Inspection on 18/10/05 for The Laurels

This inspection was carried out on 18th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 12/02/09

The Laurels 11/12/07

The Laurels 23/01/07

The Laurels 16/11/04

The Laurels 05/05/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

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 The Laurels Westfield Lane Draycott Cheddar Somerset BS27 3TN Lead Inspector Ms Sue Hale Unannounced Inspection 18th October 2005 09:25 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 The Laurels DS0000043864.V257546.R01.S.doc Version 5.0 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. The Laurels DS0000043864.V257546.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Laurels Address Westfield Lane Draycott Cheddar Somerset BS27 3TN 01934 742649 01934 743580 The.Laurels@blueyonder.co.uk 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) Brightwell Residential Care Limited Ms Donna Marie Nutt Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places The Laurels DS0000043864.V257546.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th May 2005 Brief Description of the Service: The Laurels is a residential care home for up to 20 older people. The provider is Brightwell Residential Care Limited and the acting manager is Mrs Zoe Attwood. The home is situated in the village of Draycott, between Cheddar and the city of Wells. The home has pleasant and comfortably furnished communal rooms. Residents’ bedrooms are arranged on the ground and first floor of the home, the majority of the facilities are en suite. The first floor is accessible via a stair lift. The home has a large, cultivated garden and some residents’ rooms have private patio areas. The Laurels DS0000043864.V257546.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over the course of one day (7.5 hours) in October 2005. There were twenty residents in the home. The inspection involved discussion with the people who lived and worked at the home, examination of records, policies and procedures and a tour of the premises. The inspector spoke to seven residents during the inspection. As part of the inspection process the inspector used ‘case tracking ‘as a means of assessing some of the National Minimum Standards. This process allowed the inspector to focus on a small group of people living at the home. All records relating to these people were inspected, along with the rooms they occupied in the home. As a result of this inspection 3 requirements were identified and 1 recommendation was made. What the service does well: What has improved since the last inspection? The Laurels DS0000043864.V257546.R01.S.doc Version 5.0 Page 6 The homes library has been restocked with new books, an electric piano purchased and a system for monthly, personal shopping orders has been introduced along with enhancements to the bi-weekly mobile shop. trips out for residents to do their personal shopping has been introduced The registered person stated that three bedrooms had been redecorated, the furnishings in four rooms upgraded and a further three ensuites had been fitted with new flooring. A new TV/VCR has been purchased, dishwasher and hoist replaced. New garden furniture has been purchased and existing ones refinished. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Laurels DS0000043864.V257546.R01.S.doc Version 5.0 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 The Laurels DS0000043864.V257546.R01.S.doc Version 5.0 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, 4 & 5. Prospective service users are able to visit the home and stay here on a trial basis prior to making a final decision. Families are encouraged to be involved in the decision making process. EVIDENCE: The inspector checked the personal files of two new residents. Both residents had pre admission assessments in their file. Residents spoken to confirmed that they were able to visit the home before making a decision on residency to make sure that their needs could be met at the home. Some residents had moved to the home to live near their family and had been unable to visit beforehand so their family had visited and looked around the home and met the staff. The Laurels DS0000043864.V257546.R01.S.doc Version 5.0 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, 8, 9 & 10. Care plans contained good detail and gave clear instructions to staff, however, one resident did not have a completed care plan. EVIDENCE: A sample of residents personal files were checked, one resident did not have a completed care plan and an immediate requirement in respect of this was given to the registered person on the day of the inspection. A photograph of the resident must be kept on file for identification purposes. Care plans checked contained good details for staff and specific instructions for them to follow to ensure residents social, health and care needs are met, on one file the care plan had been reviewed. The care plans seen clearly identified health needs and appointments with doctors, dentists and chiropodists were logged. The inspector did not see written evidence that residents or their families were involved in the care planning and review process. The provider has subsequently confirmed that this is in place. The Laurels DS0000043864.V257546.R01.S.doc Version 5.0 Page 10 There was no evidence on the files checked that risk assessments in relation to moving and handling, pressure sores, nutrition or falls had been undertaken. The home has relevant assessment tools to do this when such needs are identified. The pharmacy inspector visited the home after this inspection and a separate report is available as a public document. The Laurels DS0000043864.V257546.R01.S.doc Version 5.0 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. The home provides a varied activities programme that is available for all residents. EVIDENCE: A brightly coloured and detailed activities programme was displayed in the home and included events such as a fundraising cream tea, visits by the mobile library, and a musical evening. It also detailed residents’ birthdays and included details of when local clergy would be visiting the home. Comments by residents varied from those who were very satisfied with the current level of activities to some that would welcome ‘more going on in the home and more trips’. The registered person stated that regular ‘family gatherings ‘ took place with residents inviting relatives and friends to visit the home. The registered person stated that a system for monthly, personal shopping orders has been introduced along with enhancements to the bi-weekly mobile shop. An electric piano has been purchased and new books bought to restock the homes library. The Laurels DS0000043864.V257546.R01.S.doc Version 5.0 Page 12 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): 16. The complaints policy ensures that service users have a formal channel through which to raise any serious concern. EVIDENCE: A complaints policy and procedure was in place. This was evidenced by the policy within each service users guide. Residents spoken to were aware of whom to speak to if they had a complaint or problem. The Laurels DS0000043864.V257546.R01.S.doc Version 5.0 Page 13 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 homely environment for residents that is kept clean and tidy in communal and private areas. EVIDENCE: The home was clean and tidy on the day of the inspection. The home was decorated and furnished in a homely, domestic manner. Since the last inspection three bedrooms had been decorated and furnishings replaced in four rooms, and the flooring replaced in three ensuite rooms. Residents spoken to confirmed that they were able to bring in items of furniture with them in agreement with the registered person. The registered person stated that there a programme of ongoing maintenance throughout the home. This includes periodic replacement of carpets. Additionally, steam cleaning of carpets (e.g. in the dining room) is undertaken when required. The Laurels DS0000043864.V257546.R01.S.doc Version 5.0 Page 14 The garden area was pleasant and accessible to residents, new garden furniture had been purchased since the last inspection and existing garden furniture refurbished. The Laurels DS0000043864.V257546.R01.S.doc Version 5.0 Page 15 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 & 29. The numbers of care staff on duty was sufficient to meet the needs of the residents. The administration of recruitment and selection procedures needs to be improved. EVIDENCE: At the time that the inspection started there was only one senior carer on duty to look after 20 residents as there had been a mix up in the staff rota, a carer was contacted and arrived to cover the shift. There was one domestic, one cook and a care support worker who was working in the kitchen, clearing tables, distributing drinks to residents and washing up. Staff were seen to be working very hard to meet the needs of residents. Residents spoken to were satisfied with the care they receive from staff and all said that they felt ‘well looked after’. The registered person stated that the staffing numbers were determined by using the residential staffing formulae to ensure that there was always sufficient staff available to meet the needs of residents. Three staff files were checked, all files contained at least two references, evidence of identity had been obtained for two people, two files did not contain a photograph of the member of staff and application for a POVA First check and a Criminal Records Bureau disclosure had not been made for one member The Laurels DS0000043864.V257546.R01.S.doc Version 5.0 Page 16 of staff. Two of the staff files were not on the premises when the inspector arrived but were brought to the home by the registered person. Consideration should be given to devising a checklist for staff files to record the documentation required and obtained. The Laurels DS0000043864.V257546.R01.S.doc Version 5.0 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): 31, 35, 37 & 38. Procedures to safeguard residents’ finances were in place. Cleaning materials were stored safely. Care records were stored securely, but improvements could be made in relation to record keeping. EVIDENCE: Records are kept securely in the managers’ office. Two staff files were not on the premises but were brought to the home by the registered person during the inspection. These records or copies of the relevant documents must be kept on the premises and available for inspection. The Laurels DS0000043864.V257546.R01.S.doc Version 5.0 Page 18 The registered person stated that the inspection report was available in the staff office and that a notice advising residents and relatives of this is on display in the entrance hall. The home has financial polices and procedures in place to safeguard residents form financial abuse. The home does not hold monies on residents’ behalf. The accident book had not been thoroughly completed, this requires amendment. The Laurels DS0000043864.V257546.R01.S.doc Version 5.0 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 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 X 3 3 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X 3 3 The Laurels DS0000043864.V257546.R01.S.doc Version 5.0 Page 20 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. 1. Standard OP7 Regulation 15 Schedule 3 (1)(b)(2) Schedule 2(7) Requirement The registered person must ensure that all residents have a completed care plan. The registered person must ensure that a photograph of residents is kept on file. The registered person must ensure that a CRB application is made for all new staff. A POVA First check must be received before new staff start work pending the receipt of a CRB disclosure. The registered person must ensure that a thorough record is kept of any accidents in the home. Timescale for action 28/02/06 2. OP29 28/02/06 3. OP38 Schedule 4(12) 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP8 Good Practice Recommendations It is recommended that care plans routinely record falls, nutrition and pressure area risk assessments, noting “not applicable” where this is the assessment. DS0000043864.V257546.R01.S.doc Version 5.0 Page 21 The Laurels Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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. 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