integrity assessments being carried out, this is an integral part of care planning to ensure the prevention of pressure sores and thus encouraging best practice. Laurel Lodge Care Home I55 S44217 Laurel Lodge V230141 070705 Stage 4.doc Version 1.30 Page 12 All staff that handle medication have received training to do so, a random check of the medication tallied with the MAR charts. However it was noted that medication received into the home must be audited and signed for, a requirement was made. All the residents that spoke with the Inspector mentioned that the staff were extremely caring and respectful. The Inspector witnessed this first hand and noted that the carers were very gentle and one resident mentioned that they were “very lucky with the caring staff”, another said that there was a “very good family atmosphere here”. The Inspector gained the impression that the care of the dying was handled well, a scenario was related to the Inspector by the management describing the care given to a resident over a three month period with the help of other health care professionals; records were seen for this. Laurel Lodge Care Home I55 S44217 Laurel Lodge V230141 070705 Stage 4.doc Version 1.30 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 standard(s) 12,15 Social activities and meals are managed exceptionally well, the activities are variable to meet the preferences of the individuals living in the home; the meals are creative and match the expectations of the residents. EVIDENCE: The home provides a variety of activities for the residents and the Manager/Provider has recently organised IT sessions for a few of the residents. One resident commented that “ Brian” the Provider/Manager “was always trying to promote activities, but some of the residents were reluctant to join in”. This resident also stated that they were given the opportunity to go out and that the management had “done wonders in the garden”, and they were now able to go outside far more in pleasant surroundings. Another resident said that they could not see how it could be better. A number of residents were spoken to and they all made favourable comments about the food. One resident commented that “the chef is very keen to please and is very much part of the family and he always comes into the dining room after our meals to make sure we are happy with the food”. This practice was witnessed by the Inspector; the residents also commented that they always had a choice and nothing was too much trouble for the chef and his staff. Laurel Lodge Care Home I55 S44217 Laurel Lodge V230141 070705 Stage 4.doc Version 1.30 Page 14 The Chef was aware that one resident had been to the dentist and had had a filling, he arranged for that resident to be given cool easy to eat food to prevent any complications following the filling. Laurel Lodge Care Home I55 S44217 Laurel Lodge V230141 070705 Stage 4.doc Version 1.30 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 standard(s) 16,1718 Residents are confident that their concerns would be listened to and taken seriously. Service users are protected from abuse but the training for this could be improved upon. EVIDENCE: There is in place a comprehensive complaints procedure, but no record of any complaints having been made. It is required that a record is kept in the home of all complaints made by service users and what action has been taken to address the complaint. Those residents spoken with were aware of the complaints procedure and felt that they could approach the management if they had any concerns. Training has taken place in relation to abuse using an in house video, this however could be improved upon with specialised input; new staff have yet to do this training, but the manager said that it was an on going project. The staff members that the Inspector spoke with were undertaking an abuse module in their NVQ training. CRB checks were in place for all staff and these were seen. Laurel Lodge Care Home I55 S44217 Laurel Lodge V230141 070705 Stage 4.doc Version 1.30 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 standard(s) 24,25,26 A lot of improvements to the décor have taken place. The service users live in comfortable safe surroundings that the Providers are striving to continually improve. EVIDENCE: A tour of the home took place and it was noted that extensive improvements have been taking place since the present Providers took over the home. One service user commented to the Inspector that “Brian and Linda were making lots of changes and that Brian had done wonders in the garden”. The Inspector noted that there were plenty of sitting areas in the garden for use by the service users and that walkways were in the process of being constructed to maintain safe areas for the residents. The main corridor was in the process of being redecorated at the time of inspection. The home was clean and tidy although there were major improvements taking place. Laurel Lodge Care Home I55 S44217 Laurel Lodge V230141 070705 Stage 4.doc Version 1.30 Page 17 Service Users have stated that they do not wish to have locks on their doors and documents were seen to record this for all service users who have signed disclaimers. All the service users have lockable facilities within their rooms. There are controls in place to check the water tanks on a regular basis, and the policy, for Legionella was seen. The Manager has a background in microbiology and does updating sessions with the staff regarding the control of infection. Laurel Lodge Care Home I55 S44217 Laurel Lodge V230141 070705 Stage 4.doc Version 1.30 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 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 The deployment and number of staff on all shifts is sufficient to meet the needs of the residents. The home will have succeeded in getting one hundred percent of its carers NVQ status by the end of the year. EVIDENCE: The duty rotas were examined and they indicated that the home is sufficiently staffed on every shift; the home has a policy to try not to use agency staff and certainly this appeared to be so. The home has really worked hard in ensuring that the carers are NVQ qualified and some are going on to do level three. Records were seen for this and discussion with the staff members also confirmed that they had undertaken or were undertaking NVQ training. Those staff members that were spoken to also discussed the amount of training that they had undergone and stated that they all had an induction covering the mandatory subjects; they enthused about the manual handling training that they had done and were keen to learn. Laurel Lodge Care Home I55 S44217 Laurel Lodge V230141 070705 Stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,35,36,37,38 There is clear leadership within the home now that a new manager is in post. The residents are protected by the home’s practices and policies and their safety and welfare is promoted. Laurel Lodge Care Home I55 S44217 Laurel Lodge V230141 070705 Stage 4.doc Version 1.30 Page 20 EVIDENCE: Since one of the providers has taken on the role of manager the Inspector gained the impression that the home is managed well and procedures for better health care put into place. Both the providers give clear direction to the staff and discussion with the staff confirmed this to be so; there is an open transparent atmosphere within the home and both staff and residents stated that they felt that both owners were most approachable. The Inspector was very aware of the homely happy atmosphere that existed in the home and the staff were most courteous and helpful during the inspection process. It was obvious that the quality of care provided in the home is strongly influenced by the calibre of the owners/manager. Although it was obvious after discussion with the residents that there is client satisfaction it was recommended that some form of auditing is carried out to demonstrate this; the home has already done a satisfaction survey and these results need to be recorded and how they have been acted upon. Examination of records clearly indicated that the manager ensures as far as is practicable the health and welfare of the residents; all equipment is appropriately maintained and policies and procedures in place. Risk assessments are in place and these were seen, however it is recommended that untoward incidents are audited. Laurel Lodge Care Home I55 S44217 Laurel Lodge V230141 070705 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 x 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION x x x x x 3 3 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 2 2 3 3 3 x 3 3 3 3 Laurel Lodge Care Home I55 S44217 Laurel Lodge V230141 070705 Stage 4.doc Version 1.30 Page 22 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 7 Regulation 14 Requirement The registered person shall prepare a written plan as to haw the service users needs in respect of his health and welfare are to be met and shall keep the plan under review. Timescale for action Immediate and on going 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 8 2 33 38 Good Practice Recommendations It is recommended that the registered person encourages best practice by assessing all residents for skin integrity and planning apprproprate care. The registered person updates the statement of purpose to include new manager. It is recommended that the quality systems are audiited and records maintained for this. It is recommended that all accicidents are audited and records maintained. Laurel Lodge Care Home I55 S44217 Laurel Lodge V230141 070705 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 3rd Floor, Cavell House St Crispins Road Norwich NR3 1YF 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 Lodge Care Home I55 S44217 Laurel Lodge V230141 070705 Stage 4.doc Version 1.30 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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