Inspection on 08/05/07 for The Laurels

This inspection was carried out on 8th May 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 27/05/08

The Laurels 31/08/06

The Laurels 07/12/05

The Laurels 01/08/05

The Laurels 27/10/04

The Laurels 16/08/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE The Laurels Bull Lane South Kirkby West Yorks WF9 3QD Lead Inspector Stephen French Key Unannounced Inspection 8th May 2007 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Laurels DS0000006194.V333412.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 DS0000006194.V333412.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Laurels Address Bull Lane South Kirkby West Yorks WF9 3QD 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) 01977 640721 01977 640721 Superior Care Homes Limited Mrs Jessie Stringer Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places The Laurels DS0000006194.V333412.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st August 2006 Brief Description of the Service: The Laurels is a care home providing personal care and accommodation for 28 older people. It is owned by Superior Care Homes Ltd a privately owned limited company. The home is situated close to the centre of South Kirkby, a small former mining community. The home was a former vicarage that has been adapted and extended. People’s accommodation is arranged on two floors and there is a passenger lift. There are twenty bedrooms for single occupancy of which one has en-suite facilities. There are four bedrooms designed for shared occupancy of no more that 2 people. The home, which is close to local amenities, has a car park to the front and gardens and a patio area to the rear. As of the 8th May 2007 fees at the home were £359 in line with Wakefield Metropolitan District Council. People are responsible for paying for such things as hairdressing, newspapers and selected social activities. The home has a service user guide that provides information about their service for current and prospective residents. A copy of this guide is provided to all prospective admissions to the home by the management of the home along with a copy of the most recent inspection report. The Laurels DS0000006194.V333412.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 visit carried out on the 8th May 2007. The inspector arrived at the home at 9:00 am and left 4:00pm. During this visit the inspector spoke to some of the people living in the home, their relatives, some of the staff and the home’s management team. The inspector read some care records, audited a sample of medication, reviewed staff recruitment and training records and carried out a brief tour of the building. Prior to the visit 28 questionnaires were sent to the home to obtain people’s views about living at the home. Ten completed questionnaires were returned, and comments included, “I like living hear” and “ The care girls are very good”. All the questionnaires received back confirmed that people who live at the home receive the care and support they require. Some service users in the home are very frail and would not be able to complete a questionnaire. There were Twenty-four people resident in the home on the day of this visit. Relative surveys were also sent out and three were returned. Four surveys were sent to other professionals such as district nurses and GP’s but none were returned. Other information used in the inspection process included notifications from the provider to the Commission for Social Care Inspection about deaths, illnesses, accidents and incidents at the home, copies of the monthly management visit reports produced by the provider and information about the home completed by the manager. The visit has concluded that residents’ needs, both personal and recreational, are met. Residents reside in a relaxed and informal homely environment The Laurels DS0000006194.V333412.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? The manager now ensures that prior to anyone being employed by the home a criminal records check is completed and the result known before the new employee commences work. This ensures that no staff are employed by the home who are exempt from working with vulnerable people. Some redecoration of the home has been completed which has improved the environment in which people live. The Laurels DS0000006194.V333412.R01.S.doc Version 5.2 Page 7 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 DS0000006194.V333412.R01.S.doc Version 5.2 Page 8 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 DS0000006194.V333412.R01.S.doc Version 5.2 Page 9 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): 3,6 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service People who enter the home have the information they need to make an informed choice about where to live. EVIDENCE: The manager said that prior to anyone being admitted to the home she receives a community care assessment, which has been completed by the person’s social worker. This assessment determines the level of care the person will require. Following receipt of this assessment the manager said she visits the person either in their own home or in hospital. The purpose of this visit is to complete The Laurels DS0000006194.V333412.R01.S.doc Version 5.2 Page 10 a pre admission assessment which helps the manager decide if the home are able to meet the persons need. This assessment is followed up by a letter to the person informing them if the home is able to meet their needs and if they are which room they will occupy. Wherever possible, people are encouraged to visit the home and look round. Completed community care assessments and the homes pre admission assessment were seen for people who had recently entered the home, confirming that the home are following their admission procedures. The manager said that the home does not offer intermediate care. The Laurels DS0000006194.V333412.R01.S.doc Version 5.2 Page 11 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 People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service People are treated with respect, but their health would be better ensured if more detailed care planning systems were in place and if medication records evidenced that people receive their medication as prescribed EVIDENCE: People spoken with at the time of the visit said that they were satisfied with the care and support provided by the staff. This was also reflected in the comment cards received by the Commission As part of this visit, three peoples care files were examined. These contained information gathered from the pre admission assessment and community care assessment. Care plans were found to be basic and did not give sufficient The Laurels DS0000006194.V333412.R01.S.doc Version 5.2 Page 12 detail in informing staff of the actions they are to take to meet the health care needs of the people they are caring for. A discussion with the manager took place about this and advice was given on how these could be improved. One of the three files examined contained a nutritional assessment but the others did not. There were no assessments for moving and handling or skin integrity. The manager said that when a new person enters the home the staff assess their mobility and record the assistance they require in the care notes, evidence was seen that this had taken place. The manager was advised that formal assessments must be undertaken in areas such as nutrition, moving and handling and skin integrity. Where an assessment identifies that a person is at risk a detailed care plan should be put into place and reviewed at regular intervals. This will ensure that the health care needs of the people are met. There was evidence in the care plans examined that peoples wishes regarding rising and retiring times have been taken into consideration. One person said that the care staff were good and always willing to help. Interaction between care staff and people at the home was observed to be very good. Senior care staff are responsible for the administration of medication. Six people’s medications were audited against the medication administration records held by the home. One stock balances did not tally with the records held. On further investigation it was found that the stock balance from the previous month had not been carried forward. One person’s prescription stated that the medication should be given twice daily but they were no signatures to confirm that this medication had been given. The manager stated that the persons GP had changed this recently to “when required” but that it still appeared on the medication administration record as twice daily. Records examined confirmed that this had been changed by the GP therefore the medication administration record must be changed to reflect the correct instructions to confirm that the medication has been given at the correct times. The Laurels DS0000006194.V333412.R01.S.doc Version 5.2 Page 13 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 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service People’s social needs are met and the food is good. People are able to exercise choice and control over their lives. EVIDENCE: The home employs an activities organiser for twenty-seven hours per week; she is responsible for arranging and supervising all social activities within the home. People spoken to during the visit and comment cards received stated that they were very happy with the activities on offer within the home. The activities organiser records on a daily basis the people who have joined in and what activities had taken place. These include Quiz’s, trips to the local pub, skittles, movement to music and shopping trips. A trip to Bridlington is taking place in July and 23 of the people who live at the home are going. The Laurels DS0000006194.V333412.R01.S.doc Version 5.2 Page 14 The home operates an eight-week roll on menu and the day’s menu choice is displayed on the tables in the dining room. On the day of the visit the lunch consisted of Belly pork with cabbage, carrots, parsnips and potatoes followed by sponge and custard. People spoken to said that the meals were very nice and that there was always a choice available if they didn’t like what was on the menu. One relative spoken to said that she had often had a meal at the home and that it was always very nice. The manager said that meals could be eaten in the dining room or in the person’s own room if they wish. Relatives and people spoken to said that they are able to visit the home whenever they like and there are no restrictions to visiting. One relative said that when she visits the home it’s like visiting her relative in her own home. The Laurels DS0000006194.V333412.R01.S.doc Version 5.2 Page 15 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 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service People are confidant that complaints will be investigated fully and that they are protected from abuse. EVIDENCE: The home has a complaints policy, a copy of which is displayed in the reception area of the home. People are given a copy of the policy on admission and a copy is also displayed in their room. The manager said that she investigates all complaints and makes the complainant aware of the outcome of any investigation. The complaints log was examined and confirmed that the last complaint received by the home was on the 3/8/2004 and this was dealt with appropriately. People spoken to and comment cards received said they were aware of the policy and felt that the manager would deal with any concerns they had appropriately. The manager said that staff receive training in the protection of vulnerable adults as part of their induction training as well as annually. Staff training The Laurels DS0000006194.V333412.R01.S.doc Version 5.2 Page 16 records examined confirmed that this training had taken place. Three staff spoken to by the inspector gave good responses to questions asked on this subject confirming that they were aware of the actions they must take should they suspect any form of abuse taking place. The Laurels DS0000006194.V333412.R01.S.doc Version 5.2 Page 17 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): 19,21,24,25,26 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service People live in a safe comfortable environment to where only some minor redecoration is required. EVIDENCE: As part of this visit a tour of the building was conducted, this included a number of people’s bedrooms, communal lounges, dining room, toilets and bathrooms. The bedrooms seen had been personalised with the person’s own belonging such as ornaments pictures and small pieces of furniture. The manager said The Laurels DS0000006194.V333412.R01.S.doc Version 5.2 Page 18 that people are able to hold their own key to their room if they wish but that most of them prefer to have the staff lock and unlock the door for them. It was noted that as most of the bedrooms do not have an ensuite there are commodes in each bedroom. These were looking tired and worn and should be replaced to enable proper cleaning of them and improve the environment in which people live. It was also noted that some of the bedrails fitted to peoples beds to prevent them falling out, did not have bumpers fitted to them. Bumpers should be in place to prevent peoples arm and legs becoming accidentally trapped and causing injury. Some minor redecoration of some of the bedrooms and corridors is required due to damage caused by wheelchairs and this will also improve the people’s environment. There are two large lounges and a conservatory, where people can sit and watch television or listen to music. These were decorated to a good standard and the furniture was domestic in style. There are toilets and assisted bathrooms within close proximity of bedrooms and communal areas. The flooring in one toilet was in need of replacement or repair as it had began to lift from the floor and people could trip over it. This could also prevent it from being cleaned properly and poses a cross infection risk. The standard of cleanliness throughout the home was very good and there were no odours present on the day of the visit. The Laurels DS0000006194.V333412.R01.S.doc Version 5.2 Page 19 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 People who use the service experience Excellent quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service People are cared for by trained, competent staff, in sufficient numbers to meet their needs. Recruitment procedures safeguard the people. EVIDENCE: The staff duty rota was checked for the months of March and April and these confirmed that the home was working within the staffing notice set by the previous registering authority. Staff sickness and holidays are covered by staff doing overtime, agency staff is rarely used so people are looked after by staff who know them. Currently the home has fifteen care staff that have completed an National Vocational Qualification ( N.V.Q) level 2 in care training course and eight staff have enrolled on the NVQ level 3 care course, the home should be commended on achieving over 50 of its care staff having an N.V.Q. qualification. Five staff details were checked and these confirmed that the home is carrying out the appropriate checks prior to employing staff to ensure the people are safeguarded from abuse. The Laurels DS0000006194.V333412.R01.S.doc Version 5.2 Page 20 The manager said that, new staff employed by the home complete an induction course within six weeks of the joining the home. This course gives the new staff member the information they require in order to care for the people living in the home. Records examined and staff spoken to confirmed that this training is taking place. Evidence was seen in training records checked that staff have received training in such things as moving and handling, adult protection, dementia and food awareness. Staff spoken to said that they had received this training. People spoken to said that there was plenty of staff around to give them a hand if they needed. Care staff said that they felt there were adequate numbers of staff on duty to attend to the needs of the service users. They also confirmed that, sickness and holidays are covered by staff and that there are never any occasions when they work understaffed. The Laurels DS0000006194.V333412.R01.S.doc Version 5.2 Page 21 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): 31,33,35,36,38 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service The home is well managed and the views of the people who live there are taken into account EVIDENCE: People who live at the home and some of their relatives spoken to said the home was well managed and that the manager was very approachable and was aware of the needs of the people. The Laurels DS0000006194.V333412.R01.S.doc Version 5.2 Page 22 The manager has completed her registered managers award and has managed the home for five years. She is supported in her role by a deputy manager and the proprietor of the home visits regularly and is also contactable by telephone should she require any support. The manager said that staff supervision takes place. During these sessions staff are able to discuss, amongst other things, training issues and the aims and objectives of the home. Supervision records examined during the visit, and staff spoken to confirmed that these had taken place The manager completes an annual quality audit to ensure the care and service offered by the home meet the expectations of the people who live in the home. Questionnaires are sent out to each person and their relatives to gain their views on the home and the care that they receive. Results of a survey held in May 2006 were very positive and comments included “very happy” and “excellent”. There was discussion with the manager about measures, such as formal monthly quality audits on such things as care plans medication and health and safety that could monitor whether the quality of care provided meets peoples expectations People are able to keep small amounts of personal monies within the homes safekeeping. This enables them to be able to purchase small items such as sweets, newspapers and pay for hairdressing. Three amounts of people’s personal monies were checked and the balances tallied with the records held by the home. Movement and handling training has been provided to the majority of staff members this year, staff confirmed this when interviewed. There are policies and procedures in place surrounding health and safety and the manager is aware of her responsibilities towards the people who live in the home and staff. Regular fire safety checks are carried out and recorded. Staff receive training in fire prevention. The homes fire risk assessment and fire policy was examined and was found to be in order. Certification in relation to servicing of gas electricity and electrical equipment is in place and up to date. The Laurels DS0000006194.V333412.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 3 X X 3 3 3 STAFFING Standard No Score 27 4 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 3 x 3 The Laurels DS0000006194.V333412.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 (3) c Requirement Risk assessments for e.g. moving and handling, nutrition and tissue viability must be in place and reviewed at regular intervals. Where a risk is identified a detailed care plan must be in place which informs the staff of the actions they are to take to meet the needs of the person. Timescale for action 31/08/07 The Laurels DS0000006194.V333412.R01.S.doc Version 5.2 Page 25 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 Care plans should be more detailed and direct the staff in the actions they are to take to meet the needs of the people they are caring for. Daily entries in the care files should evidence that the person’s social and psychological well-being is being met The stock balances of the previous months medication should be recorded onto the Medication administration record. When a persons prescription is changed the staff should ensure they receive written confirmation of this from the GP The areas identified during the visit as requiring redecoration e.g. bedrooms and corridors should be actioned to improve the environment in which people live. The commodes in people’s bedrooms should be renewed so they can be easily cleaned and look better for the people who use them. The flooring in the toilet identified should be replaced or repaired to prevent people tripping and so that it can be easily cleaned to prevent cross infection. The manager should complete formal audits on areas such as e.g. environment, choice of meals and produce an action plan on how any shortfalls can be addressed The bed rails fitted to people’s beds should have bumpers fitted to them to prevent people getting trapped. 2. OP9 3. 4. 5. 6. 7. OP19 OP23 OP25 OP33 OP38 The Laurels DS0000006194.V333412.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND 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 DS0000006194.V333412.R01.S.doc Version 5.2 Page 27 - 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!