Inspection on 28/02/07 for The Laurels

This inspection was carried out on 28th 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 06/11/07

The Laurels 23/03/06

The Laurels 06/07/05

The Laurels 07/10/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Clover House

Langrigg House

Parkside

Dystlegh Grange

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

CARE HOMES FOR OLDER PEOPLE The Laurels 10 Norfolk Road Carlisle Cumbria CA2 5PQ Lead Inspector Jacqueline Southern-Leigh Unannounced Inspection 28th February 2007 10:50 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.V325069.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 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.V325069.R01.S.doc Version 5.2 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 29 Category(ies) of Dementia - over 65 years of age (8), Learning registration, with number disability over 65 years of age (3), Old age, not of places falling within any other category (18) The Laurels DS0000022640.V325069.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 29 service users to include: up to 18 service users in the category of OP (Older people, not falling within any other category) up to 3 service users in the category of LD(E) (Learning disability over the age of 65 years of age) up to 8 service users in the category of DE(E) (Dementia over the age of 65 years of age) 23rd March 2006 Date of last inspection 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-nine 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 two double bedrooms available for people who wish to share. All of the bedrooms have en-suite 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. Current Fees for the home are £385 to £452 per week. The Laurels DS0000022640.V325069.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced Key Inspection starting at 10.50am and finishing at 2.25pm on 28th February, it was necessary to return to the home on the following day as the Manager was not present during the main inspection. The inspection included a tour of the premises, meeting with residents and staff and looking at the homes policies and procedures. Information was also gathered prior to the inspection in the form of a PreInspection Questionnaire that was completed by the home and questionnaires that were completed by residents and their relatives. 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 summary of this inspection report can be made available in other formats on request. The Laurels DS0000022640.V325069.R01.S.doc Version 5.2 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 DS0000022640.V325069.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures that it can meet the needs of prospective residents and provides them with relevant information regarding the home. EVIDENCE: The Laurels has a comprehensive guide which is given to all prospective residents that explains the services and facilities available at the home. A copy of the homes Statement of Purpose is kept in the reception area. All residents are assessed prior to admission by the manager, either in the potential residents home or in hospital. The manager uses an assessment form devised by the home called the Daily Living Plan, the care plans are then completed by the manager following this assessment. On the day of admission Care staff complete an additional sheet with personal preferences and other relevant information. The care plans are also assessments of risk for the different activities of daily living. Each resident has an initial six-week probationary period where they have a chance to see if the home is the right environment for them, this also gives The Laurels DS0000022640.V325069.R01.S.doc Version 5.2 Page 8 the home the opportunity to see if the resident settle at the home and to ensure the home can meet the residents needs. All residents receive a written contract, this is in the process of being updated. Residents are also issued with a private furnishing agreement which describes the furniture available in the room and the requirements necessary for residents to bring their own furniture into the home. Potential residents and their families are able to visit the home and look at any available rooms prior to admission. The home does not offer intermediate care. The Laurels DS0000022640.V325069.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 & 11 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 reasonable assessment procedure that meets the needs of the service users and ensures that health, personal and social care is maintained. EVIDENCE: All residents have an assessment of needs which includes health, personal and social care needs, these assessments are set out in a plan of care for each individual resident. The plans are fairly basic but they contain the essential information. From the information contained in the plans of care, up-date records and talking to the residents the health care needs of the residents are currently being met. The home has policies and procedures in place for the safe administration, storage and disposal of medication. Medication charts and drugs checked on the day were found to be correct, there was one recording error found on the chart but the Senior Carer on duty was able to resolve the problem on the day of inspection. Only adequately trained staff are able to administer medication. There are currently no residents administering their own medication. The Laurels DS0000022640.V325069.R01.S.doc Version 5.2 Page 10 Residents feel that they are treated with kindness and respect, one resident told me that ‘the staff treat us very well, they are always kind’. The questionnaires returned by the residents were all positive regarding the care and support they receive and staff listening to their opinions. The Laurels DS0000022640.V325069.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home supports the residents to maintain a balanced lifestyle with options for choice. EVIDENCE: The home provides regular and varied activities for the residents, some residents choose to attend the majority of the sessions while others pick specific activities to take part in. Activities take place from 1.30 until 4.00pm on most days, some activities are pre-planned around the holidays such as Valentines, Easter and Christmas, others are based around the residents preferences such as quiz’s, word puzzles and music session. Relatives and visitors are encouraged to attend special events throughout the year. Last year the residents raised money to purchase a large screen for the second lounge area, the home shows DVD’s on the screen, there are also lap tops available for the residents use, they are able to email relatives and display photographs on the screen via the lap tops. Visitors are welcome at the home, there are no restrictions, one resident told me that her visitors are made welcome and are given refreshments when they visit. The home organises visits when ever possible to local attractions. The Laurels DS0000022640.V325069.R01.S.doc Version 5.2 Page 12 All residents now have breakfast served in their rooms, lunch and evening meals are generally served in the dining room, however residents can choose to have these meals in their rooms as well. There is a choice offered at each meal time, at lunch time there is also a sweet trolley that serves at least five different home-made desserts. The meal served on the day of inspection looked appetising and was well presented, one resident told me ‘the food here is wonderful, no one could have any complaints, it is good wholesome, fresh food’. The Laurels DS0000022640.V325069.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 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 robust complaints process that protects the rights of the residents. EVIDENCE: The home has a complaints procedure in place, all residents are given an individual copy on admission to the home. The home has not provided specific Protection for Vulnerable Adults training, however a high percentage of the staff have undertaken National Vocational Qualifications in care which include sections on safeguarding and protecting vulnerable people. The manager also reported that she talks to all staff on induction about aspects of restraint and issues of choice for the residents. There have been no formal complaints since the last inspection. The Laurels DS0000022640.V325069.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment of the home is clean, warm and safe, it meets the needs of its residents. EVIDENCE: The Laurels is a large converted property, there twenty-five single bedrooms all with en-suite toilets and sinks, there are also two double bedrooms with ensuite facilities, one is currently in use as a single room. Four bedrooms now have new en-suite showers, there are plans to increase the number of bedrooms with showers in the future. The home has two bathrooms with hoists available for the use of residents. There are other hoists available around the home. The home has a lift for access to the first floor and there is a stair lift on some sections of the stairs. The rooms are all nicely decorated, the home provides nice fitted wardrobes and beds, residents can in consultation with the manager bring in their own furniture and they are able to personalise their own bedrooms. The Laurels DS0000022640.V325069.R01.S.doc Version 5.2 Page 15 The are two main communal areas and a smaller private room that can be used by residents, these areas are all nicely decorated and appropriate for use. There are no telephones in the rooms and no public telephone, the senior carers on duty now carry phones that the residents can use in private, residents can also access emails via lap tops provided for residents use. Home has a mini-bus which is used to take residents on trips, the owners mother has a large garden that is used in the summer to provide afternoon tea for the residents. There is a small patio area that can be used in the summer, but it only has one table and chairs. The home is clean and tidy, there were no unpleasant odours around the home. The Laurels DS0000022640.V325069.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A staff team that has been recruited, inducted and trained adequately to give a good standard of care meets the service users needs. EVIDENCE: Care Staff currently employed at the home are expected to undertake a wide range of duties as well as providing personal and health care for the residents. The care assistants are responsible for all the activities sessions each afternoon, this is a role that brings the staff and residents together and allows the staff to get to know the residents in a social setting, this role enhances the overall care given by the staff. However, the care staff are also responsible for doing all the laundry in the home and for certain elements of cleaning the residents bedrooms and bathrooms. The kitchen staff finish at 3.00pm each day, the care staff then take over in the kitchen re-heating and serving the evening meal for all the residents and cleaning the kitchen afterwards. It was noted from the Pre-Inspection Questionnaire completed by the manager that 26 staff have left the home since March 2006, based on the current staffing levels this is over 100 staff turnover and raises serious concerns regarding why care staff are leaving the home. The manager is unsure why the home has experienced such a high turnover of staff over the last year. Staff files were checked, recruitment policies and processes are in place and these were seen to be followed in the files. All new staff follow an induction The Laurels DS0000022640.V325069.R01.S.doc Version 5.2 Page 17 programme called Skills for Care, this is used as part of the National Vocational Qualifications (NVQ) in care. The manger is very keen to get all care staff to undertake NVQ training, this support was confirmed by the staff on duty. Currently 60 of the staff have an NVQ in care at level 2 or above. Statutory training for staff in areas such as fire safety, manual handling, first aid and risk assessments is up-to-date. The Laurels DS0000022640.V325069.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,34,35,36,37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home safeguards the rights and best interests of the residents. EVIDENCE: The Registered Manager of the home is Kathreen Burns she is also a Registered Nurse and an Assessor for National Vocational Qualification (NVQ). Ms Burns has managed the home for the last four years. The home has regular residents meeting usually held every month, this gives the residents an opportunity to discuss all aspects of the home with the manager and staff, there are minutes taken and all residents are given a copy. The home also produces a newsletter, the aim is to produce this every quarter, it has lots of photographs of events that have taken place at the home as well as up-dates on staff achievements and other information the residents may find interesting. The Laurels DS0000022640.V325069.R01.S.doc Version 5.2 Page 19 The home does not handle the financial interests of any of the residents, there is an appropriate system in place for dealing with the small amounts of cash that residents keep at the home. All bedrooms have a safe available for the residents use. The staff receive regular supervision from the manager, this is recorded in their personal files. New staff undertake an induction programme, which is overseen by the manager, they will then work with senior staff until they are deemed as competent and safe to work with the residents independently. The home has a polices and procedures file that covers all aspects of the safe and efficient running of the home, this includes Health and Safety, the polices are up-dated on a regular basis. The service contracts for the home are up-todate. The Laurels DS0000022640.V325069.R01.S.doc Version 5.2 Page 20 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 3 3 3 3 The Laurels DS0000022640.V325069.R01.S.doc Version 5.2 Page 21 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. 1 Refer to Standard OP27 Good Practice Recommendations The Registered Manager should review the numbers and job content of Care Assistants to ensure the residents receive a good level of care and support. The Laurels DS0000022640.V325069.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 DS0000022640.V325069.R01.S.doc Version 5.2 Page 23 - 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!