Inspection on 02/09/05 for Laurels Nursing Home The

This inspection was carried out on 2nd September 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.

Other inspections for this house

Laurels Nursing Home The 01/05/07

Laurels Nursing Home The 23/02/06

Laurels Nursing Home The 15/03/05

Laurels Nursing Home The 03/09/04

Laurels Nursing Home The 03/02/04

Similar services:

Snydale Care Home

Abbey The

Hawkhills

Larchfield Manor

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 THE LAURELS NURSING HOME High Street Norton Doncaster DN6 9EU Lead Inspector Stephanie Kenning Unannounced 02 September 2005 09:30 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. THE LAURELS NURSING HOME 20050902 The Laurels X00015 UN Stage 4 S15864 V215494 J55.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Laurels Nursing Home Address High Street Norton Doncaster South Yorkshire DN6 9EU 01302 709691 01302 708409 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Kenneth Swales Ms Julie Riley Care Home with Nursing 20 Category(ies) of OP Old Age: 20 registration, with number PD(E) Physical Disability over 65: 20 of places THE LAURELS NURSING HOME 20050902 The Laurels X00015 UN Stage 4 S15864 V215494 J55.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 15 March 2005 Brief Description of the Service: The Laurels nursing home is situated in the village of Norton near Doncaster. It is attached to the Laurels residential home that is also owned by the Swales family. It is registered for up to 20 older people who need nursing care and therefore has qualified nurses on duty 24 hours a day. The recent extension and alterations has created all single bedrooms with en-suite toilets and washbasins. A shower room is the only part of the alterations still to be completed, with just the fittings to be installed. Many of the rooms are larger and some have patio doors giving access to the grounds. The service user accommodation is all on the ground floor with access to the gardens that are shared with the adjacent home. The main kitchen and laundry are located in the adjacent home. There is a large car park and additional parking near to the main entrance, which is accessible for wheelchairs via a ramp. THE LAURELS NURSING HOME 20050902 The Laurels X00015 UN Stage 4 S15864 V215494 J55.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection started at 9.30 am and finished about 5pm, and included inspecting both of the care homes on the site. A tour of the building was undertaken to assess the progress of the alterations. Documentation was seen including care plans, Staff rotas, and service user admission and discharges information. The inspector spoke with 7 service users in the main lounge and 2 others in their rooms, and 5 service users returned comment cards stating their view of the home. In addition 2 relatives were spoken with and a further 9 returned comment cards. Discussions were held with staff and with the manager and owners of the home, and a lunchtime meal was sampled. What the service does well: What has improved since the last inspection? The extension and alterations are almost complete, with all rooms now single and en-suite facilities provided. Many of the rooms have patio doors on to the grounds and are larger than before. Some redecoration of corridors and other communal areas has improved the appearance. Staff are consulting with service users more to ensure that they follow the routines of their choice. There has been good retention of staff and an increase in the register of relief staff. Several staff have obtained National Vocational Qualifications, including the manager achieving level 4 in management. Some reorganisation of medicine storage and procedures linked to the supplying pharmacy are improved. THE LAURELS NURSING HOME 20050902 The Laurels X00015 UN Stage 4 S15864 V215494 J55.doc Version 1.40 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. THE LAURELS NURSING HOME 20050902 The Laurels X00015 UN Stage 4 S15864 V215494 J55.doc Version 1.40 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 THE LAURELS NURSING HOME 20050902 The Laurels X00015 UN Stage 4 S15864 V215494 J55.doc Version 1.40 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) 3, 4, 5 Prospective service users and their relatives are able to make a choice about the home based on visits to the home, and an assessment that can determine if the home can meet their needs. EVIDENCE: Service users and relatives stated that they had been made very welcome at the home, staff had listened to their requests, and that their needs were being met. There were many positive comments, such as the staff are wonderful, they always try an alternative if I don’t like something, and I’m really pleased with my room, it is larger, has a nicer outlook and has an en-suite. Assessments were seen on file in service users files including assessments undertaken prior to admission that were used to determine if someone was suitable. They cover all the required areas of the standard, and give prospective service users an opportunity to state any particular needs, that may affect the decision. THE LAURELS NURSING HOME 20050902 The Laurels X00015 UN Stage 4 S15864 V215494 J55.doc Version 1.40 Page 9 All the people who commented stated that they liked living at the Laurels, that they felt well cared for and that the staff treated them well, indicating that their needs were being met. All service users had visited the home prior to admission or had asked a relative to visit on their behalf, and had been able to stay for a trail period before making their decision. THE LAURELS NURSING HOME 20050902 The Laurels X00015 UN Stage 4 S15864 V215494 J55.doc Version 1.40 Page 10 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, and 11. The health and personal care needs were well documented, and showed that attention to detail was carried out. Medicine procedures have been improved to meet previous recommendations. All service users that commented said that staff treated them with respect and upheld their privacy. EVIDENCE: A selection of service users care plans were read, and case tracked with those individuals to ensure that the care stated was being carried out as recorded. The care plans were informative and had all the different assessments and plans in place to enable staff to carry out their jobs. The plans had all been reviewed monthly and had been changed when a change of circumstance had occurred, showing that staff were quickly identifying health needs and attending to them. The recording system had charts for staff to complete as they carry out personal care and activities each day with individuals, and some of these had significant gaps that did not show the accurate care given, and could result in confusion about whether something had been done. The medication room and storage has been reorganised to separate internal and external medications, and is now labelled to help staff to put things in the THE LAURELS NURSING HOME 20050902 The Laurels X00015 UN Stage 4 S15864 V215494 J55.doc Version 1.40 Page 11 correct and safe place. There have been some changes to the procedures between the home and the supplying pharmacist that have improved the communication and therefore the safety for service users. The medicine trolley does not have a securing bracket for attaching it to the wall of the new medicine room, and this should be done for safety. Service users that commented about the home all said that staff treated them well and their privacy respected. There was clear and respectful communication between staff and service users, for example, at mealtimes, and appropriate assistance was given. All personal care was carried out in service users rooms ensuring their privacy. Staff were able to describe how they care for people that are very ill in a sensitive and respectful manner, illustrating the comfort they give to those service users and their families, including those that die at the home. THE LAURELS NURSING HOME 20050902 The Laurels X00015 UN Stage 4 S15864 V215494 J55.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 There is good contact with the local community and a range of activities and outings have been provided. The meals are of a good standard, with choices and alternatives provided. Service users do get to exercise choice and control over their daily lives. EVIDENCE: A number of activities are provided, such as, communion and church services both monthly, craft and bingo each week, coffee mornings with fundraising, and a number of outings have taken place over the summer. Some service users chose not to join in these activities, and two people commented that they did not find the activities suitable for themselves, which could be explored further to try to address their particular needs. Interests are recorded on the assessments and care plans. Relatives felt welcome at the home, and there is a quiet sitting room that can be used if a service user wishes to see someone in private without going to their bedroom. There is regular support from the local community at THE LAURELS NURSING HOME 20050902 The Laurels X00015 UN Stage 4 S15864 V215494 J55.doc Version 1.40 Page 13 fundraising events and also at the weekly coffee mornings when service users spend time talking to the visitors and catching up on local news. Service users have been able to personalise their rooms with their own belongings, including some items of furniture. They have choices about how they spend their day, including meal choices, and alternatives were provided when the main choices were not acceptable. The meals were presented attractively, at nicely set tables and were hot, well cooked and of good quality. Staff assisted some service users appropriately and discreetly, showing sensitivity to their needs. THE LAURELS NURSING HOME 20050902 The Laurels X00015 UN Stage 4 S15864 V215494 J55.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18 Service users are listened to and the home management take complaints and suggestions seriously. The care staff were aware of the policy regarding abuse. EVIDENCE: Service users stated that they are able to discuss concerns or suggestions with the manager, the owners or care staff, and felt that they were listened to. Complaints are few, but dealt with appropriately, and recorded as required. Training has raised care staff awareness of the signs of abuse and how to deal with suspicions in order to protect the service user. THE LAURELS NURSING HOME 20050902 The Laurels X00015 UN Stage 4 S15864 V215494 J55.doc Version 1.40 Page 15 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, 20, 21, 23, 24, 25, 26. The home is clean, well presented and comfortable, with good bedrooms, ensuite facilities and pleasant communal areas. EVIDENCE: The building was well maintained, and there were no obvious hazards to service user safety. Access around the home is good due to all the facilities being on the ground floor. The communal areas are comfortable and offer sufficient space for the number of people that use them. Redecoration of some of the communal areas including corridors has taken place since the previous inspection, giving a fresh look to those areas. All rooms have en-suite toilets and wash- hand basins that were appreciated by the current service users. In addition to the two existing bathrooms, a shower room is to be located on the new corridor, though this is not yet complete. Many of the service user rooms are larger than before the alterations and some have patio doors leading to the grounds of the home. Service users liked their rooms, and many were personalised with possessions brought from their THE LAURELS NURSING HOME 20050902 The Laurels X00015 UN Stage 4 S15864 V215494 J55.doc Version 1.40 Page 16 previous homes. Each of the rooms has space for a comfortable chair and some service users were spending significant periods of time in their rooms. The home was clean and free of offensive odours throughout, and service users and relatives appreciated this. The laundry facilities are located in the adjacent care home and therefore it caters for 50 people. Occasionally some items of laundry were stated to have gone missing or have been damaged, and was raised as a concern by staff working in the home. THE LAURELS NURSING HOME 20050902 The Laurels X00015 UN Stage 4 S15864 V215494 J55.doc Version 1.40 Page 17 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 There is an experienced and stable team of staff, including a mix of carers, nurses and ancillary staff. EVIDENCE: There were 3 carers and the nurse manager on duty as well as 2 domestic staff, and this appeared sufficient for the number of service users (19), though staff did seem constantly busy. Two of the relatives commented that they did not always feel that there were sufficient staff on duty, and this should be explored. Staff retention has been good and there were some new relief staff that will help the home with absences such as sickness or holidays. A number of care staff achieved NVQs and more were due to register, with a plan to complete the training in 6 months and paid incentives for completion. The Laurels hopes to achieve 50 of staff trained to level 2 NVQ sometime next year. As the home is registered to take people with nursing needs a Registered Nurse is on duty 24 hours a day, in addition to the nurse manager, to oversee the care of service users. THE LAURELS NURSING HOME 20050902 The Laurels X00015 UN Stage 4 S15864 V215494 J55.doc Version 1.40 Page 18 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. The home is well run by the manager and the owners, who are well known by service users who feel able to raise concerns and suggestions with them. EVIDENCE: The registered manager Julie Riley is a registered nurse with many years experience including managing care homes. She has recently completed level 4 NVQ in Management and has submitted additional units to claim the Registered Managers Award. She is well liked and respected by everyone at the home, and has created an atmosphere of openness and consultation, that enables the service users and staff to feel valued. Two of the owners work at the home on a daily basis, managing the financial and administrative work and the building maintenance. There are joint meetings with the managers of the two homes on site and the owners, in which planning and decisions are made. There are also service user and relative meetings, and staff meetings where ideas are put forward and discussed. Progress has been made on all THE LAURELS NURSING HOME 20050902 The Laurels X00015 UN Stage 4 S15864 V215494 J55.doc Version 1.40 Page 19 requirements and recommendations made by previous CSCI inspections. Two relatives did not know how to access a copy of the previous inspection report and should be enabled to do so. THE LAURELS NURSING HOME 20050902 The Laurels X00015 UN Stage 4 S15864 V215494 J55.doc Version 1.40 Page 20 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 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 x 4 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 x 3 4 3 3 x x x x x THE LAURELS NURSING HOME 20050902 The Laurels X00015 UN Stage 4 S15864 V215494 J55.doc Version 1.40 Page 21 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 21 Regulation 23 Timescale for action The number of bathrooms should 31/12/05 be increased to meet the standard during the current variation to registration. This requirement is outstanding from previous inspections and timescales. Secure the medicine trolley to 15/11/05 the wall of the new storage room. Requirement 2. 9 13 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. 5. Refer to Standard 7 12 26 27 33 Good Practice Recommendations Encourage care staff to complete the charts to reflect the care they have given. Explore the wishes of all service users regarding activities. Consult staff regarding the laundry service. Consult with relatives regarding staffing levels. Consider how to promote the accessibility of inspection reports for relatives. THE LAURELS NURSING HOME 20050902 The Laurels X00015 UN Stage 4 S15864 V215494 J55.doc Version 1.40 Page 22 Commission for Social Care Inspection First Floor, Barclay Court Heavens Walk Doncaster DN4 5HZ 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 THE LAURELS NURSING HOME 20050902 The Laurels X00015 UN Stage 4 S15864 V215494 J55.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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