Inspection on 19/02/07 for The Laurels

This inspection was carried out on 19th February 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

The Laurels 15/12/08

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

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 The Laurels 56 Lydia Road Walmer Deal Kent CT14 9JY Lead Inspector Mrs Penny McMullan Key Unannounced Inspection 19 February 2007 09:30 The Laurels DS0000023126.V326310.R01.S.doc Version 5.2 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 DS0000023126.V326310.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 Adults 18-65. 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 DS0000023126.V326310.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Laurels Address 56 Lydia Road Walmer Deal Kent CT14 9JY 01304 364275 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) Mr Michael Beales Mr Michael Beales Care Home 3 Category(ies) of Learning disability (3) registration, with number of places The Laurels DS0000023126.V326310.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st December 2005 Brief Description of the Service: 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 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. There are additional charges for hairdressig, newspapers and some activities such as cinema. Information on the homes services and the CSCI reports for prospective clients/relatives will be referred to in the Service User Guide. There is no current email address for the home. The Laurels DS0000023126.V326310.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is based on evidence gained from a pre-inspection questionnaire completed by the home; comment cards received from clients, families, and visiting professionals; and a site visit of 5.5 hours to the home. The site visit includes talking to clients, staff, the Registered Manager; a partial tour of the building; inspection of records; and various observations. Feedback from relatives indicates they are overall satisfied with the service being provided. Further comments have been included in this report. What the service does well: What has improved since the last inspection? What they could do better: One client said she could not think of anything that the home could do better. The Laurels DS0000023126.V326310.R01.S.doc Version 5.2 Page 6 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. The Laurels DS0000023126.V326310.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Laurels DS0000023126.V326310.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to carry out an assessment of needs of clients prior to admission to the home to ensure that all care needs will be met. EVIDENCE: The current clients have lived in the home since 1995 therefore there have been no recent admissions. This standard could not be fully assessed. However the home has arrangements in pace for prospective clients, together with appropriate documentation to ensure client’s needs are identified and met. The Laurels DS0000023126.V326310.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a consistent care planning system in place to provide staff with the information they need to meet client’s needs. The home promotes client’s rights and choices. Clients are supported to take responsible risks within the homes risk assessment management strategy. EVIDENCE: Each client has a thorough and detailed care plan, which covers all aspects of health and social care. The care plans are consistently reviewed and if required additional information is provided on specific individual medical needs. Clients are aware of the plans but did not wish to discuss them. The Laurels DS0000023126.V326310.R01.S.doc Version 5.2 Page 10 Clients are supported in making choices about all aspects of their daily lives. Preferences are recorded in the care plan and clients say they have choice in things they wish to do. All three clients are supported with their finances and clear documentation is in place. There are detailed risk assessments in place, which outline a safe practice of work and identify clear guidelines for staff. Environmental risk assessments have also been completed. The Laurels DS0000023126.V326310.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clients are supported and encouraged to take part in activities of their choice. Clients are supported to maintain family contact and assisted to exercise choice over their lives. Nutrition is well managed, promoting healthy eating with choice and variety. EVIDENCE: The clients enjoy many activities, both individually and as a group. They all go to church, one attend colleges, one to a day centre, and various other events within the local community. The clients are supported to help with household tasks and have planned activities throughout the week. They confirm they go out to lunch and to the local town to shop. On Wednesday there is a craft The Laurels DS0000023126.V326310.R01.S.doc Version 5.2 Page 12 session, which is held in the home and their various artwork is displayed on the wall in the dining area of the lounge. Client comments included, “I really enjoy sewing”, “I like going to the day centre’. The home has purchased a new car for transporting clients to their chosen destinations. It is also used for outings and going to various local towns to shop. Family contact is encouraged and one client went home for Christmas and her family telephone on a regular basis. Another receives visits from her brother and sister and they usually go out together for a couple of hours. Feedback from relative comment cards indicates the home is welcoming and relatives are satisfied with the care being provided Clients are supported to go out in the community and have a varied busy weekly programme in place covering their individual preferences and choices. Staff say the clients will make it quite clear if they do not wish to participate in their programme. The home promotes client’s rights and choices. Two clients’ say the staff knocks on the door before entering their room and they are helped sensitively to shower. Staff support individuals in a friendly respectful manner. Client feedback from surveys says that the staff listens to them. The daily meals are recorded in the menu book. Clients say they enjoy the food and it is good. The kitchen is domestic in size and the menu appears varied and nutritious. Staff confirm they are able to choose and have something different on the menu if required, and sometimes they choose to go out for a meal or have a take away. Lunch was relaxed and unhurried. Dislikes and allergies are recorded in the care plan. Staff feedback indicates the food is good. The Laurels DS0000023126.V326310.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health needs of clients are met with evidence of good multi disciplinary working taking place on a regular basis. Personal care is offered in a way protect clients privacy and dignity and promote independence. The medication at this home is well managed promoting good health. EVIDENCE: The home supports the clients in all aspects of their daily lives including personal care by encouraging them to do as much as they can for themselves. The routines of the home are flexible to ensure clients have some control over their lives and remain as independent as possible. Apart from the Registered Manager all other staff are female ensuring personal care is supported by the The Laurels DS0000023126.V326310.R01.S.doc Version 5.2 Page 14 same gender. The staff in the home has worked in the home for several years, therefore clients benefit from continuity of staff. The health care needs of the clients are monitored through the care plans and there is clear evidence of specific health professionals being involved in their care when required. Clients are able to visit the GP or dentist accompanied by staff. Clients confirm they had visited the dentist recently. All health care appointments are recorded and monitored. All medication is appropriately stored and MAR sheets (medical administration records) are in good order. The Registered Manager monitors the accuracy of the records daily and takes any action required if the sheets are not in good order. All staff administering the medication has received the appropriate training. The Registered Manager also observes their competency when administering the medication. Homely remedies are checked with the GP and also recorded when administered. One client has specific medication monitoring due to her medical condition. The Laurels DS0000023126.V326310.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 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 satisfactory complaints system in place. Arrangements are in place to ensure clients are protected from abuse EVIDENCE: The home has a complaints procedure, a copy of which is displayed on the notice board. There have been no complaints since the last inspection. Clients say they have no complaints but would speak to Manager if they had. One client says ‘I would tell Mike (The Registered Manager) and he would do something about it’. The home has an Adult Protection Policy, which includes whistle blowing. The majority of staff have received adult protection training. Prospective staffs are checked against the POVA register. There are appropriate systems in place to ensure client’s money is handled in a safe way. The Laurels DS0000023126.V326310.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is decorated and furnished to a good standard creating a comfortable environment for those living there. Laundry facilities are satisfactory and policies and procedures are in place to control the risk of infection. EVIDENCE: There is an ongoing maintenance programme in place for the home. It is homely, comfortable and there are no unpleasant odours. The home is situated in a quite residential area, which is close to the town. Furnishings and fittings are of good quality and redecoration is ongoing. The bedrooms have been redecorated, the bathroom re tiled and new showers fitted. The bedrooms are personalised to individual taste and clients say ‘I like my bedroom, and I choose the colour myself’. The Laurels DS0000023126.V326310.R01.S.doc Version 5.2 Page 17 The home has a domestic washing machine and there are policies and procedures in place for infection control and laundry facilities are satisfactory. The home is in the process of ensuring that all staff receives infection control training. The Laurels DS0000023126.V326310.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff have a good understanding of client’s support needs. Arrangements are in place to ensure that clients are supported and protected by the homes recruitment policies and procedures. The arrangements for the induction of staff and training of staff are in place with the staff demonstrating a clear understanding of their roles. EVIDENCE: The home has two members of staff on duty during the day and one during the evening, and one staff member sleeps in overnight. Over 80 of staff hold NVQ 2 or above and have received training to meet client’s needs. Staff feedback indicates there is always enough staff on duty to enable clients to carry out their activities. The home is proactive with training and staff feel they can access any training which would help them to do their job well. The Laurels DS0000023126.V326310.R01.S.doc Version 5.2 Page 19 Staff files viewed contained the required information including, Criminal Records Bureau (CRB), Checks. There was an issue with regard to one CRB, which was from a previous employee. The Registered Manager took immediate action to contact POVA first and apply for a new CRB, therefore a requirement was not made in this report. Training certificates were also on file, proof of identity, two references, the application form and health declaration. Each member of staff has an individual training list detailing all training courses they have attended. Mandatory training is being provided together with appropriate updates. There are additional courses being booked for infection control and updates in moving and handling, and health and safety. Some specialist training has also been provided such as, NAPPI, epilepsy and the administration of rectal diazepam, and medication awareness. The Laurels DS0000023126.V326310.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of clients. The Company regularly reviews aspects of its performance to ensure client’s views have an influence on the homes development plan for the future. The home is providing a safe environment for clients to live in. EVIDENCE: The registered manager has been running the home for over 10 years. He is very experienced and has completed his NVQ 4 in Health and Social Care and will be completing the RMA award this year. He already holds an HNC in The Laurels DS0000023126.V326310.R01.S.doc Version 5.2 Page 21 Managing Health Care Services, an NVQ 3 in Care Management, is an NVQ assessor, and holds all of the general certificates that the rest of the staff hold (e.g. moving and handling, first aid etc.). Staff say ‘he is a great manager and is very supportive’, clients also say ‘he does a good job’. The home has a quality assurance system in place and last year clients completed a questionnaire. All responses were positive. The home also holds client meetings and the Registered Provider/Manager also carries out a Regulation 26 audit to ensure the quality of care provided in the home is maintained. There is an annual development plan in place. All staff are receiving mandatory training. A sample of the safety checks was carried out and all documentation is in order. Accident forms were tracked through to the daily records to ensure the ongoing monitoring of health care needs. The fire book was in good order and weekly fire tests have been completed. Environmental risk assessments are in place and the electrical installation and PAT testing has also been completed. The Laurels DS0000023126.V326310.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 Adults 18-65 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 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 x 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x The Laurels DS0000023126.V326310.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? 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 The Laurels DS0000023126.V326310.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 The Laurels DS0000023126.V326310.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!