Inspection on 06/02/06 for The Laurels

This inspection was carried out on 6th February 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 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 31/07/09

The Laurels 01/12/08

The Laurels 27/12/07

The Laurels 15/11/06

The Laurels 16/08/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE The Laurels West Carr Road Attleborough Norfolk NR17 1AA Lead Inspector Ann Catterick Unannounced Inspection 6th February 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 DS0000064440.V272656.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 DS0000064440.V272656.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Laurels Address West Carr Road Attleborough Norfolk NR17 1AA 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) 01603 307900 Goodwood Care Homes Ltd Mr Ian Richard Gooderham Position Vacant Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39), Physical disability (39) of places The Laurels DS0000064440.V272656.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Adults 50 years and over including physical disability. Date of last inspection 16th August 2005 Brief Description of the Service: The Laurels is a single storey building that is registered as a residential home for up to thirty-nine service users providing care to elderly people not falling into any other category and to people over fifty years of age with physical disabilities. It provides accommodation in the form of thirty-three single bedrooms and three shared rooms. None of the rooms has en-suite facilities and there are four bathrooms, one shower and eleven toilets available to service users. The home does not provide nursing care for service users and health care is by access to community resources. A chiropodist and dentist visit the home as required and a hairdresser visits weekly, for which charges may be made as appropriate. Personal care needs are attended to with assistance as required, although the home states that service users are encouraged to be as independent as possible. Fees include accommodation, furnishings, care and laundry. The Laurels DS0000064440.V272656.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the 6th of February and lasted for 8 hours. The inspector was able to speak with the Proprietor, manager, staff and service users as well as have a tour of the building and look at records and files. Some information was gained from 11 comment cards received by CSCI from service users and a pre inspection questionnaire completed by the manager. All comment cards were positive about the staff, care and food. Two comments were made suggesting there could be more activities in the home. All of those service users spoken to were positive about the care they received and the overall quality of the service provided was good. What the service does well: What has improved since the last inspection? Since the last inspection there have been considerable improvements to the environment. The hallways have been decorated with attractive prints bought for the walls. The hairdressing room has been decorated and is now an attractive place for service users to sit and have their hair done. There have been new carpets in some bedrooms and new bedroom furniture has been provided. The home was clean and tidy with no offensive odours. The improvements to the environment are very positive. Chemicals are now stored safely and corridors that service users use are free from hazards. Radiators are not yet covered but these had been ordered and the first of these were to be fitted the week after the inspection. The Laurels DS0000064440.V272656.R01.S.doc Version 5.1 Page 6 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 DS0000064440.V272656.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 DS0000064440.V272656.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): None of these standards were inspected on this occasion. EVIDENCE: The Laurels DS0000064440.V272656.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 and 9 All service users have a care plan that identifies how their personal and health care needs can be met. The home has a policy and procedures that ensure safe practice with regard all aspects of the administration and care of medicines. EVIDENCE: There were no photographs on care plans. Much of the information needed was included but this could be more detailed. For example the care plan may say that the service user needs glasses but does not identify whether they need glasses for distance or reading. One care plan identified that a service user had a rash that was caused by continence pads but did not identify how this could be resolved. A service user was identified as diabetic with a weight chart in the care plan but no weight had been recorded. The home has a policy and procedure for the care of medicines. On the day of inspection the administration of medication was observed and good practice The Laurels DS0000064440.V272656.R01.S.doc Version 5.1 Page 10 took place. The storage, receipt, disposal and recordings and administration of medication were all in good order and those staff that administered medication had received the appropriate training. The Laurels DS0000064440.V272656.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, 14 and 15 The lifestyle experienced within the home appeared to meet the expectations and preferences of service users. Staff within the home encourage service users to exercise choice and control over their own lives. Service users have a good choice and variety at breakfast and lunch times. The menu at teatime was limited. EVIDENCE: Those service users spoken to were very positive about their life experiences within the home. They are able to rise and retire when they chose. Some service users spent most of the time in their rooms whereas other used the communal facilities. Service users made the comment that if they needed staff and rang their call bell this was responded to very quickly. An activity person had been appointed to spend some dedicated time with service users spending one to one time with them or getting involved in other group activities. Some service users felt that there could be more opportunities for activities within the home. The proprietor is planning to increase the hours of the activity The Laurels DS0000064440.V272656.R01.S.doc Version 5.1 Page 12 person. The manager had identified some service users preferred hobbies and was aiming to encourage them to pursue these within the home. Staff encourage service users to be as able and independent as they can be given them as many choices and opportunities as possible. Generally service users spoke very positively about meal times. The dining area is large and spacious offering a pleasant area to eat you meal. A menu board has been placed on the wall in the dining area to inform service users of what the meal is for that day. The teatime menu was unadventurous offering few hot teas with sandwiches being the main option for most days. A recommendation has been made in this area. The Laurels DS0000064440.V272656.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 The home has a complaints procedure that service users and relatives are made aware of. The service users are protected by the homes policy and procedures relating to adult protection although they need to be updated to include information relating to local procedures. EVIDENCE: The complaints procedure with details of the CSCI was seen displayed on the wall at the front of the home. This is also within the Service Users Guide. There had been five complaints in the last 12 months and these were dealt with appropriately. There have been no complaints since the new proprietor has been in post. The home has a policy and procedures for the protection of vulnerable adults but this is outdated and needs to be revised. It did not include up to date definitions of abuse or the information relating to local policies and procedures. A requirement has been made in this area. Training in the area of adult protection was planned for the near future. Those staff spoken to were clear that if they had any concerns about the way service users were treated they would go to the manager and/or the proprietor. The Laurels DS0000064440.V272656.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 Service users live in a safe, well -maintained environment and there have been several improvements since the last inspection. The home was clean and hygienic free from any offensive odours. EVIDENCE: The manger has an inspection and risk assessment file that includes all information relating to the maintenance and repair of the building. There is a diary for all staff to use to report any fault or repair. This was seen as good practice as the fabric and condition of the building, and it’s content, were continually monitored. Several improvements have been made since the last inspection and these include decoration and re carpeting of corridors, new carpets in some of the bedrooms, new bedroom furniture and improved front door security. The hairdressing room has been redecorated and new pictures and prints have been placed on the walls. The Laurels DS0000064440.V272656.R01.S.doc Version 5.1 Page 15 The home was clean and tidy with corridors uncluttered. The home was free from any offensive odours. The Laurels DS0000064440.V272656.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): 30 The staff working in the home are encouraged to complete training to ensure that they are competent in their role and able to meet the needs of service users. EVIDENCE: 52 of staff have achieved NVQ the training they received within spoke very positively about staff their jobs. Training profiles need has been made in this area. level 2 or above. Staff spoke positively about the home. Those service users spoken to saying that they were caring and good at to be developed for staff. A recommendation The Laurels DS0000064440.V272656.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 The manager in post is experienced and has made application to become the registered manager. Service users are consulted about the service they receive but the home has not yet developed a system of recording and publishing this information. Service users finances are safeguarded within the home and the home has minimal involvement with service users’ money. The health and safety of service users is promoted and protected with ongoing work in this area continuing. The Laurels DS0000064440.V272656.R01.S.doc Version 5.1 Page 18 EVIDENCE: The manager was the Register Manager in another home prior to this position and has completed her Registered Manager award. She has made application to become the Registered Manager of the Laurels. She has experience and knowledge in working with older persons. The home collates some information with regard the quality of the service but this is yet to be collated in any way that could enable it to be used as a working tool for improvement or for the findings to be published. A requirement has been made in this area. The home has minimum involvement with service users finances. Service users and/or their family or advocates are encouraged to take responsibility for this. All service users have a lockable facility in their bedroom to keep money safe although they are not encouraged to have large amounts. If service users have their hair done or see the chiropodist the home pays and then invoices the service user if they do not have the money to pay for it. Small amounts money for one or two service users are kept in a locked cupboard and any transactions are recorded with receipts and counter signatures. Staff receive induction and foundation training and staff complete all mandatory training. All senior staff are first aiders. Since the last inspection the manager has ensured that chemicals are stored safely. Staff have been advised of good practice in this area. COSHH posters were displayed in the home. All hot water outlets now have a water temperature regulator. Radiator cover have been ordered and those that offer most risk to service users are being covered first. These were due to be done the week following the inspection. The home has addressed some of the issues of where items are stored and corridors that service users had access to were free from hazards. The home was safe and secure on the day of inspection and improvement has been made to the entrance area. The Laurels DS0000064440.V272656.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 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 3 x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x x 2 The Laurels DS0000064440.V272656.R01.S.doc Version 5.1 Page 20 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 OP18 Regulation 13 (6) Requirement The Registered Provider must ensure that the policy and procedure relating to the protection of vulnerable adults reflects current practice. The Registered Provider must ensure that there is a system within the home for reviewing and improving the quality of the service provided. The registered provider must ensure that all radiators are covered or of low temperature surfaces or have been assessed as being of no risk to service users. Some progress has been made in this area. Timescale for action 01/04/06 2. OP33 24 01/04/06 3 OP38 13 (4) c 01/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations That it would be good practice to review and improve the DS0000064440.V272656.R01.S.doc Version 5.1 Page 21 The Laurels 2 3 4 OP10 OP15 OP30 format of care planning to include more detail. That it would be good practice to review the policy of leaving bedroom doors open when service users are not in them. That it would be good practice to review the teatime menu to include more variety and hot options. That it would be good practice to develop training profiles for all staff. The Laurels DS0000064440.V272656.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 DS0000064440.V272656.R01.S.doc Version 5.1 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. 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