Inspection on 15/12/08 for The Laurels

This inspection was carried out on 15th December 2008.

CSCI found this care home to be providing an Excellent service.

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

The Laurels 19/02/07

The Laurels 21/12/05

The Laurels 02/08/05

The Laurels 21/03/05

The Laurels 14/07/04

The Laurels 17/02/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Laurels 56 Lydia Road Walmer Deal Kent CT14 9JY     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Joseph Harris     Date: 1 5 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: The Laurels 56 Lydia Road Walmer Deal Kent CT14 9JY 01304364275 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Michael Beales Type of registration: Number of places registered: Mr Michael Beales care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 3. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home The Laurels is a small, family type home, set in a quiet residential area of Walmer near Deal. It provides care and support for 3 clients with learning disabilities, and currently all of the clients and staff, with the exception of the manager, are female. The accommodation in the home is set over 2 floors and consists of two client bedrooms, a bathroom and an office/sleep in bedroom on the first floor with one bedroom, a lounge/dining room, a kitchen, and a shower room with toilet on the ground floor. Outside there is a small lawned area to the front and a larger lawned garden area with Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 3 Brief description of the care home to the rear with space for the clients and staff to sit outside, and a garden shed at the end of the garden. There are some small shops and local amenities within easy reach of the home, with the resort and town of Deal being about 20 minutes walk or a short drive or bus ride from the home. Walmer Castle is also just a short drive away. The towns of Dover and Sandwich are also within easy driving distance. Clients are supported in the enjoyment of a wide range of activities and outings of their choice, some within the home and others in the local community. The current fees for the service at the time of the visit are £500 per week. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection culminated in a site visit to the service on the 15th December 2008. The site visit commenced at 10am and lasted for around 4 hours. During the course of the visit the inspector had conversations with all of the service users, staff on duty and the manager. A range of documentation was examined including individual service user files, recruitment records, health and safety documentation, medication records and other information relating to the running of the home. The manager returned the Annual Quality Assurance Assessment (AQAA) when we asked for it, which was also used to inform the inspection process. Care Homes for Adults (18-65 years) Page 6 of 26 Care Homes for Adults (18-65 years) Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs of prospective service users would be assessed prior to admission. Evidence: The current residents have lived in the home for approximately 13 years and there have been no recent admissions to the home. This standard, therefore, could not be assessed fully. However, the home has processes and documentation in place in respect of needs assessment should the situation change. Care Homes for Adults (18-65 years) Page 10 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The individual needs and choices of service users are respected. Evidence: Every resident has an individual service user file containing care and support plans addressing all aspects of health and personal care. There is clear guidance to enable staff to consistently meet individual needs. The plans are regularly reviewed and discussed with the service users as appropriate. Service users are supported to make decisions affecting their day-to-day lives and can choose how they spend their time. The manager acts as financial appointee for all of the service users. This is a long-standing arrangement and suitable processes have been put in place to ensure the protection of residents money. Records of all incoming and outgoing transactions are maintained along with proof of purchase. Service users receive their weekly allowance and are assisted by the home to manage their daily finances appropriately. Risk assessments have been developed for each of the residents. These are written Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: and applied in a positive and enabling way encouraging responsible risk taking. The risk assessments are reviewed on a regular basis and updated as required. Care Homes for Adults (18-65 years) Page 12 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users have a lifestyle that suits their needs. Evidence: The activity programme enjoyed by the residents has been developed with each individuals needs and preferences in mind. Some service users choose to visit a local day centre for people with learning disabilities a number of times per week. There are also activities such as a music club and arts group at a local community centre. An art therapist visits the home on a weekly basis and one resident proudly showed off some of her recent work saying I like doing art, its fun. The staff organise regular outings to either run daily errands or to local places of interest. In addition to this a range of pastimes are followed in the home. One resident said, I did my Christmas shopping in Canterbury. Residents are currently saving up spending money for their annual holiday in Tenerife. Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: Residents relatives and friends are welcome to visit the home at all reasonable times and the staff ensure that relatives are kept informed of any significant events. Two of the service users are spending time with their families over Christmas. Residents can make choices and participate in the daily life of the home. They are encouraged and supported to be involved in household chores and activities. One person said that she can get up when she likes and spends time listening to music in her bedroom when she wants. The home ensures residents have a healthy and balanced diet taking into account personal preferences. A record of meals is maintained demonstrating a varied range of food with choices available. All of the service users said that the food is nice and they can choose what they want to eat. Care Homes for Adults (18-65 years) Page 14 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal and healthcare needs of the service users are met. Evidence: Service users are supported with their personal care needs by an experienced staff team. Staff were observed to interact positively and in a relaxed manner with residents. The care plans clearly detail the support each individual requires and promote independence. Service users stated that they get on well with the care staff and manager and confirmed that they are supported with respect and dignity. The home maintains clear healthcare records showing evidence that individual healthcare issues are monitored and addressed appropriately. Each service user is registered with a GP and the home reported that they receive good support from the community learning disability teams when required. The home seeks the involvement of specialists such as a nurse specialising in epilepsy for one individual. Complimentary healthcare needs such as visits with the chiropodist, dentist and optician are routinely arranged. The home has policies and procedures in place covering the administration of medication and all staff have undertaken appropriate training. Medication records and Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: storage facilities are well-maintained and organised. None of the service users have been assessed as able to self-medicate. The manager stated that the home receives good support from the dispensing pharmacy. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users views are listened to and acted upon and they are protected from forms of abuse. Evidence: The home has a complaints procedure which is displayed in the home and contained within the service user guide. The residents were observed to be comfortable talking to staff and any concerns are generally raised informally and dealt with as they arise. One service user said, I like my home, Im very happy. There have been no complaints since the last inspection. All staff have had training in abuse awareness issues and Adult Protection processes. Staff demonstrated a good understanding of these issues. Policies and procedures are in place to support this. No adult protection alerts have been raised since the last inspection. Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is suitable for the individual and collective needs of the service users. Evidence: The Laurels is located on a residential road in Deal within reasonable driving distance of the town centre and seafront. There is adequate street parking to the front of the building and a well maintained garden to the rear. The house is a small family-style home that comprises an open-plan lounge/dining area, kitchen, shower room/toilet and one bedroom on the ground floor. There are two bedrooms, a bathroom/toilet and an small office/sleep-in room on the upper floor. A new cooker has recently been installed and carpets throughout the home. The house is clean and hygienic, comfortable and homely. All of the bedrooms were seen and the residents showed a pride in their rooms, which have been personalised according to taste. One resident said, this is my home, its very nice. It was reported that the home meets all requirements with regard to fire safety and environmental health legislation. Hazardous substances are securely stored and an number of minor adaptations have been made to support the residents in their daily lives. Care Homes for Adults (18-65 years) Page 18 of 26 Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are supported by an experience, competent and well trained staff team. Recruitment processes ensure the protection of service users. Evidence: The home benefits from a stable staff team who have worked in the service for many years. There have been no staff changes since the last inspection. 80 percent of the team have achieved a National Vocational Qualification at level 2 or above. One member of the care staff has achieved NVQ level 4 and another has NVQ level 3. The member of the team who does not yet have an NVQ is in the process of working towards this qualification. The manager has established a positive staff training programme ensuring that all mandatory training is provided and updated as required. In addition to this the staff team complete competency assessments on key topics to underpin their knowledge. Other service specific courses are provided depending on the needs of the home and changes in legislation such as the Mental Capacity Act 2005, epilepsy and courses specific to people with learning disabilities. One recruitment file was examined that contained all the required information including CRB and POVA checks, two written references, proof of identity and records of training amongst other things. Care Homes for Adults (18-65 years) Page 20 of 26 Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run and in the best interests of the service users. Health and safety issues are monitored and addressed. Evidence: The manager has been running the home for over 10 years and has completed all the necessary qualifications for this role including his NVQ 4/RMA and an HNC in managing care services. He has established a very good rapport with staff and service users alike demonstrated by the stability of the staff team and contentment of the residents. The manager continues to monitor, improve and develop the service where possible. Parts of the home have been refurbished over the past year and record keeping and staff training is of a consistently high standard. Service user and other stakeholders views of the home are formally received in surveys annually and residents have opportunities to provide feedback on a regular basis through house meetings or informally with the manager and staff. Audits are completed covering key issues affecting the home on a monthly basis. All health and safety records examined were complete and up to date including fire Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: safety records, service certificates, maintenance issues and risk assessments. Staff receive all required training and there are safe working practices in place to underpin this. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - 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!