Inspection on 17/05/07 for Lauren Court Residential Care Home

This inspection was carried out on 17th May 2007.

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 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

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

CARE HOMES FOR OLDER PEOPLE Lauren Court Residential Care Home Shelley Road Blacon Chester Cheshire CH1 5US Lead Inspector Paul Ramsden Unannounced Inspection 17th May 2007 09:35 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 Lauren Court Residential Care Home DS0000068893.V331000.R01.S.doc Version 5.2 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. Lauren Court Residential Care Home DS0000068893.V331000.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lauren Court Residential Care Home Address Shelley Road Blacon Chester Cheshire CH1 5US 01244 374237 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) Meridian Healthcare Ltd Stacey Louise Armstrong Care Home 47 Category(ies) of Old age, not falling within any other category registration, with number (47) of places Lauren Court Residential Care Home DS0000068893.V331000.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum for 47 service users to include:*Up to 47 service users in the category of OP (Old age not falling within any other category). New service Date of last inspection Brief Description of the Service: Lauren Court is a two-storey care home; access between floors is via the shaft lift or the stairs. The home is owned by Meridian Healthcare Limited and is located in the Blacon area of Chester, close to the local shops and other community facilities. There is a garden with sitting areas available for the residents to use; this was accessible and well maintained. There are adequate car parking facilities available. Residents accommodation consists of 47 single bedrooms all of which have ensuite facilities. A variety of lounge and dining areas are provided for residents. There are an adequate number of toilets and a variety of bathrooms within the home. Lauren Court has an adequate number of toilets and a variety of bathrooms available. Aids to help independence are in evidence throughout the home; these include bath hoists, grab rails and an emergency call bell system. The current fee range for the home is £343 - £380 per week. Lauren Court Residential Care Home DS0000068893.V331000.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on the 17 May 2007 and lasted 8.5 hours. Paul Ramsden, Inspector, undertook the visit. All of the key standards for older people were looked at. This visit was just one part of the inspection. Before the visit the home manager was also asked to complete a questionnaire in order to provide up to date information about services in the home. Questionnaires were made available for residents and families to find out their views and other information received since the last key inspection was reviewed. Seven resident and three relative survey forms have been returned. During the visit various records and the premises were looked at. A number of residents, relatives and staff members were spoken with; they gave their views about the home and the service provided. Meridian Healthcare Limited took over the ownership of Lauren Court on the 1 December 2006; it was originally registered in May 2006. The registered manager is currently on maternity leave and another manager has been seconded from one of the company’s other homes to manage the home on a temporary basis. She is very experienced and was able to demonstrate her ability to run the home. What the service does well: The staff members at Lauren Court provide a good standard of care to the residents that live at the home, they were seen to be treating clients with respect and dignity and were able to demonstrate an awareness of their diverse needs. Good relationships were seen to exist between residents and staff and those people that commented all said that the staff members were good. Comments from residents and relatives included; “I have never been so well looked after in my life”, “Mum has settled in brilliantly, I visit most days and the manager is lovely”. Residents confirmed during the visit that routines within the home were flexible and that this gave them some control over their lives and enabled them to be more independent. Catering within the home was well managed and all of the residents spoken with said the food was good. Lauren Court Residential Care Home DS0000068893.V331000.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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 summary of this inspection report can be made available in other formats on request. Lauren Court Residential Care Home DS0000068893.V331000.R01.S.doc Version 5.2 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 Lauren Court Residential Care Home DS0000068893.V331000.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information and opportunities to visit before choosing to move in are available and residents are assessed prior to admission to ensure that their needs can be met at the home. EVIDENCE: The home provides a range of information to residents; these include the statement of purpose and the service user guide; this is available in large print. These documents include all of the information required under the Care Homes Regulations 2001 and Standard 1 of the National Minimum Standards for Older People. As part of the inspection process the care files of three people living at the home were looked at. New Meridian pre-admission assessments demonstrating that a resident’s individual needs were being assessed in an accurate and consistent way had been carried out. The new manager and senior staff members with input from the resident [where possible] and family Lauren Court Residential Care Home DS0000068893.V331000.R01.S.doc Version 5.2 Page 9 members now undertake the assessments in order to identify specific individual needs before a service is provided. Where applicable the assessment documentation provided by the placing authority was also seen on the files. Lauren Court Residential Care Home DS0000068893.V331000.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The clients care plans seen provided sufficient information for staff members to be able to take appropriate action to meet an individuals needs. EVIDENCE: Since taking over the ownership of Lauren Court Meridian Healthcare has been introducing its own care planning system into the home. Since the temporary manager has been working at the home a considerable amount of work has been undertaken and this changeover is nearly completed. Senior and care staff members are now also fully involved in the care planning process. The staff members spoken with during the visit said that prior to the temporary managers arrival the care planning system was managed by the home manager and they had no involvement in it. There was no diary for appointments or a written staff communication system in place. They only knew, for example, when a resident had a hospital appointment if the manager told them. Lauren Court Residential Care Home DS0000068893.V331000.R01.S.doc Version 5.2 Page 11 The care plans seen as part of the case tracking process covered identified care needs and provided staff members with the necessary information for them to look after a person’s needs. Risk assessments, including falls had been completed where necessary. There is documentation within the new system to enable the care plans to be reviewed as and when necessary. The health and well being of residents was being monitored and an appropriate record of development and actions taken was being kept. Residents or their families/advocates are involved in the care planning process. Staff members spoken with had a good understanding of the people they were supporting and were able to meet their diverse needs; they continually monitor the residents’ health needs and there was evidence to show that they were receiving appropriate support from health care professionals. This included GPs, community nurses, optician, dentist and chiropodist. The changing needs of individuals are discussed as and when required; the inspector was able to see this in practice during the visit. All personal care is carried out in the privacy of a resident’s bedroom or one of the bathrooms. The residents spoken with during the inspection all said that the standards of care provided were very good and that they had been able to express their opinions and wishes about their daily routines. It was also seen throughout the visit that residents were being treated with courtesy, respect and good humour by staff. Staff members were seen to be interacting with individuals in an appropriate and respectful manner, knocking on bedroom doors before entering and addressing people appropriately. Meridian healthcare has a written policy on the receipt, administration [including self-administration] safekeeping, handling, recording and disposal of medication within its homes. Lauren Court uses a blister pack system dispensed by a local pharmacist. No obvious issues were seen during the inspection visit. The pre-inspection questionnaire gives the names of those staff members who administer medication. Lauren Court Residential Care Home DS0000068893.V331000.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents spoken with were positive about the home and the support they received so they could maintain contact with friends and family and make choices about their daily lives. EVIDENCE: Residents were able to move around freely within the home and a choice of sitting areas was available. They confirmed that routines within the home were flexible and that they were able to make choices in many areas of daily living, for example times of rising and retiring, where to spend their time and with whom and participation in planned activities. A number of positive comments were made by residents about the standards of care provided to them during the inspection; these included, “Fan, bloody, tastic, staff are nice”, and “Staff are as good as gold”. Staff members were seen to knock on the door and to await permission before entering a resident’s bedroom. A variety of social and other activities are organised and information about forthcoming events was displayed. Links with the local community are maintained and people are able to come and go from the building. Visitors are free to visit the home at any reasonable Lauren Court Residential Care Home DS0000068893.V331000.R01.S.doc Version 5.2 Page 13 time. Personal mail was delivered unopened, or given to relatives if appropriate. Meals can be eaten in the dining room or in the privacy of residents’ own rooms. The temporary manager has introduced a new four weekly menu; this has the flexibility to meet individual needs and choices. All of the residents that commented said that the food was good and that choices were available. Special diets are prepared where necessary. The kitchen was seen to be clean, tidy and well organised and during a discussion with one of the chef’s she confirmed that since the temporary manager had been at the home the kitchen staff members had taken over the responsibility of food ordering, this had previously been done by the home manager without any record of consultation with the residents. Lauren Court Residential Care Home DS0000068893.V331000.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives are able to complain and action is taken to respond to their concerns. Adult protection training for staff is available to ensure the continued safety of residents. EVIDENCE: There is a clear complaints procedure for the home; leaflets about complaints and the procedure that will be followed are available in the entrance area. This is also included in the service user guide and a copy is in each of the bedrooms. The pre-inspection questionnaire indicates that two complaints have been received during the previous 12 months; these were responded to within the agreed timescale. The residents spoken with during the visit confirmed that they knew what to do if they were unhappy or wanted to make a complaint. The home has an Adult Protection procedure (including Whistle Blowing), which complies with the Public Disclosure Act 1998 and the Department of Health Guidance ‘No Secrets’. The temporary manager is aware of the appropriate procedures to follow should an incident arise. Staff members receive training in this area. Lauren Court Residential Care Home DS0000068893.V331000.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in a safe, homely, clean and comfortable home. EVIDENCE: A tour of the premises was undertaken; this included the lounges, communal areas and a number of bedrooms. Furnishings, fittings and lighting in the lounges and communal areas are of a good quality and are domestic in character. The temporary manager has ordered new lounge and dining room furniture that is more appropriate to the needs of the residents. Bedrooms seen during the inspection were personalised, comfortable, wellfurnished and contained items of furniture belonging to residents’. The home provides adaptations for use by residents with mobility problems: these include bath and toilet aids, hoists, grab rails and wheelchairs. Lauren Court Residential Care Home DS0000068893.V331000.R01.S.doc Version 5.2 Page 16 The manager explained that the hairdressing room upstairs was not fit for its purpose because it was too small was to be converted into a walk-in shower room and a bathroom, which strangely does not have any bath or shower fitted will become the hairdressing salon. This is a sensible alteration and will considerably improve the facilities. Improvements to the staff room are also underway. These are sensible alterations and will considerably improve the facilities available for both residents and staff members. The home was found to be clean and tidy on the day of the visit. Prior to the temporary managers secondment the washing and ironing was undertaken by one of the general assistants on duty, since being at the home she has appointed a designated laundry assistant. This has improved the system for the care of people’s clothes. During a discussion with the laundry assistant on duty she said that since the temporary manager had been working at the home more staff had been appointed, staff morale had improved and there were more training courses being made available. Lauren Court Residential Care Home DS0000068893.V331000.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff members work positively with residents and families to improve the quality of life of people living in the home. A robust staff recruitment process is in place in order to protect residents from possible harm. EVIDENCE: Staff on duty and rotas seen demonstrated that staffing levels and the skill mix of staff is adequate to meet the needs of the residents within the home. Staff members were cheerful and friendly. Residents and relatives spoken with were complimentary about staff attitude and competence. The pre-inspection questionnaire shows that 5 care staff members are currently qualified to NVQ level 2, a recognised qualification for staff involved in delivering care. The temporary manager explained that prior to her secondment the senior staff members working at the home had no involvement in care planning, contacting GP’s, arranging appointments etc, this was all undertaken by the home manager. As a consequence and in order to enable them to do their jobs more effectively they are now enrolled on a “Role of a senior carer” course. Lauren Court Residential Care Home DS0000068893.V331000.R01.S.doc Version 5.2 Page 18 The files for three recently appointed members of staff seen contained all of the required information and a robust recruitment procedure was in place for the protection of residents. Prospective staff members are checked against the POVA list before employment commences and CRB disclosures are obtained. New staff members are routinely inducted through the company’s induction procedure to ensure that they are suitably trained when starting work. Lauren Court Residential Care Home DS0000068893.V331000.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is being well run and managed on a day-to-day basis. There are appropriate procedures in place to make sure that residents are safe. EVIDENCE: The temporary manager has a considerable amount of experience and is registered with the Commission for Social Care Inspection. She has completed the registered managers award and has attended courses/training in order to fulfil her management responsibilities. She was able to demonstrate an awareness of the diverse needs of the client user group and how to manage the staff team. A number of positive comments about the manager and the changes she has introduced were made during the visit. One of the staff members said, “The manager is approachable, seniors have more responsibility and life is easier” Lauren Court Residential Care Home DS0000068893.V331000.R01.S.doc Version 5.2 Page 20 A quality assurance survey to ascertain whether people are happy with the standards of care being provided is an ongoing process. Meridian does this by sending out questionnaires to residents and their families, the findings are to be collated and a report will be made available. Lauren Court does not handle any finances for residents. There is a comprehensive health and safety manual as well as policies and procedures in relation to safe working practices in place. There was evidence that staff were receiving training in areas such as moving and handling, first aid and adult protection. The temporary manager keeps a record of statutory and other training undertaken by staff and is going to carry out an audit of staff training in order to ensure that all of the staff team have attended the appropriate courses for their job. The fire precautions record book was up to date and demonstrated that checks of the alarm system, emergency lighting, fire drills and staff training were taking place. Monthly visits to comply with regulation 26 of the Care Homes Regulations are being carried out. Lauren Court Residential Care Home DS0000068893.V331000.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Lauren Court Residential Care Home DS0000068893.V331000.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NA 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 Timescale for action 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 Lauren Court Residential Care Home DS0000068893.V331000.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Lauren Court Residential Care Home DS0000068893.V331000.R01.S.doc Version 5.2 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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