Inspection on 01/03/06 for The Laurels - Winsford

This inspection was carried out on 1st March 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 - Winsford 24/08/06

The Laurels - Winsford 17/08/05

The Laurels - Winsford 16/02/05

The Laurels - Winsford 04/08/04

The Laurels - Winsford 26/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE The Laurels - Winsford Walnut Drive Winsford Cheshire CW7 3HH Lead Inspector Bronwyn Kelly Unannounced Inspection 09:30 1st March 2006 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 - Winsford DS0000006519.V281844.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 - Winsford DS0000006519.V281844.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Laurels - Winsford Address Walnut Drive Winsford Cheshire CW7 3HH 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) 01606 593048 01606 863401 www.clsgroup.org.uk CLS Care Services Limited Care Home 41 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (10), Old age, not falling within any other of places category (31) The Laurels - Winsford DS0000006519.V281844.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum number of 41 service users to include: * Up to 31 service users in the category of OP (older people not falling within any other category) * Up to 10 service users in the category of DE(E) (Dementia over the age of 65) needing personal care only * Up to 5 service users in the category of DE (Dementia under 65 years of age) needing personal care only The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 17th August 2005 2. Date of last inspection Brief Description of the Service: The Laurels is a registered care home providing accommodation and personal care for 41 older people and older people with dementia. The home is managed by CLS Care Services, a not for profit organisation which manages a number of homes in the North West. The Laurels is situated in the Wharton district of Winsford, approximately one mile from the town centre, within walking distance of a number of community facilities. There are good links with the local community. The Laurels was purpose built in the late 1960s and provides single bedroom accommodation on the ground and first floors. In addition, one unit of the home (Willow) has been converted to provide specialist self-contained accommodation for ten older people with dementia. A separate staff team cares for the residents in this unit. There are several very comfortable lounges of different sizes, providing a good choice of communal areas around the home. Large enclosed and secure grounds with seating areas and walkways are provided. Two friendly cats live in The Laurels, who are much loved by some of the residents. The Laurels - Winsford DS0000006519.V281844.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over six hours on one day. A tour of the building took place, and with the permission of the residents, a number of bedrooms were seen. A variety of records were examined as part of the inspection. Part of the process of the inspection is to listen to the views of the residents that live in the home and listen to the views of their relatives and visitors. On this occasion, four residents were spoken with privately and group discussions took place in lounge and dining areas with a number of other residents and their visitors. Three visiting relatives were happy to give their view of the home during the inspection, and two of these completed a comment card. The views of four care staff, care team leader, domestic staff and the acting manager were also listened to. Four residents’ comment cards were completed during the inspection. What the service does well: The residents at The Laurels live in a comfortable and well-maintained environment. They all gave very positive comments about the care they receive from the staff group. Some of the comments received from residents included: • “I would recommend this home” • “I think it is the best move I have ever made” • “Everyone is so friendly” Some of the comments received from relatives included: • “Very happy with care and cleanliness – staff are excellent” • “I am able to have meals with my relative – they are better than I could cook” • “I feel I am visiting friends when I visit” There is a friendly, relaxed atmosphere in the home and communication between staff, residents and their families is good, with residents benefiting from many visitors. . The Laurels - Winsford DS0000006519.V281844.R01.S.doc Version 5.1 Page 6 Various activities and outings take place, which residents can join in with if they wish. The staff team are a happy group who are well trained and able to meet the needs of the residents. The standard of care is good. The Commission for Social Care Inspection has not received any complaints regarding the home. What has improved since the last inspection? What they could do better: Staff training to a minimum of NVQ level 2 should be achieved for 50 of the care staff group. The new manager should complete her training for the job within the recommended time scale. Systems to ensure all staff are appropriately supervised should be in place. The Laurels - Winsford DS0000006519.V281844.R01.S.doc Version 5.1 Page 7 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 - Winsford DS0000006519.V281844.R01.S.doc Version 5.1 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 - Winsford DS0000006519.V281844.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. Standard 6 does not apply, as intermediate care is not provided Good information is available for service users to help them make a decision about moving into the home. Residents’ needs are assessed before they move in to ensure they can be met. EVIDENCE: A new service user guide entitled ‘Your Guide to Living at The Laurels’ has been recently produced. A copy of this is given to all prospective and new residents so that they are able to make an informed choice about whether or not the home is suitable and able to meet their individual needs. A copy is available for any visitors to see and most of the residents have a copy in their bedroom. (One resident, who has many years of office experience, is enjoying helping with the photocopying of these) This guide provides information about what the home offers to residents living there and the range of facilities and lifestyle residents can expect. The Laurels - Winsford DS0000006519.V281844.R01.S.doc Version 5.1 Page 10 The admission procedure ensures that new residents are fully assessed prior to moving into the home. Either the acting manager or care team leader visits each prospective resident in their own home or hospital before they move into The Laurels. Records were seen of this, and residents confirmed that this takes place. Assessments from social services or medical professionals are also part of this process, ensuring all needs of the residents can be met at the home. The Laurels - Winsford DS0000006519.V281844.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 There is a clear care planning system in place to provide staff with the information they need in order to meet the needs of the residents. Arrangements are in place to ensure the health care needs of residents are identified and met. Personal support is provided in a way that enables residents to have privacy, dignity and independence. EVIDENCE: Five residents’ plans of care were seen and each clearly showed what staff need to do to meet their needs. They were well written, up to date and reviewed on a regular basis. This ensured that residents’ changing needs were always recorded in the plans of care. All contained risk assessments, moving and handling information, and information about contact with medical professionals. Further development of these plans to include more information about residents’ hobbies and their social and leisure needs is planned. The Laurels - Winsford DS0000006519.V281844.R01.S.doc Version 5.1 Page 12 Residents spoken with confirmed that the doctor was called in promptly when they felt unwell. The care plans showed that residents have regular visits from a chiropodist, dentist and optician. A separate section of each resident’s care plan is used for recording any medical interventions, which enables effective monitoring. Referrals are made to other health care specialists as and when required. There are good links established between Willow unit and local psychogeriatric departments, which provide good support to the residents and staff. Senior staff in the home that give out medication have attended a medication training course. Policies and procedures for dealing with medication are in place, and the systems seen were well organised and in good order. The Laurels - Winsford DS0000006519.V281844.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13 and 14 Social activities provided in the home and links with the local community are well organised and provide stimulation and interest for the residents. Visits to the home by family and friends are encouraged at any time, helping to ensure that residents maintain contact with their family. Support is offered to residents in such a way as to promote choice and control over their lives. EVIDENCE: Since the last inspection, residents said there has been an improvement in the range and frequency of activities and outings. A new activities co-ordinator has recently been employed and she is developing the range of social activities available for residents. A new activities lounge has been completed, with the addition of a bar and shop. The ladies in the home enjoy attending a ‘Thursday Club’ each week, and a similar event for gentlemen is being developed. Recent events have included trips to concerts, pub lunches, Christmas parties and theatre visits. In-house activities include musical events, craft, discussion groups and bingo. Fund raising activities for the residents’ Comforts Fund are taking place and a weekly bingo is held in a local club for the home. Good links with the local church are being developed. The Laurels - Winsford DS0000006519.V281844.R01.S.doc Version 5.1 Page 14 The routines for the residents living in Willow unit are flexible and generally geared to the knowledge and understanding of the needs of each resident. The new activities co-ordinator is developing her role in this unit. There was evidence that the staff in this unit had formed good relationships with the residents and their families. Many of the families of the residents live locally and visit the home on a regular basis. There are no restrictions on visiting, and some join the residents for lunch on a regular basis. Visitors spoken with said they are welcomed into the home at any time. Both staff and residents gave examples of the way in which residents are encouraged to have choice in their lives and remain as independent as possible. The Laurels - Winsford DS0000006519.V281844.R01.S.doc Version 5.1 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 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 satisfactory complaints procedure ensuring that any concerns of residents or their families are dealt with promptly and correctly. Arrangements for protecting residents from abuse are satisfactory so residents are not at risk from harm or poor practice. EVIDENCE: The complaints procedure is available in the service user’s guide and a copy is displayed in the entrance hall. Information regarding how to contact the CSCI is also displayed. Residents spoken with said they knew who to speak to if they had any concerns about living in the home. There is a culture of openness in the home, where relatives and residents are encouraged to communicate with staff in a relaxed manner. Relatives spoken with said if they ever raised any minor concerns or issues with the staff, then these are acted upon and resolved quickly. A lot of the staff have worked at the home for many years, and know the families of the residents well. The staff spoken with displayed a good understanding of adult protection procedures. The acting manager has completed a training course on adult abuse and is planning for all staff to take part in a video and training pack exercise to update their knowledge. The homes policies and procedures for handling residents’ money and financial matters are thorough and protect residents from abuse. The Laurels - Winsford DS0000006519.V281844.R01.S.doc Version 5.1 Page 16 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 The home provides a comfortable and safe environment for those living there and those visiting. EVIDENCE: The Laurels provides a comfortable and homely environment for residents. A number of the lounges are well furnished with ordinary domestic style leather sofas or three-piece suites. All residents commented that they are very comfortable. The acting manager has identified a number of areas of the home that are in need of re-decoration or refurbishment. The communal space in ‘Willow’ unit is open plan, spacious, light and airy, providing very comfortable accommodation. There is also a second smaller quiet lounge available for residents. The Laurels - Winsford DS0000006519.V281844.R01.S.doc Version 5.1 Page 17 Since the last inspection, a secure and private garden area has been created at the rear of the home for the residents living in Willow unit. This will provide more independence and choice for residents who wish to go outside. The gardens to the front of the home provide residents with an attractive area to sit outside. A greenhouse is provided, and some residents kept the home supplied with tomatoes last summer. The standard of cleanliness throughout the home is good, with no noticeable odours. Policies and procedures are in place for the control of infection and health and safety, protecting staff and residents. The Laurels - Winsford DS0000006519.V281844.R01.S.doc Version 5.1 Page 18 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): 27,28 and 29 Staff at the home are well trained and employed in sufficient numbers to meet the needs of the residents. The procedures for the recruitment of staff are robust, providing safeguards to people living in the home. EVIDENCE: Since the last inspection, the number of ‘bank’ or agency staff has reduced with the result that residents are cared for by staff that they know. Following recent interviews, four new staff are about to commence work at the home. The staff group at The Laurels have been continuing with their training, and are working towards to reaching the government’s December 2005 target of 50 trained care staff. To date, 9 of the 27 care staff group (33 ) hold a minimum of NVQ level 2. Three care staff have commenced their training. Four care team leaders have completed NVQ level 3 and two have almost completed their training. In-house training for staff continues on a regular basis according to need. The staff spoken with said they had good opportunities to attend training courses relevant to their jobs. All said they enjoyed working in the home, and were well supported by the acting manager. One staff member said “We are a happy group and work together well as a team.” The Laurels - Winsford DS0000006519.V281844.R01.S.doc Version 5.1 Page 19 Specialist training in dementia for staff working in Willow unit is planned for the near future. Two staff files were seen and contained evidence of two references and the necessary CRB checks having been obtained before the staff member commenced duties. Staff files also contained evidence that new staff members undertake an induction course. The Laurels - Winsford DS0000006519.V281844.R01.S.doc Version 5.1 Page 20 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 36. The acting manager is experienced and supported by senior staff, ensuring the residents live in a well run home. Opportunities are given to residents to express a view on the running of the home and services received. Policies and procedures for safeguarding residents’ money provide security. EVIDENCE: The acting manager at The Laurels has a number of years experience as care team leader at the home. She currently is undergoing registration procedures as a manager with CSCI, and has commenced training towards the Registered Managers Award. A quality assurance system is in place, and residents and/or their families have recently completed a satisfaction questionnaire. The results of this survey The Laurels - Winsford DS0000006519.V281844.R01.S.doc Version 5.1 Page 21 have been collated and a summary is available in the service users’ guide. Residents’ meetings are also held on a regular basis, enabling them to voice an opinion about their lives at The Laurels A number of the care staff spoken with said that one-to-one supervision with their line manager was not taking place. Records showed that the frequency of staff supervision was not taking place as often as recommended. . Systems and safeguards are in place to assist residents who do not wish or are unable to care for their own money. Small amounts of money are sometimes left for safe keeping by relatives. The accounts and receipts for this were seen. The Laurels - Winsford DS0000006519.V281844.R01.S.doc Version 5.1 Page 22 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 3 3 2 3 3 The Laurels - Winsford DS0000006519.V281844.R01.S.doc Version 5.1 Page 23 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. Standard Regulation Requirement Timescale for action 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 3 Refer to Standard OP28 OP31 OP36 Good Practice Recommendations A minimum of 50 of the care staff should be trained to NVQ level2 or equivalent The manager should complete her training for the Registered Managers Award within the recommended time scale. All care staff should receive formal supervision at least six times a year. The Laurels - Winsford DS0000006519.V281844.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 - Winsford DS0000006519.V281844.R01.S.doc Version 5.1 Page 25 - 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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