Inspection on 23/01/07 for Laurieston

This inspection was carried out on 23rd January 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

Laurieston 23/02/09

Laurieston 09/01/06

Laurieston 27/06/05

Laurieston 29/09/04

Laurieston 10/05/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Laurieston Albion Terrace Saltburn-by-Sea TS12 1JY Lead Inspector Ania Swann Key Unannounced Inspection 23rd January 2007 10:00 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 Laurieston DS0000000076.V328234.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. Laurieston DS0000000076.V328234.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Laurieston Address Albion Terrace Saltburn-by-Sea TS12 1JY 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) 01287 623890 Mr D Caley Mrs K Caley Mrs Kathleen Caley Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Laurieston DS0000000076.V328234.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th January 2006 Brief Description of the Service: Laurieston is a large detached Victorian house overlooking Riftswood and the Valley Gardens. It is conveniently situated for easy access to all local amenities such as shops, post office, banks, churches and public transport including the railway station. There is a lawned front garden providing an attractive outside sitting area. Accommodation is provided in ten single and three double bedrooms. Two rooms have en-suite facilities, the others have a wash hand basin. There is a large lounge with two separate seating areas and a dining room. Weekly fees for residents range from £350 to £360. Laurieston DS0000000076.V328234.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day, a total of eight inspection hours. The inspector spoke to three residents, two relatives and four staff including the manager. A range of documents was examined, including staff records and residents files. There were five completed service user surveys and five relative comment cards returned to the inspector. A tour of the home environment also formed part of the inspection. The inspector was received well by all the staff and residents, and the staff were very co-operative and willing to be involved in the inspection. What the service does well: What has improved since the last inspection? Laurieston has had improvements made to the environment. A new walk-in shower replaces the existing shower. The communal areas have been repainted and carpets have been replaced in two of the bedrooms. The manager organised a new event for all the staff from the home. A two day ‘team building’ course had a very positive affect on the staff, and those staff the inspector spoke to, said it made the good working relationships among the staff even better. This has an impact on the way that residents are cared for. Laurieston DS0000000076.V328234.R01.S.doc Version 5.2 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 summary of this inspection report can be made available in other formats on request. Laurieston DS0000000076.V328234.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 Laurieston DS0000000076.V328234.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, 2, 3 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have the information they need to make an informed choice about the suitability of the home. Residents receive a contract that clearly sets out what the resident can expect from the service. The needs of the residents are assessed prior to moving in to Laurieston and residents are assured that their needs can be met. Prospective residents and their relatives are given the opportunity to visit the home before moving in. Laurieston DS0000000076.V328234.R01.S.doc Version 5.2 Page 9 EVIDENCE: Each resident is provided with a guide that sets out clearly the aims and philosophy of the home, and gives details about the accommodation and facilities on offer. The guide was observed by the inspector to be available in the entrance of the home, and residents that spoke to the inspector confirmed they had received a copy. The residents confirmed in their discussion with the inspector that they had been given a contract which is clear and easy to understand, and outlines what they can expect from the service. There was a copy of the contract evident in the resident’s files. During a discussion with the inspector, the manager confirmed that either the manager or the matron go out to a prospective residents home and do a preadmission assessment to ensure that the home can meet the needs of the individual. Pre-assessments are also done through Care Management arrangements and these are evident in the resident’s files. Residents confirmed to the inspector in the service user surveys, and in discussion on the day of inspection, that they and their families were given the opportunity to visit the home for a visit or stay for the day prior to moving in. Laurieston DS0000000076.V328234.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, 10 & 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The resident’s health, personal and social needs are met by the home but the care plan documentation needs developing so that staff can identify the current needs of the resident and any changing needs can easily be highlighted. The home works to a safe and efficient medication policy supported by clear procedures and residents are able to take responsibility for administering their own medication if they wish. Residents are treated with respect and dignity and staff ensure that privacy is maintained. Staff from the home treat residents who are near the end of their life with care and sensitivity, and the staff support the family and the home’s other residents during the bereavement process. Laurieston DS0000000076.V328234.R01.S.doc Version 5.2 Page 11 EVIDENCE: Five sets of resident’s records were looked at during the inspection. They showed evidence of assessment of needs and details of the individuals’ daily routines and likes and dislikes. There is a key worker system in place and one of the relatives confirmed that she knew who the key worker was for her family member. The key worker reviews the care of the individual resident on a monthly basis. The documentation of the care plan could be further developed so that staff can record the needs or potential problems of a resident in a more structured and clear way. This would help the review process and staff would be able to monitor any changes more easily. There is evidence in the files to show that relevant health professionals are involved in the home and make visits when requested. A GP was visiting a resident to review pain control on the day of inspection. Staff will accompany residents to the doctors and hospital appointments if family members are not available. The home pays for chiropody services for the residents. One resident told the inspector “everyone comes to see us – doctor, optician, dentist – they all come”. The residents are encouraged to be physically active, and there are daily opportunities for ‘armchair’ exercises. The inspector observed a session during the inspection, and residents confirmed that they take place daily. One of the residents chooses to administer her own medication, and the staff support her with this. The medication systems were looked at and found to be appropriate. The care staff have training in correct use of the systems used in the home and are aware of the guidance. In a discussion with one of the residents the inspector was told “the staff are good with me and they certainly respect my wishes and me”. Staff were observed knocking before entering residents bedrooms. Residents are able to remain at Laurieston during their last days, unless medical needs dictate otherwise. A relative of a resident nearing the end of her life said “my mum is really well looked after – even if she had a million pounds she wouldn’t be able to get better care anywhere else”. The staff support residents and families following the death of a loved one. One resident whose spouse had died said “the staff have been good – marvellous when my husband died. They helped me sort out everything”. Laurieston DS0000000076.V328234.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 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to enjoy a full and stimulating lifestyle that meets their interests and needs. Laurieston provides a healthy, balanced diet to its residents. Family and friends are made to feel welcome in the home, and residents maintain contact with the local community as they wish. Residents are helped to exercise control over their lives. EVIDENCE: The home provides a varied programme of activities that takes into account the residents different interests and abilities. There are daily exercise sessions that residents can perform sitting in a chair. The staff organise bingo, quizzes and games for the residents and a popular event is when the staff read out loud from a magazine or book. There are also outside trips arranged to the local theatre or to have a meal in a restaurant. Laurieston DS0000000076.V328234.R01.S.doc Version 5.2 Page 13 A relative told the inspector “it’s like home from home. They’re stimulated and not just left to sit. My Dad has a better social life since he moved in here then he had before he moved in”. One of the residents told the inspector that “there is a communion service in the home about once a month, and people from the church come in to the home as well. And if I want to go out to the church, I can always ask the staff and they’ll take me”. “The home is very obliging – they offer all the visitors a cup of tea or coffee”. “I like that they involve families – we get invited to social evenings. Nothing is too much trouble and you’re always made to feel welcome”. Residents can choose to see their relatives in the communal lounge or their bedroom, and in fine weather families and residents can use the garden to sit and socialise. Residents can choose to bring personal possessions into the home. Meals are generally taken in the dining room, but there is flexibility to accommodate the residents’ individual preference. One resident said she liked to have her meals in her room. The food is cooked well and nicely presented. Residents are offered an alternative to the main meal if they don’t like what is on offer. Tables are set attractively and mealtimes enjoyed by the residents; “the meals are very good”. Laurieston DS0000000076.V328234.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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a complaints procedure that is clearly written, easy to understand, and is available to anyone associated with the service. Residents are protected from abuse and feel safe living in the home. EVIDENCE: The complaints procedure is clearly set out in the residents’ guide. A copy of this is evident in each resident’s bedroom and is also available in the entrance hall of the home for all visitors to see. Discussion with two of the residents and two family members confirmed that they had a good understanding of how to make a complaint, but they had not had reason to do so. They all commented that they had confidence in the staff and knew that any concerns would be dealt with. “The manager is very approachable – she’d sort it out”. The complaints records show that there have been no complaints or concerns received since the last inspection. Residents and visitors told the inspector that they were happy with all aspects of the home. Laurieston DS0000000076.V328234.R01.S.doc Version 5.2 Page 15 Training of staff in the area of protection is regularly arranged by the home. Staff training files showed that the staff have had “No Secrets” adult protection training since the last inspection. Policies and procedures are in place to ensure the safety and protection of the residents. One relative said that she had “peace of mind that my Dad is safe and well cared for”. Laurieston DS0000000076.V328234.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a very well maintained environment, which provides aids and equipment to meet the care needs of the residents. It is a very pleasant, safe place to live. The home is well lit, clean and tidy and smells fresh. EVIDENCE: A tour of the home showed a very well maintained environment. The inside and outside of the building are in good condition. Laurieston provides a homely environment and is decorated to a good standard. The carpets are clean, and some have been replaced in resident’s bedrooms. Laurieston DS0000000076.V328234.R01.S.doc Version 5.2 Page 17 Residents can meet relatives and friends in the comfortable lounge or in the privacy of their own room. In fine weather, residents and their visitors can sit out and enjoy the attractively laid out and well maintained garden area. There is a passenger lift to give residents access to the first floor. The home provides specialist equipment to meet the needs of the residents. All the residents are encouraged to have their own possessions around them, and this was evident in the resident’s bedrooms where there were pictures, photographs and other personal items that made the room more individual and homely. Where rooms are shared it is only by agreement and curtains are provided to maintain the residents privacy. Residents are given the choice to move into a single room when one becomes vacant. The residents confirmed to the inspector that they agreed to share a room, but this is not documented. It would be good practice to record such detail in the residents file as evidence that the resident has made a positive choice to share the room. The management has policies and procedures for infection control and the staff are trained appropriately. Laurieston DS0000000076.V328234.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are met by the appropriate number of staff who are skilled in their role. Residents say they feel safe. The home has a good recruitment procedure that ensures the residents are supported and protected. The staff are appropriately trained to meet the needs of the residents. EVIDENCE: The duty rota shows that the home has four staff on duty in the morning to meet the needs of the residents. This is the busiest part of the day and the manager has paid particular attention to ensure the home is staffed appropriately at this time. Staff told the inspector that they felt the residents got good care. The staff have achieved NVQ Level 2 or 3 in Care and evidence of certificates were seen in the staff training files. Discussion with the manager highlighted that the manager and the matron have completed the Diploma in Care and Managers Award. Laurieston DS0000000076.V328234.R01.S.doc Version 5.2 Page 19 Training records show that the staff have completed training beyond the basic requirements. The training is relevant and is focussed on improving outcomes for residents. Care staff have undertaken training courses in Managing Conflict, Mental Health Awareness, Optical Awareness, Diabetes care and have also attended mandatory training in Fire Safety Awareness and Manual Handling. Residents said that they feel safe living in the home, and that the staff are “excellent” and “very on the ball”. They have confidence in the staff that care for them. The service has a good recruitment procedure that is followed in practice. The home does not use agency or temporary staff. Laurieston DS0000000076.V328234.R01.S.doc Version 5.2 Page 20 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, 36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has the required qualifications and experience and is competent to run the home. The home is run in the best interests of the residents, and ensures effective safeguarding and management of resident’s money including record keeping. Staff are appropriately supervised and supported. The manager is very committed to ensuring the health, welfare and safety of residents and staff. Laurieston DS0000000076.V328234.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager has completed the Diploma in care and the Registered Managers Award and demonstrates her experience and ability in running the home. The manager is resident focused and leads and supports a strong staff team who have been trained to a high standard. The staff confirmed to the inspector that they think the manager is “a good manager” and “a good boss”. There are meetings with the residents that take place three monthly, and minutes of the meetings were evident in the files. A newsletter to residents and their families is issued every month, and the latest edition is available on the notice board in the dining room. Discussion with the manager informed the inspector that the manager undertakes quality assurance and she works continuously to try and improve services and provide an increased quality of life for the residents. A review of the residents personal allowances shows that records are kept accurately and the correct amount of money is evident. The personal allowances are stored securely. Care staff confirm that they receive supervision very regularly and staff records show that an appraisal takes place twice yearly. The manager does direct observations or shadowing of the staff, and a care worker confirmed that the manager does give feedback to the individual staff member. The manager lives on the premises and is available to the staff for advice. Staff are expected to attend at least eight staff meetings each year. A two day team building activity was attended by all the staff with the aim of giving the staff the opportunity to spend time together, look at their own strengths and weaknesses, and build on existing good relationships. The staff that the inspector spoke to commented that they found the experience very good and worthwhile. The manager undertakes regular audits of all aspects of the home, and this is evident in the records. Records show that maintenance checks are done as scheduled. Weekly checks of the fire alarms and doors are carried out, and whether the staff respond appropriately. Any recommendations made by the Fire Officer are undertaken by the home and this is evident in the records kept on display in the entrance hall of the home. The staff stated that the manager “knows and understands the residents really well”. A relative told the inspector “the manager’s very good – she does extra bits and she’ll go out of her way to get what the residents want”. Laurieston DS0000000076.V328234.R01.S.doc Version 5.2 Page 22 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 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 3 x 3 3 x 3 Laurieston DS0000000076.V328234.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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. 1. Refer to Standard OP7 Good Practice Recommendations The documentation of the care plan could be further developed so that the current needs of the resident are written in a clear, structured way. The staff could then review the plan as they currently do, and identify any changes that are required to the residents individual care, amending the care plan accordingly Where two residents have agreed to share a room, this should be documented in the residents file as evidence that the individual resident has made a positive choice. 2. OP23 Laurieston DS0000000076.V328234.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 Laurieston DS0000000076.V328234.R01.S.doc Version 5.2 Page 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!