Inspection on 08/06/05 for The Laurels, Huntley

This inspection was carried out on 8th June 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 30/11/05

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 Glos GL19 3EA Lead Inspector Eleanor Fox Unannounced 8 June 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_S16615_The Laurels_V227965_080605_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Laurels Address Main Road Huntley Glos 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 McCreery Mrs Patricia McCreery Care Home - Personal Care 8 Category(ies) of OP Old age (8) registration, with number of places The Laurels D51_D03_S16615_The Laurels_V227965_080605_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 17 November 2004 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_S16615_The Laurels_V227965_080605_Stage 4.doc Version 1.30 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 hours. It consisted of a tour of the property; inspection of all the written care records; recruitment files and other available documents; plus discussions with the Manager and members of staff working in the Home. She also observed the service of the lunchtime meal to the residents. The inspector had the opportunity to talk to six of the residents who were in the lounge of the Home during her visit What the service does well: What has improved since the last inspection? What they could do better: Some further improvements in care planning, medication administration, recruitment processes, and record keeping are required to fully promote the safety and well being of the residents living at the Laurels. The Laurels D51_D03_S16615_The Laurels_V227965_080605_Stage 4.doc Version 1.30 Page 6 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_S16615_The Laurels_V227965_080605_Stage 4.doc Version 1.30 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_S16615_The Laurels_V227965_080605_Stage 4.doc Version 1.30 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) 3,5 and 6 Due to thorough admission processes, each person, together with their families, may be assured that their particular care needs may be met at the Laurels. EVIDENCE: The Manager takes responsibility for assessing prospective residents for the Laurels. She said that she normally uses a documented format, which covers all areas of the person’s care needs; there were no pre-admission assessments available for inspection on this occasion. One lady did confirm that the Manager had been to visit her before she came into the Home. Four of the residents at the Laurels had initially been admitted for short-term respite care, giving them the opportunity to experience life there before they made a commitment to a permanent stay. During discussion with six of the residents, they pointed out to the inspector how important it was in a small home for everyone to get on with each other. Intermediate care is not provided in this Home. The Laurels D51_D03_S16615_The Laurels_V227965_080605_Stage 4.doc Version 1.30 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, 8 and 9 Carers are not provided with the consistently recorded care planning information they require to care for all the residents’ needs. Medication systems require improvement to ensure that residents are not put at any risk of potential errors. EVIDENCE: The care records of all eight residents were read in detail on this visit. On admission, the majority of people have a full assessment of care needs completed; this is reviewed and amended if necessary on a monthly basis. However, this exercise had not been completed for one person, giving the carers no clear guidance on the care required. Comprehensive personal care and daily records do provide evidence that this resident has responded positively at the Home, gaining weight and appearing more relaxed and cheerful than when the person was first admitted to the Home. A handover book has recently been introduced to assist communications. Records showed that residents had received care from the community nursing team and other healthcare specialists. The Laurels D51_D03_S16615_The Laurels_V227965_080605_Stage 4.doc Version 1.30 Page 10 On the whole drug administration is addressed correctly although it was observed that the person responsible for completing the hand written records on the medication sheets had not signed the documentation, as is required. In addition, the drug fridge had not been locked securely. Members of staff have just completed formal training in medication administration. The Home has received notification that a trained pharmacist will undertake a full medication audit at the Home in the near future. The Laurels D51_D03_S16615_The Laurels_V227965_080605_Stage 4.doc Version 1.30 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) 12 , 13 and 15 Opportunities are provided for varied and stimulating activities and social contacts, as desired. Residents have the benefit of nutritious balanced meals, providing choice and variety. EVIDENCE: The Home maintains ‘Activity Records’ for each of the residents; these are completed correctly. During the visit, six of the residents were sitting together in the sitting room. One was knitting; another was completing a word puzzle. The residents appeared to get on very well, chatting amiably with each other. They confirmed that, in good weather, they are able to make use of the sturdy garden furniture, which is provided outside. Some additional activities have now been provided at the request of some of the residents. Visitors are welcome at any time. One person went out with members of her family; another person was awaiting her son and his family. The Home’s menus have recently been reviewed, following discussions with the residents about their particular likes and dislikes. These have been developed over a three-week period and offer variety and choice. The Laurels D51_D03_S16615_The Laurels_V227965_080605_Stage 4.doc Version 1.30 Page 12 The residents all spoke about the food served in the home in a complimentary manner. One described the “wonderful roast beef meal they had enjoyed on Sunday”; another was enthusiastic about the “light pastry” served at the Laurels. Lunch was served in the dining area beside the kitchen and also at a table in the lounge. One person preferred to eat her meal in the privacy of her bedroom. The Laurels D51_D03_S16615_The Laurels_V227965_080605_Stage 4.doc Version 1.30 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 standard(s) 16 and 17 The Home has a satisfactory complaints system in place with evidence that service users and their families feel their views are listened to and acted upon. There are arrangements in place to ensure that residents’ legal rights are protected. EVIDENCE: The Home has a fully detailed Complaints Policy written in clear language, which is readily available to the residents. There have been no formal complaints since the last inspection but residents did confirm that they are comfortable to raise any concerns or worries, and are confident that some action to rectify the matter will be taken. Although given the opportunity, none of the residents chose to register a vote at the recent Election. Information on how to source advocacy support is advertised in the Home. The Laurels D51_D03_S16615_The Laurels_V227965_080605_Stage 4.doc Version 1.30 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 standard(s) 19, 23, and 24 Residents live in clean, comfortable and well-maintained accommodation, much of which has been decorated and furnished to a good standard. EVIDENCE: Since the last inspection, replacement windows have been installed in some of the bedrooms and new patio doors have been provided. There is a small damp patch on the ceiling of one of the bedrooms, which requires repair, but the remainder of the Home appears homely and well maintained. The majority of bedrooms have en suite facilities and are of a good size to meet the residents’ needs. They are welcome to bring in possessions and small items of furniture to personalise their bedrooms; there was much evidence of this throughout the Home. The entire home was fresh and clean. The Laurels D51_D03_S16615_The Laurels_V227965_080605_Stage 4.doc Version 1.30 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) 27, 29 and 30 Appropriately trained employees, in numbers sufficient to meet the needs of the residents, are employed at the Home. Consistent recruitment safeguards are not yet in place to offer protection to residents at the Laurels. EVIDENCE: Currently there are eight residents living at the Home, six of whom are classed as ‘low dependency’. Duty sheets show that there is always at least one carer on duty in the Home with the Manager providing on-call and overnight cover at the Laurels, she and her family live in the property. One of the carers stays at the Home when the Manager is away. The Home also employs additional staff to cover catering and cleaning duties. Examination of personnel records show that careful recruitment procedures are usually followed when employing new members of staff although all the required employment checks must be submitted before the member of staff joins the team. In one instance, no CRB or POVA clearance had been requested for a recently employed member of staff. The Laurels D51_D03_S16615_The Laurels_V227965_080605_Stage 4.doc Version 1.30 Page 16 Current application forms for prospective new employees only request information about the two most recent jobs, not a full employment history, as must be obtained. Members of staff received Basic Food Hygiene training in April and have also recently attended a course in medication administration and storage; they are due to undergo a manual handling update in July. Two carers are about to commence NVQ, level 2 tuition. The Laurels D51_D03_S16615_The Laurels_V227965_080605_Stage 4.doc Version 1.30 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 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, 33, 35, 36 and 37 There is a good programme of self-review and consultations in place at the Home; these include seeking the views of residents, relatives and members of staff, and acting on the results. Systems are also in place to ensure that the financial interests and the welfare of people using the service are safeguarded. EVIDENCE: The Manager, a trained nurse, is currently undertaking the Registered Manager’s Award. It is anticipated that this will be completed in October. The Manager has also attended training events arranged at the Home, ensuring that she remains fully updated in care practices. The Laurels D51_D03_S16615_The Laurels_V227965_080605_Stage 4.doc Version 1.30 Page 18 Residents are consulted about the meals that are prepared in the Home and any other issues, which may arise. Following a request at a recent meeting, a selection of greetings cards is now provided at the Laurels. All those who were questioned, confirmed that each member of staff is most supportive, -“they will do anything for you” and “they are so kind”, and “they’re wonderful”. Although the facility is not required at the current time, there are facilities in place to look after residents’ personal monies in a secure and correctly documented fashion. Most of the records are maintained correctly although there were no photographs provided for two of the residents, as is required. Staff supervision processes have been commenced but, in the records seen on this occasion, there was only one formal record of any supervision meeting in the last twelve months. The Laurels D51_D03_S16615_The Laurels_V227965_080605_Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x 3 3 x x STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x 3 x 3 x 3 2 2 x The Laurels D51_D03_S16615_The Laurels_V227965_080605_Stage 4.doc Version 1.30 Page 20 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. 2. 3. Standard 7 7 9 Regulation 14 15 13(2) Requirement The needs of each service user must be assessed and reviewed appropriately A written plan of care must be produced for each service user The person making the record in the drug administration documentation must sign any handwritten instructions. Drug storage areas must be locked securely The ceiling in one bedroom must be repaired All members of staff must be subject to full recruitment procedures (previous timescale 30.11.04 not met) Supervision processes must be undertaken six times a year A photograph must be provided of each service user Timescale for action By 31.7.05 By 31.7.05 By 31.7.05 4. 5. 19 29 23(2b) 19 By 30.9.05 By 31.7.05 6. 7. 36 37 18(2) Schedule 3(2) By 30.9.05 By 31.7.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. The Laurels Refer to Good Practice Recommendations D51_D03_S16615_The Laurels_V227965_080605_Stage 4.doc Version 1.30 Page 21 Standard 1. 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