Inspection on 25/04/06 for The Laurels

This inspection was carried out on 25th April 2006.

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 17/04/07

The Laurels 05/12/05

The Laurels 22/06/05

The Laurels 16/09/04

The Laurels 21/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE The Laurels 45 High Street Market Deeping Lincs PE6 8EB Lead Inspector Roger Harrison Key Unannounced Inspection 25th April 2006 09:30 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 DS0000002447.V287781.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 DS0000002447.V287781.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Laurels Address 45 High Street Market Deeping Lincs PE6 8EB 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) 01778 344414 Mr Desmond Micheal Shiels Mrs Jacque Sonia Shiels Mr Desmond Micheal Shiels Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places The Laurels DS0000002447.V287781.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: The Laurels is a grade II listed building originating from the early 1800’s. It is situated a quarter of a mile from the town centre of Market Deeping. The town has a range of facilities including shops, pubs and banks. On the ground floor there are six single and one shared bedroom and on the first floor there are eleven single and two shared bedrooms. There is a courtyard area to the side of the property with chairs and tables and a grassed area to the rear. The home is registered to provide accommodation for up to twenty-three older persons who need personal care however as one twin room is being used as a single the maximum occupancy is currently for twenty-two residents. This is a family run business, the owners working in the home on a daily basis. One has overall responsibility for care management within the home. Fees at the home on 25/04/06 Range from: £357.00 - £390.00 pw The Laurels DS0000002447.V287781.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Key inspection was undertaken using a review of all the information regarding all Inspection records and information provided by the Manager available to the Inspector about The Laurels, and through undertaking a visit to the home, with the inspector using a method of inspection called “case tracking”. This involved identifying three residents who currently live at the home and tracking the experience of the care and support they have received during the time they have lived at The Laurels. The inspection site visit was achieved by the inspector talking to the manager, touring the home, looking at information on care plans and files, talking to residents and care staff, and observing day-to-day care practice within the home. What the service does well: 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 DS0000002447.V287781.R01.S.doc Version 5.1 Page 6 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 DS0000002447.V287781.R01.S.doc Version 5.1 Page 7 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. [Standard 6 does not apply]. Resident’s needs are assessed prior to any admission taking place and clear information is provided for all residents to ensure a full understanding of the way that care will be provided. Trial periods of care are used to confirm that all physical and social care needs can be met. EVIDENCE: Three residents confirmed that they were included in making an informed choice to move in to the home, and one family carer said “The Manager came out to see Mum before she moved here to assess whether she could come”. Records show that assessments take place prior to admission and service users have access to the service users guide and statement of purpose, which have recently been updated further and put together in one place by the Manager to make them easy to read and understand. The manager confirmed that all service users were given a copy of the homes terms and conditions to read on admission to the home and that the home uses a trial/introductory period for all new residents, which is used to carry out a further assessment of need within their new enviroment. This is used to confirm whether the home is able to meet the long-term needs of each resident. Since the last Inspection the The Laurels DS0000002447.V287781.R01.S.doc Version 5.1 Page 8 Manager has taken action to ensure that residents photographs are available with care plan information for each individual. The Laurels DS0000002447.V287781.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): 7,8,9 and 10. Residents are treated with respect; their health needs supported and are protected by the homes policy and procedures for supporting them with medication. Care plans are in place, which need to be organised so that they show how needs are being met for each individual and that reviews are consistently recorded and maintained to show clear outcomes. EVIDENCE: During this Inspection visit three staff members and the Manager told the Inspector that Care plans are developed by the care team and are reviewed with residents to ensure action is taken to address any changes to need. Two residents told the inspector that they receive good physical and social support. One resident said “I know I have a care plan and they look at my needs every day”. Care plan and risk assessment information looked at by the Inspector showed information to confirm that some progress has been made since the last Inspection to demonstrate that reviews of care plans are undertaken. However, the information about each resident was not set out in a structured way, or recorded in enough detail, which made it difficult to get a good understanding of how all needs are being met and reviewed. All residents are encouraged to self medicate wherever possible. On the day of the Inspection visit all residents needed some level of support with medicines. Medicines are The Laurels DS0000002447.V287781.R01.S.doc Version 5.1 Page 10 kept in a locked, wall mounted and mobile cabinet in a locked room. Trained staff take responsibility for handling and administering medication and activity observed during the inspection demonstrated consistency in practice. Residents told the inspector that medicines are kept and given on their behalf with one resident saying “They look after my medicine and make sure I get it at the time I need it”. On the day of inspection medication record systems were up to date and signed appropriately, to confirm that all residents are receiving medication as prescribed. The Laurels DS0000002447.V287781.R01.S.doc Version 5.1 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): 12,13,14 and 15. The manager and care team support the right for residents to maintain control over their lives through encouraging family and community contact. Food in the home is varied and of high quality offering a wholesome diet for residents. EVIDENCE: Comments from residents and observations made on the day of the Inspection visit indicated choices are given at all times. During a meeting between the Inspector and eight residents comments received included; “This is a lovely place with lovely staff both day and night” and “It feels like home to me, the food is good, I go to church each week and the hairdresser comes here for all of us or individually as we wish”. Residents described activities including singing using the home piano, games and visits from outside entertainers. Residents and their family carers were coming and going as they pleased within the home throughout this visit and two family members told the Inspector that they are happy with the support provided by the care team. Resident’s rooms have safety locks, which can be easily used whilst respecting privacy. Care records checked contained information showing dietary requirements and the equipment used to assist residents with their dietary needs. Guidelines and information is in place for staff to refer to when handling or preparing meals. A staff member spoken to had a good knowledge of the dietary needs and preferences of the residents asked about and indicated that drinks and snacks are available on request outside of mealtimes. The Laurels DS0000002447.V287781.R01.S.doc Version 5.1 Page 12 The Laurels DS0000002447.V287781.R01.S.doc Version 5.1 Page 13 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 and 18. There are satisfactory procedures in relation to complaints and adult protection matters to ensure residents are protected. EVIDENCE: Neither the home nor the CSCI have received any concerns about the service since the last two inspections. Relatives confirmed that they were aware of the complaints procedure and had received a copy of it and had had it explained to them. They knew that they could contact the home owners at any time if they had any concerns. They also said that they felt able to approach staff at any time and had been told to raise any suggestions or concerns they may have. Residents spoken to all said that they would feel comfortable to talk to staff if they had any problems and knew who was in charge. During the Inspection the Manager showed the Inspector a copy of the revised local authority adult protection procedures and three staff members told the Inspector that if any concerns were raised regarding adult protection they would report to the Manager immediately. No adult protection matters have been raised. The Laurels DS0000002447.V287781.R01.S.doc Version 5.1 Page 14 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 and 26. A comfortable, clean and well-maintained environment is provided for residents. EVIDENCE: During this Inspection the Manager sought permission from residents to enable the Inspector to view rooms, and communal living areas either with them or with the Manager. These were observed to be clean and well maintained throughout. Residents told the Inspector that they had been well supported to personalise their rooms with comments received confirming that; “ I love my room, I could bring anything here that I wanted to” and “Its as near to my own home as I can make it”. Since the last Inspection the Managers have purchased a new, fully equipped bath for the downstairs bathroom and have upgraded the homes lift to support the safety of all residents. Work has also been undertaken to ensure safe access for all residents to exit the home, with clear signs showing where to go in the event of a fire. The home-owners have informed the Fire department of the action they have taken to improve safety at the home. The Laurels DS0000002447.V287781.R01.S.doc Version 5.1 Page 15 The Laurels DS0000002447.V287781.R01.S.doc Version 5.1 Page 16 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): 27,28,29 and 30. There is an appropriate mix of skilled trained staff in adequate numbers to meet the needs of residents. The manager ensures that staff are recruited safely and that all checks are made to ensure the safety and protection of residents. EVIDENCE: During this Inspection visit discussions between three staff members, the Manager and a member of the local G.P. Practice nursing team confirmed that there is a consistent staff team in place with few staff changes, which ensures that staff work as a team and know the social and physical needs of all residents well. Daily records and separate notes are used for residents with higher needs to make sure communication across staff shifts is maintained. A visiting nurse told the Inspector that “We work as a team here. If there are any needs that the care team have difficulty meeting we review this together and the nurse team provide support”. Since the Last Inspection the Manager confirmed she had updated all staff files to make sure proof is in place that the right checks are made when recruiting new team members. Three staff members described the process of Induction and showed the Inspector a checklist to be used for a new staff member. The staff team also described training received, which was also detailed in a pre Inspection report provided by the Manager, and that seven staff members had been supported to undertake NVQ qualifications. The Laurels DS0000002447.V287781.R01.S.doc Version 5.1 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): 31,33,35 and 38. There is an established competent Manager in place who takes her responsibilities seriously. Resident’s needs are at the centre of practice within the home, with the Manager and staff undertaking daily consultation which helps to promote the overall health, safety and independence of residents. EVIDENCE: Mrs Shiels is the registered Manager but The Homes owners support each other actively in the day-to-day “hands on” management of the home. This helps provide a consistent basis for maintaining the environment, supporting staff and taking time to listen to the needs of residents. A group of residents told the Inspector that both owners are present nearly everyday, are always on call, and that they meet regularly with them in the communal area to discuss their needs. The Manager confirmed that questionnaires provided by the Commission had been given out to all residents and they encouraged feedback. Five residents and three staff members told the Inspector that they trusted the Manager and that they felt supported to raise any issue direct. The manager The Laurels DS0000002447.V287781.R01.S.doc Version 5.1 Page 18 highlighted that they do not manage resident’s finances and always encourage and support individuals and their families to do this. Since the last Inspection the Manager has taken action to further promote residents safety by replacing and refurbishing a main bathing area and through the levelling and landscaping the rear garden to enable easier access and use. The Laurels DS0000002447.V287781.R01.S.doc Version 5.1 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 X X 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 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The Laurels DS0000002447.V287781.R01.S.doc Version 5.1 Page 20 YES. 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. 1. Standard OP7 Regulation 13(4)c 14(2) 15(1)2 Requirement It is required that care plans are structured to clearly identify each service users needs and demonstrate how these are met. All care plan information must be reviewed at least once each month. Service users and their representatives (where appropriate) must be involved in the devising of care plans where possible. [This requirement was made on 05/12/05. Some progress has been made but further work is required]. Timescale for action 28/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Laurels DS0000002447.V287781.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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. Extracts may not be used or reproduced without the express permission of CSCI The Laurels DS0000002447.V287781.R01.S.doc Version 5.1 Page 22 - 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!