Inspection on 30/11/05 for The Laurels

This inspection was carried out on 30th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Laurels 19/03/09

The Laurels 13/08/08

The Laurels 22/06/07

The Laurels 26/07/06

The Laurels 21/07/05

The Laurels 10/11/04

The Laurels 17/09/04

The Laurels 10/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Laurels (The) 130/134 Church End Lane Runwell Wickford Essex SS11 7DP Lead Inspector Ray Burwood Unannounced Inspection 30th November 2005 10:00 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 Laurels (The) DS0000018035.V270014.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Laurels (The) DS0000018035.V270014.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Laurels (The) Address 130/134 Church End Lane Runwell Wickford Essex SS11 7DP 01268 764105 01268 450909 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) The Laurels Limited - Roger Green & Co Care Home 22 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (22) of places Laurels (The) DS0000018035.V270014.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st July 2005 Brief Description of the Service: The Laurels is registered for the accommodation and care of twenty-two older people over the age of 65, who may have a range of care needs. One double room is provided and there are some en-suite facilities provided. The home provides a comfortable lounge area with a large adjoining conservatory. Further facilities include a dining/sitting room and a small television room that can also be used to provide a private area for service users and visitors. Bathrooms and toilet facilities are provided throughout the home in sufficient numbers. A passenger lift accesses the first floor. The home is nicely furnished and decorated. At the rear of the home there is a well-designed and stocked garden providing adequate seating. The home is located within a short distance of Wickford town centre on bus and train routes. There is off road parking facilities to the front of the home. Laurels (The) DS0000018035.V270014.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on the 30th November 2005 with the assistance of the Acting Manager, service users, and staff working in the home. The inspection took five hours to complete with a total of ten standards inspected. Seven standards were met, two were partially met and one standard was not met. This particular standard (Recruitment) gave rise to an Immediate Requirement Notice being issued to the Provider/Manager. Time was spent looking around the premises, and the examination of service users’ and staff records. Interviews took place with service users and staffs’ views of the home heard. The home provides a comfortable environment that is maintained to a high standard and a good quality of care offered. On the day of the inspection, service users were complimentary about the home and the staff who supported them. During the inspection, concerns were raised with the Acting Manager and the Responsible Individual/Registered Manager that a breach of the home’s registration conditions under Section 24 of the Care Standards Act 2000 may have taken place. This will be dealt with separate to the inspection. What the service does well: What has improved since the last inspection? Care planning documentation has been updated and includes individual profiles for each service user to enable quicker access to essential information for new staff or agency staff. Laurels (The) DS0000018035.V270014.R01.S.doc Version 5.0 Page 6 Since the last inspection a new conservatory has been added to the home’s communal areas and provides additional space for service users to use. Further developments are underway to improve bathing facilities, and redecorating and refurbishment continues around the home. Records in relation to the servicing and certification of equipment have been updated and now comply with regulations. 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. Laurels (The) DS0000018035.V270014.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Laurels (The) DS0000018035.V270014.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6. EVIDENCE: The home does not offer intermediate care. All key standards and other standards relating to Choice Of Home were inspected at the previous inspection 21/07/05. Laurels (The) DS0000018035.V270014.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,9 and 10. Service users’ care plans are comprehensively detailed and give clear evidence of their needs and wishes. The home must endeavour to pursue GP’s regarding the correct dosage instructions on prescriptions and ensure dates of opening are maintained on liquid medication bottles. EVIDENCE: The home’s care planning documentation has been updated, with some service users’ contributions, to include individual profiles that focus on essential information for new members of staff, or agency workers. Care plans sampled contained comprehensive information in terms of risk assessments and the recording of daily activities. The home’s medication system was inspected and medicines found to be correctly administered with records in place, however, some medication was being received into the home with the required dosages being prescribed “ as and when required “ (PRN). The Care Manager evidenced correspondence she had included in medicine requests to General Practitioners highlighting the Laurels (The) DS0000018035.V270014.R01.S.doc Version 5.0 Page 10 need to have the correct dosage information to the pharmacist. Some bottles of liquid medication remain unmarked regarding the date of opening. From discussions with service users and observations made during the inspection, the standard of care, the dignity and respect shown by staff towards service users, was of a high standard. Two service users who have chosen to share the home’s double room are able to maintain their privacy through the provision of screens. Laurels (The) DS0000018035.V270014.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14. The home encourages service users to exercise choice and control over their lives through the promotion of independence within a risk assessment framework. EVIDENCE: Relatives of service users handle their financial affairs and arrangements with small amounts of personal allowances administered by the home. Records and receipts were seen to be correct. The Care Manager confirmed that a few of the service users are able to look after their own personal allowances, and have lockable cupboards in which to keep them secure. Access to advocacy services is available to service users who may wish to have independent advice or representation. Service users’ bedrooms seen during the inspection, contained a range of furniture, audio and visual equipment that they have brought into the home. An inventory of personal possessions is kept in service users’ files. Laurels (The) DS0000018035.V270014.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The above key standards were inspected at the home’s previous inspection on the 21/07/05 and were met. EVIDENCE: Laurels (The) DS0000018035.V270014.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 20. A comfortable, safe, and well-maintained environment is provided, to meet the different needs and lifestyles of individual service users. EVIDENCE: The home is well maintained and is suited to service users’ needs and expectations. It is decorated and furnished to a high standard that creates a comfortable and homely atmosphere. A programme of redecoration and refurbishment is ongoing with more recent work being completed on the new conservatory adjoining the lounge. Double patio doors open to a ramp to allow wheelchair access to the large garden area that provides a range of seating areas, a bird aviary and storage for garden furniture and gardening equipment. Further facilities include a dining/sitting room and a small television room that can also be used to provide a private area for service users and visitors. Laurels (The) DS0000018035.V270014.R01.S.doc Version 5.0 Page 14 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): 29. The home’s standard of vetting and recruitment practices does not ensure that appropriate checks are carried out, potentially leaving the service users at risk. EVIDENCE: The files of three members of staff were sampled and inspected and found not to contain essential information regarding checks on candidates applying to work in the home. Of the three files inspected only one had the required information. One file did not contain a POVA 1st check or a CRB Disclosure and only had one reference. The Care Manager explained that checks had been applied for through their umbrella body some time ago. The second file had one reference. The Registered Person was given an Immediate Requirement Notice, followed up on the 1st December 2005 by a letter confirming the breach of regulation. Laurels (The) DS0000018035.V270014.R01.S.doc Version 5.0 Page 15 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): 33, 35 and 38. The home is run in the best interests of service users, however, the further development of a quality assurance system could help to provide better outcomes for service users. The financial interests of service users are protected through a rigorous system of checks and record keeping. The health and safety of service users and staff is maintained through regular workplace safety checks and the servicing of equipment. EVIDENCE: The Acting Manager confirmed that the home’s Quality Assurance system was in its early stages of development. Some questionnaires have been circulated to service users and their families. Further development is required to seek the views of other stakeholders who support the home professionally or individuals who visit service users, in order to produce a report of the findings. Ideas were Laurels (The) DS0000018035.V270014.R01.S.doc Version 5.0 Page 16 discussed with the Acting Manager on how a report may be produced following, the information gathering process. Service users’ financial arrangements are dealt with by their families, or if this is not possible, by their representatives. Small amounts of personal allowances are handled by the home if the service user does not wish to. A small number of service users do look after their own personal allowances and are provided with lockable facilities. Receipts and records of transactions were inspected and found to be correct. Small amounts of cash were kept in a secure manner. Safety certificates for the home’s electrical installations, gas boiler and portable appliance testing were up to date. Safety checks in relation to fire protection in the home is carried out weekly/monthly and records maintained. Laurels (The) DS0000018035.V270014.R01.S.doc Version 5.0 Page 17 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 3 X X X X X X STAFFING Standard No Score 27 X 28 X 29 1 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 X X 3 Laurels (The) DS0000018035.V270014.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? YES 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 OP9OP9 Regulation 13 (2) Requirement Timescale for action 31/01/06 2 OP29OP29 3 OP33OP33 The registered person must ensure that bottles of medication are marked with the opening date, and medication is suitably prescribed by the G.P. (Previous timescale of 31/07/05 not met) 19 (1)(b) The registered person must not employ a person to work in the home until the appropriate checks have been carried out. 24 1(a)(b) The registered person must 2, 3. ensure that there is a system in place to monitor the quality of care. (Previous timescale of 31/07/05 not met). 01/12/05 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Laurels (The) DS0000018035.V270014.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Laurels (The) DS0000018035.V270014.R01.S.doc Version 5.0 Page 20 - 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!