Inspection on 30/11/05 for The Laurels, Huntley

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, Huntley 09/05/07

The Laurels, Huntley 29/08/06

The Laurels, Huntley 08/06/05

The Laurels, Huntley 17/11/04

The Laurels, Huntley 08/06/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE The Laurels Main Road Huntley Gloucestershire GL19 3EA Lead Inspector Eleanor Fox Unannounced 30 November 2005, 09:30 th 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 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 D51_D03_16615_The Laurels_v248013_261005_ UI_stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Laurels Address Main Road Huntley Gloucester GL19 3EA 01452 831484 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Patricia Alice McCreery Mrs Patricia Alice McCreery Care Home 8 Category(ies) of OP Old Age (8) registration, with number of places The Laurels D51_D03_16615_The Laurels_v248013_261005_ UI_stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8/6/05 Brief Description of the Service: The Laurels is a comfortable well-maintained Care Home providing personal care for eight service users who are aged 65 years and over. The house is situated on the A40 in the village of Huntley, approximately 6 miles from the City of Gloucester. The eight single bedrooms, five with en suite facilities, are located on the ground floor, with toilets, shower and assisted bathing facilities within easy access. A lounge/dining room is provided for the service users’ use. They also have the benefit of a small private garden at the rear of the house. The proprietor and her family live in the property; the Manager provides overnight cover for the Home. All the bedrooms are equipped with emergency call facilities. The Laurels D51_D03_16615_The Laurels_v248013_261005_ UI_stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector undertook this unannounced inspection over a period of 3.5 hours. During the day she talked to all the service users, read their care records, visited their bedrooms and observed the service of the lunchtime meals. The inspector also spoke with members of staff, and looked at a selection of recruitment records and other documents, which were available in the home on that day. Finally, the inspector talked to the Manager who was on duty for part of the day. She was most cooperative in providing information as requested. What the service does well: What has improved since the last inspection? What they could do better: The Home must ensure that each resident is fully assessed prior to admission. The Laurels is registered to accept elderly people who require personal care only. People suffering from mental health illnesses, dementia or who require nursing care may not be admitted. The Laurels D51_D03_16615_The Laurels_v248013_261005_ UI_stage4.doc Version 1.40 Page 6 Improvements continue to be required in the care planning documentation; specific care needs are still not fully identified and appropriate written guidance is not always provided for staff. Robust management procedures and processes must be fully implemented to ensure that the Home is run in the best interests of the residents living there. 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 D51_D03_16615_The Laurels_v248013_261005_ UI_stage4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Laurels D51_D03_16615_The Laurels_v248013_261005_ UI_stage4.doc Version 1.40 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 standard(s) 3 and 4 The implementation of a thorough assessment process would ensure that the needs of every prospective resident might be met at this home. EVIDENCE: There was one person admitted for respite care who had care needs that the home was unable to meet adequately. The documentation that was available suggested that this person was suffering from a condition for which the home does not have a registration. The Manager did confirm that an assessment had been undertaken prior to the admission of this person but there was no written record of this to show that all the necessary criteria (in Standard 3.3) had been addressed. Urgent arrangements were being made on this day to move this person to suitable care accommodation. Staff at the home do receive training in care related issues but are not trained to care for people with mental health illnesses. There is also nobody on duty at the home who is awake all night; the Manager provides on call night support. She does live on the upper floor of the house and is readily available if required. The Laurels D51_D03_16615_The Laurels_v248013_261005_ UI_stage4.doc Version 1.40 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 standard(s) 7, 9 and 10 The care planning systems in place still do not fully provide the staff with the information they require to care for all the residents’ needs. However, care is delivered in a manner that preserves the residents privacy and upholds their dignity. EVIDENCE: The written care documentation plus the staff handover book were read in detail on this visit. These are disorganised with some providing only very minimal information of any variety. The records still not contain clear guidance to the staff of the care required for each resident, particularly when specific care needs, such as continence needs, mobility difficulties and dealing with inappropriate behaviour have been identified. A risk assessment completed for one person did not reflect that person’s current altered condition. Nevertheless, very full daily records are maintained. On questioning, it was evident that the staff on duty had been informed verbally of the correct care to give to each resident. They all appeared to be receiving attentive care. The Laurels D51_D03_16615_The Laurels_v248013_261005_ UI_stage4.doc Version 1.40 Page 10 The Manager discussed planned improvements of the care planning processes and produced alternative documentation, which she intends to introduce shortly. Medication administration was not addressed in detail on this visit but it was observed that a lock has been provided on the fridge dedicated to the storage of medications. These drugs can now be stored securely. Handwritten drug administration records are clearly written, signed and drugs appear to have been administered as directed. One person was undergoing a review of her care. This was conducted in the privacy of her bedroom. Another lady spoke to her visitors in the privacy of her room. It was confirmed that any required care is always given behind closed doors, either in the resident’s bedroom, en-suite facility or the bathroom. Staff were heard to talk to all the residents in a polite but friendly manner. The Laurels D51_D03_16615_The Laurels_v248013_261005_ UI_stage4.doc Version 1.40 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 standard(s) 14 The consideration and respect that is shown by staff towards residents ensures that residents are able to exercise control and choice in their daily lives EVIDENCE: On this day, seven of the residents were sitting together in the sitting room of the Home. They chatted to each other and to the inspector, describing various events plus any changes in the home, which had occurred in the last six months. During conversation it was evident that the residents continue to feel very much ‘at home’ at the Laurels and appear to get on well together. Two people rigorously confirmed that they are able to live their lives as they choose, as far as they are able. They are also given the opportunity to provide input into the day-to-day running of the home. They acknowledged that the staff respect their wishes and views. Documentary advice on how to source advocacy assistance is available in the front hall. Each person has been able to personalise their bedrooms with photographs and other treasured possessions. The Laurels D51_D03_16615_The Laurels_v248013_261005_ UI_stage4.doc Version 1.40 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 standard(s) 18 The Home’s robust policies and procedures and provision of appropriate staff training, give residents the assurances that they may expect to live in a safe environment. EVIDENCE: The home does have a documented policy on addressing abuse. Members of staff are required to read the policy as part of the induction processes. Legislation relating to the Protection of Vulnerable Adults is correctly followed at this home. One person who was questioned was unaware of the Department of Health ‘No Secrets’ guidance. It is recommended that the home should source a copy. The Laurels D51_D03_16615_The Laurels_v248013_261005_ UI_stage4.doc Version 1.40 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 standard(s) 19 and 26 Residents continue to live in clean, comfortable and well-maintained accommodation, the majority of which has been decorated and furnished to a homely standard. EVIDENCE: Although it was a cold foggy day, the Home was warm, clean and welcoming. There was no evidence of offensive odours in any area. Since the last inspection work has commenced to address a ‘damp problem’ in one bedroom. The final decorative improvements will be completed in early January when arrangements have also been made to refurbish the main corridor of the home. The remainder of the Laurels is well maintained and equipped with furniture to suit the needs of the residents living there. The laundry facilities continue to be well organised. They are safely managed, with due regard to infection control procedures. Residents wear their own clean well-presented clothing. The Laurels D51_D03_16615_The Laurels_v248013_261005_ UI_stage4.doc Version 1.40 Page 14 The Laurels D51_D03_16615_The Laurels_v248013_261005_ UI_stage4.doc Version 1.40 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28 and 29 The home encourages care staff to undertake a care qualification, in order that they can fully understand their roles. Robust recruitment procedures must be consistently implemented to ensure that suitable staff are employed for the protection of residents. EVIDENCE: Four carers are employed at this home. One has already been awarded a National Vocational Qualification, level 2; two more are working towards the accreditation. One person has been appointed to work at the Laurels since the last inspection. Observation of the personnel records showed that, on the whole, correct recruitment processes had been followed. The applicant had completed a full application form and health questionnaire; a record had been maintained of the interview processes and two satisfactory written references obtained. The Manager confirmed that a POVA (Protection of Vulnerable Adults) check and Criminal Record Bureau screening had been completed although there was no evidence of this in the records. She has been requested to provide proof that these procedures had been completed to the Commission for Social Care Inspection. The new employee had been fully inducted when she commenced duties at the home. The Laurels D51_D03_16615_The Laurels_v248013_261005_ UI_stage4.doc Version 1.40 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 37 and 38 Although further improvements in the development and implementation of effective policies and procedures are still required, residents may be assured that they are protected and their rights are upheld at this home. EVIDENCE: The owner/manager of the home is a trained nurse; she has just successfully completed the Registered Manager’s Award. She also ensures that she remains clinically updated and keeps abreast of current good practice. The majority of records seen on this visit were stored securely and maintained correctly although it is recommended that residents’ care details should be kept in a less prominent position, as confidential information could be freely available to anyone visiting the home. There are still no photographs provided for two residents living at the Laurels. The Laurels D51_D03_16615_The Laurels_v248013_261005_ UI_stage4.doc Version 1.40 Page 17 There was evidence that health and safety issues are addressed in a satisfactory manner in this home, with the provision of necessary equipment and staff training, as required. Members of staff are aware of their duties if a fire should occur. All necessary safety checks and maintenance of equipment appears to be undertaken in a timely fashion although full records were not available on this day. The Laurels D51_D03_16615_The Laurels_v248013_261005_ UI_stage4.doc Version 1.40 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 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 2 x x x x x x 3 STAFFING Standard No Score 27 x 28 3 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 3 x x x x x 1 3 The Laurels D51_D03_16615_The Laurels_v248013_261005_ UI_stage4.doc Version 1.40 Page 19 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 3 Regulation 14 Requirement The Home must not admit any residents suffering from medical conditions, which the Home is not registered to care for. The home must ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of the residents The needs of each service user must be assessed and reviewed appropriately (Time frame 31/7/05 not fully met) A written plan of care must be produced for each service user (Time frame 31/7/05 not fully met) The ceiling in one bedroom must be repaired (Time frame 30/9/05 not fully met) Evidence must be provided that all members of staff are subject to full recruitment procedures A photograph must be provided of each service user (previous time scale 31/7/05 not met). Timescale for action 31/12/05 2. 4 18(1a) 31/12/05 3. 7 14 (2) 31/1/06 4. 7 15 31/1/06 5. 6. 7. 19 29 37 23(2b) 19 Schedule 3(2) 31/1/06 31/1/06 31/1/06 The Laurels D51_D03_16615_The Laurels_v248013_261005_ UI_stage4.doc Version 1.40 Page 20 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. 2. Refer to Standard 18 37 Good Practice Recommendations It is recommended that the home should source a copy of the Department of Health guidance, No Secrets. It is recommended that residents’ care details should be kept in a less prominent position, as confidential information could be freely available to anyone visiting the home. The Laurels D51_D03_16615_The Laurels_v248013_261005_ UI_stage4.doc Version 1.40 Page 21 Commission for Social Care Inspection Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester GL3 4AB 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 D51_D03_16615_The Laurels_v248013_261005_ UI_stage4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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