Inspection on 27/01/06 for Laurels Retirement Home

This inspection was carried out on 27th January 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 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 Retirement Home 27/08/09

Laurels Retirement Home 22/08/07

Laurels Retirement Home 24/10/06

Laurels Retirement Home 02/08/05

Laurels Retirement Home 14/03/05

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Laurels Retirement Home 195 Barrack Road Christchurch Dorset BH23 2AR Lead Inspector Martin Bayne Unannounced Inspection 11:30 27 January 2006 th 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 DS0000061915.V281328.R01.S.doc Version 5.1 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. DS0000061915.V281328.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Laurels Retirement Home Address 195 Barrack Road Christchurch Dorset BH23 2AR 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) 01202 470179 01202 485200 info@laurels.uk.net Mr Richard Kitchen Mrs Elizabeth Kitchen Mrs Tarina Ruth Price Care Home 20 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (20) of places DS0000061915.V281328.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users should only be admitted to the home who have low to medium dependency needs i.e. have mild to moderate dementia and intermittently need interventions that require reassessment, there is some likelihood of specialist referral. Physical or mental health is sometimes fluctuating, erratic or unstable, sometimes requiring intensive or unpredictable interventions. Service users must not be admitted to the home who present aggressive, violent or wandering behaviour. 2nd August 2005 Date of last inspection Brief Description of the Service: Laurels Retirement Home is a residential care home registered for twenty places under the category of OP (Old Age) and DE(E). It is an older style property, with a more recent extension, situated on one of the main roads into Christchurch town centre. Mr and Mrs Kitchen took over as proprietors of the home in September 2004. Mrs Price who was formally employed as Head of Care by the previous owners became the registered manager in June 2005 and has worked in the home for many years. The majority of rooms are single with two of these being en-suite and one of the four double rooms is also en-suite. The home has a lounge and a dining room, which also has a small seating area that looks out onto the patio. There are stair lifts to the upper floors. To the rear of the property is a secure, private patio area with seating where service users can entertain visitors. DS0000061915.V281328.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place between 11:30am and 3:00pm, with the aim of evaluating the home against core standards and also to follow-up on the requirements and recommendations made at the previous inspection. During the inspection seven service users were spoken with and one member of staff. The registered manager, Mrs Price assisted with the inspection. Prior to the inspection comments cards had been sent to service users, their relatives, GPs and other health and social services staff. Information from the returned cards was also used to form judgements on the standard of service provided at the home. What the service does well: What has improved since the last inspection? The three recommendations resulting from the CSCI pharmacy inspection have been taken on by the home, an updating of the medication policy, recording of allergies on the medication administration records and obtaining a medication cabinet that complies with current regulations. The home has also fitted a lock to the fridge used to store medications requiring refrigeration as required at the pharmacy inspection. The home is having the car parks and front paths block paved. Since the last inspection the home has had a Parker bath installed. The testing of the fire safety system has been carried out as required and records kept up to date of these tests. Since the last inspection the chef has made available a choice of meal for the main meal of the day. The residents spoken with said that they now had no complaints about the food provided in the home. DS0000061915.V281328.R01.S.doc Version 5.1 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. DS0000061915.V281328.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection DS0000061915.V281328.R01.S.doc Version 5.1 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 the following standard(s): 3 Service users benefit from a full assessment of need being undertaken before they are offered a place at the home. EVIDENCE: The personal file for one resident was viewed and used to track the required paperwork that the home must maintain in respect of people living at the home. It was found that the manager, prior to the person being offered a place at the home, carried out a full assessment of need as well as obtaining the care management assessment. The home does not provide an intermediate care service. DS0000061915.V281328.R01.S.doc Version 5.1 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 the following standard(s): 7 9 10 Service users benefit from care plans being in place to inform the staff of the agreed care needs. The home has appropriate policies and procedures for the storing and administration of medicines in the home. Service users are treated with respect and their dignity maintained. EVIDENCE: The care plan and related documentation was seen for the resident tracked through the inspection. The home was found to have full, in depth care plans and also a summary version, which inform a new staff members, or in the event of having to use agency staff, of the care needs of residents. Reviews of care plans are were found to be taking place through entries in the daily record. It was agreed that the care plans would be initialled and dated to better reflect that the care plans were up to date. This will be followed up at the next inspection. The personal files were also found to contain all of the other required information such as a photograph of the resident, key contacts, general risk assessments, moving and handling risk assessments and a history of any falls. At the last inspection three recommendations and one requirement were made in respect of medication issues as a result of a CSCI pharmacy inspection. It DS0000061915.V281328.R01.S.doc Version 5.1 Page 10 was found that all three recommendations had been addressed; updating the home’s medication policy, providing details on the medication administration records of any known allergies of residents and providing a medication cabinet that complies with the Misuse of Drugs (Safe Custody) Regulations 1973. The requirement was also found to have been met with the fitting of a lock to the fridge for the storage of medications that require refrigeration. The medication administration records were viewed and these were found to have been completed correctly with no gaps in the records. The home uses a unit dosage system that is supplied by a local pharmacist and these are delivered to the home. It was agreed that the office would be kept locked when the bags are being stored waiting for collection or having just been delivered to the home and waiting to be stored in the medication cabinet. This would provide better security for medication storage. During the inspection the inspector was able to speak with seven of the residents accommodated at the time of inspection. All of those spoken with said that the staff team were very kind, courteous and respectful of their dignity and privacy. Residents are able to have a key to the lock on their bedroom door should they choose to make their bedrooms more private. DS0000061915.V281328.R01.S.doc Version 5.1 Page 11 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 15 Service users enjoy a lifestyle in the home that meets their expectations and are provided with a wholesome balanced diet. EVIDENCE: The residents spoken with said that their lifestyle expectations were met at the home. A Holy Communion service is held in the home each month and the registered manager informed that should there be any other denominational or religious needs, the home would ensure that these would be met. The residents reported that in terms of stimulation and recreation the home provided a satisfactory level of service. The registered manager informed how the needs of some individuals had been met and also on the group activities arranged in the home. An “Extend” exercise group is held in the home each fortnight and soon to be held each week. In addition two different outside entertainers regularly visit the home, a craft group is held each week and the staff also undertake activities with the residents in the afternoons. At the last inspection a requirement was made that the home must be able to demonstrate that food served to residents is varied and properly prepared. Since the last inspection, in order to meet this requirement the home has added a choice of meal for the main midday meal. The seven residents spoken with informed that they food was in general to their liking and that should they not like what is provided and alternative can be offered. The home currently DS0000061915.V281328.R01.S.doc Version 5.1 Page 12 provides specialist diets for two diabetic residents and one who requires a gluten free diet. Residents are able to have their meals within their rooms if this is their choice. DS0000061915.V281328.R01.S.doc Version 5.1 Page 13 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): 18 Service users benefit from a full complaints procedure that is well-publicised and adult protection policies and procedures that underpin protection of vulnerable adults. EVIDENCE: Since the time of the last inspection there have been no complaints made to the manager and none have been brought to the attention of CSCI. The home maintains a complaints log and the residents are informed through the Service User Guide and resident’s contract of the complaints procedure. The home was found to have a copy of the local “No Secrets” document and also has its own policies and procedures that link into this main procedure. The home has policies and procedures on confidentiality, abuse and how to report on suspected incidents and whistle blowing. It was reported that all of the staff have received training in adult protection through internal training and also from an outside trainer as part of the dementia training undertaken by all of the staff. DS0000061915.V281328.R01.S.doc Version 5.1 Page 14 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 The home provides a safe, well-maintained environment for the residents. The home is clean and complies with infection control measures. EVIDENCE: As part of the inspection a tour of the building was made during which time a number of bedrooms were seen. The home was found to be warm and clean with evidence that residents are able to bring their own furniture to personalise their rooms. The doors leading out of the home are currently alarmed to inform the staff should a person leave the building. This arrangement was put in place as the home accommodates some people who at risk of getting lost should they leave the building. The possibility of the front door being locked was discussed and it was agreed that should the manager feel that this be a better arrangement for protecting residents, a risk assessment should be carried out and the results discussed with CSCI. At the last inspection it was reported that a Parker bath was to be installed in one of the bathrooms and it was found at this inspection that this had now DS0000061915.V281328.R01.S.doc Version 5.1 Page 15 been carried out providing more suitable bathing facilities. A new electric hoist is also to be fitted to another bath. The manager informed that there were plans to have the access to the WC on the first floor improved and the kitchen is to be refurbished later in the year. These improvements will be followed up at the next inspection. At the time of the inspection work was being carried out on paving the car parking area to the front of the building. The home has an enclosed garden for the use of the residents. The home was found to have taken appropriate steps in maintaining infection control. In the hallway is a gel disinfector dispenser that people entering the home are encouraged to use. The home has a sluice room and there were procedures in place for the staff on how to use this facility. Protective clothing is supplied to staff in carrying out their duties and all of the staff receive infection control training. DS0000061915.V281328.R01.S.doc Version 5.1 Page 16 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 30 The safety and well-being of residents could be seriously undermined through employment of staff without a Criminal Record Bureau check. Staff are trained to meet the needs of the service users. EVIDENCE: At the last inspection a requirement was made concerning Criminal Record Bureau (CRB) checks as it was found that there was a member of staff who had started working at the home before a satisfactory CRB had been returned. It was found at this inspection that this member of staff was still awaiting the return of their CRB as this had been lost by the umbrella organisation that had undertaken the check. It was also found that a further three members of staff were also working without a returned CRB. The serious ramifications for the home in breaching this regulation were discussed and the requirement remains in force. It was found that other recruitment checks had been carried out as required. All staff who work at the home receive induction training and are trained in core subjects such as, first aid, food hygiene, infection control, manual handling, health and safety and administration of medication. All of the staff have also received training in care of people with dementia using person centred care approach. DS0000061915.V281328.R01.S.doc Version 5.1 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 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): 35 38 Service user’s financial interests are safeguarded and health and safety of service users is promoted and protected. EVIDENCE: The registered manager said that one of the owners, Mr & Mrs Kitchen visited the home at least once a week, however no report required under Regulation 26 has been written since July 2005. A requirement that a report of these visits be written and a copy sent to CSCI was made. The registered manager informed that the home is not appointee for any residents and that only small sums of money are held on behalf of some residents. The record keeping system for these were viewed and there was evidence that good records were being held with receipts kept and a balance of money held. DS0000061915.V281328.R01.S.doc Version 5.1 Page 18 At the last inspection two requirements were made in respect of the fire safety systems. At that time there was no evidence that fire drills were being carried out to the required timescale and there were breaks in the records for the testing of the fire safety system. The fire logbook was inspected and it was found that test and inspections and fire drills were being carried out as required. DS0000061915.V281328.R01.S.doc Version 5.1 Page 19 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X 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 X 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 3 DS0000061915.V281328.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes 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. Standard Regulation Requirement Care staff must not be employed until an enhanced CRB check is obtained. As a minimum a POVA first check must be sought if a staff member needs to be appointed for operational reasons. This is a repeat requirement from 02/08/05 The registered provider must carry out an unannounced visit to the home and prepare a written report on the conduct of the home. Timescale for action 1. OP29 19 Schedule 2 27/01/06 2. OP31OP29 26 20/02/06 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 DS0000061915.V281328.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 DS0000061915.V281328.R01.S.doc Version 5.1 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. 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. 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