CARE HOMES FOR OLDER PEOPLE
The Laurels 10 Norfolk Road Carlisle Cumbria CA2 5PQ Lead Inspector
Paula Malaney Unannounced Inspection 23rd March 2006 11:00 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 The Laurels DS0000022640.V271318.R01.S.doc Version 5.1 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 DS0000022640.V271318.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service The Laurels Address 10 Norfolk Road Carlisle Cumbria CA2 5PQ 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) 01228 527972 Mrs Kathreen Burns Mrs Kathreen Burns Care Home 28 Category(ies) of Dementia - over 65 years of age (8), Learning registration, with number disability over 65 years of age (4), Old age, not of places falling within any other category (16) The Laurels DS0000022640.V271318.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. To accommodate sixteen older people (16OP). To accommodate 8 older people with dementia (8 DE(E)). To accommodate 4 older people with a learning disability (4(LD(E)). Date of last inspection 6th July 2005 Brief Description of the Service: The Laurels is a residential care home registered with the Commission for Social Care Inspection to provide personal care and accommodation for up to twenty-eight people. The home provides permanent accommodation and offers respite care when accommodation is available. The Laurels is owned by Mrs Kathreen Burns and Mr Wilson Briggs and Mrs Burns is the registered manager. The home is situated in a pleasant residential area approximately one mile from Carlisle city centre. The property is a large, extended older building which has been adapted for use as a care home. Accommodation for residents is provided on the ground and first floors of the home. The home is equipped with a passenger lift and stair lift to assist residents to access accommodation on the first floor. Accommodation for residents is mostly in single rooms and there are three double bedrooms available for people who wish to share. All of the bedrooms have ensuite toilet and wash hand basin facilities. The home provides shared accommodation in the form of a large lounge with dining areas and a separate sitting room where residents can receive visitors in private if they wish. There are accessible bathroom and toilet facilities close to all areas used by residents. The Laurels DS0000022640.V271318.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and was carried out on 23rd March 2006. The inspection focussed on how well the home meets the needs of the people living there. This was assessed by speaking to residents, care staff and the manager, observing activity in the home and examining the records which care homes are required to hold. What the service does well:
The home provides a high standard of care which meets residents’ personal and health care needs. Residents are treated with respect and are supported to make choices and maintain control of their lives. The atmosphere in the home is friendly and relaxed. Care staff take time to talk to residents as they carry out their duties. Residents said they like talking to the staff and that they “enjoy a good laugh” with them. Care staff ensure that residents’ privacy and dignity are protected. Meals are varied and attractively presented and residents receive a nutritious diet. Menus are discussed at residents’ meetings and are changed in response to the comments received. The home is well maintained and is decorated to a high standard. Residents are provided with comfortable and pleasant accommodation to live in. Residents said the accommodation provided is “very nice”. The layout of the communal areas is suitable to allow a range of activities to be carried out at the same time. The owners have continued to invest in the premises to ensure the accommodation is of a high standard and suitable to meet residents’ needs. Care staff are skilled and well trained. Specialist training is provided to ensure care staff have a thorough understanding of the needs of the residents and how best to support them. All care staff have achieved NVQ level 2 or above in care. The home is well managed. Appropriate procedures are followed to protect residents’ rights and safety. The management team are committed to providing a high standard of care which meets residents’ needs. There are good systems in place for including residents in decisions about how the home is run. Residents know they can affect how their care is provided. The Laurels DS0000022640.V271318.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Laurels DS0000022640.V271318.R01.S.doc Version 5.1 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 DS0000022640.V271318.R01.S.doc Version 5.1 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 and 4. Admissions to the home are well managed and residents know that the services provided will meet their needs. EVIDENCE: The home has good systems for handling new admissions. The admission procedures include residents’ needs being assessed before they are offered accommodation in The Laurels. Individuals’ needs are identified and known to the staff in the home. Residents receive a high standard of care which meets their needs and takes account of their preferences. The Laurels DS0000022640.V271318.R01.S.doc Version 5.1 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): 8, 9 and 10. Residents are treated with respect and their privacy is protected in the home. Residents receive the health care support they require to maintain their health and well-being. EVIDENCE: Residents and care staff have developed positive relationships. Care staff treat residents with respect and call them by their preferred name. The atmosphere in the home is friendly and relaxed. Residents are comfortable with the care staff who support them. Care staff talk to residents as they carry out their duties. Residents said they like talking to the staff and that they “enjoy a good laugh” with them. Care staff take appropriate actions to ensure that residents’ privacy and dignity are maintained. Care staff take advice if they are concerned about a resident’s health. Residents receive health care from their own GPs, the local District Nursing team and specialist health care services as they need. The home has good procedures for handling medication which protect residents’ independence and well-being. The Laurels DS0000022640.V271318.R01.S.doc Version 5.1 Page 10 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): 14 and 15. Residents maintain control over their lives and the decisions they make are respected. Residents benefit from receiving a nutritious and varied diet which takes into account their dietary needs and personal preferences. EVIDENCE: Residents maintain control over their lives and make choices about how they spend their time in and away from the home. The decisions residents make are respected. Meals are varied and attractively presented and provide a nutritious diet. Residents choose their meals from a menu which is changed regularly. Residents choose whether to take their meals with other people or on their own. Advice is taken regarding residents’ nutritional needs and specialised diets and nutritional supplements are provided as individuals require. Residents said that additional choices are provided if they don’t like the meals offered by the menu. Menus are discussed at residents’ meetings and are changed in response to their comments. The Laurels DS0000022640.V271318.R01.S.doc Version 5.1 Page 11 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): 18. Service users are protected from abuse by robust procedures and staff knowledge and awareness. EVIDENCE: Care staff are knowledgeable about the home’s procedures for protecting service users from abuse. Clear procedures are followed to protect residents’ financial interests. Appropriate advice is taken if staff are concerned that a resident is at risk of harm. The home’s recruitment and disciplinary procedures ensure that care staff are suitable to work with residents and maintain their safety. The Laurels DS0000022640.V271318.R01.S.doc Version 5.1 Page 12 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, 20 and 26. Residents live in a pleasant, clean and safe environment which is suitable to meet their needs. EVIDENCE: The home is well maintained and is decorated to a high standard. Residents are provided with comfortable and pleasant accommodation to live in. Residents have their own possessions in their bedrooms and have personalised their accommodation as they wish. Residents said the accommodation provided is “very nice”. Residents choose whether to spend time with other people or on their own. The layout of the communal areas is suitable to allow a range of activities to be carried out at the same time. The owners have continued to invest in the premises to ensure the accommodation is of a high standard and suitable to meet residents’ needs. The home has a range of equipment to assist residents to stay independent including specialised equipment provided for individual residents. There are appropriate toilet and washing facilities close to all accommodation used by residents.
The Laurels DS0000022640.V271318.R01.S.doc Version 5.1 Page 13 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 and 28. Care staff are well trained and skilled and provide a high standard of care. EVIDENCE: Care staff receive a range of training to give them the skills and knowledge to meet residents’ needs. Specialist training is provided to ensure care staff have a thorough understanding of the needs of the residents and how best to support them. All care staff have achieved NVQ level 2 or above in care. Care staff are skilled and competent and provide a high standard of care. All staff in the home receive training to enable them to carry out their duties safely. The Laurels DS0000022640.V271318.R01.S.doc Version 5.1 Page 14 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, 32, 33 and 38. Residents benefit from living in a well managed home and their safety, rights and interests are protected. EVIDENCE: The home is well managed. Appropriate procedures are followed to protect residents’ rights and safety. The management team are committed to providing a high standard of care which meets residents’ needs. Residents and their families are comfortable raising concerns with the staff and manager. There are good systems in place for including residents in decisions about how the home is run. Residents are given choices and know they can maintain control over their lives and can affect how their care is provided. The Laurels DS0000022640.V271318.R01.S.doc Version 5.1 Page 15 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 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 3 X X X X X 3 STAFFING Standard No Score 27 4 28 4 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 4 X X X X 3 The Laurels DS0000022640.V271318.R01.S.doc Version 5.1 Page 16 Are there any outstanding requirements from the last inspection? Not applicable. 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 DS0000022640.V271318.R01.S.doc Version 5.1 Page 17 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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