Inspection on 17/08/05 for The Laurels - Winsford

This inspection was carried out on 17th August 2005.

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 - Winsford 24/08/06

The Laurels - Winsford 01/03/06

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 Walnut Drive Winsford Cheshire CW7 3HH Lead Inspector Bronwyn Kelly Announced 17 August 2005 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 F51 F01 S 6519 The LaurelsI V 236303 Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Laurels Address Walnut Drive Winsford Cheshire CW5 5DQ 01606 593048 01606 863401 thelaurels@clsgroup.org CLS Care Services Limited 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) No registered manager in post at present. June Lomas is acting manager. Care Home (OP) Old Age (31) DE(E) Dementia (5) DE(E) Demetia over 65 (10) Category(ies) of (OP) Old Age (31) registration, with number DE(E) Dementia over 65 (10) of places DE Demetia (5) The Laurels F51 F01 S 6519 The LaurelsI V 236303 Stage4.doc Version 1.40 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 2 The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Date of last inspection 16th February 2005 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 and dining areas of different sizes, providing a good choice of communal areas around the home. Large enclosed grounds with seating areas and walkways are provided. A friendly cat lives in The Laurels, who is much loved by some of the residents. The Laurels F51 F01 S 6519 The LaurelsI V 236303 Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over a period of seven hours, commencing at 09.30 am. A tour of the building took place, and with the permission of the residents, a number of bedrooms were seen. Seven residents were spoken to individually and privately and each agreed to answer questions and fill in a comment card with assistance. General group discussions also took place in lounges and dining areas with a number of other residents. Three visiting relatives were spoken with during the day and four relative’s comment cards were received in the post following the inspection. The views of the staff on duty during the inspection were listened to. This included the acting manager, care team leader, three care assistants, domestic staff and the cook. 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. One resident commented, “You feel at home living here”. Another said, “It’s nice for my family to know that I am being well cared for”. Some comments received on comment cards from relatives include: • “I am very pleased with the way that the staff look after my father”. • “The Laurels has an excellent reputation in the care of the elderly”. • “The staff in the dementia unit are all very kind and caring”. • “ Dad was well cared for his three week stay”. There is a friendly, relaxed atmosphere in the home and communication between staff, residents and their families is good. Residents have a choice of food from a daily menu, and they gave good comments about the quality of the food. The residents’ plans of care are well written and up to date. Residents or their families are involved in the process where possible. The Laurels F51 F01 S 6519 The LaurelsI V 236303 Stage4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Laurels F51 F01 S 6519 The LaurelsI V 236303 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 F51 F01 S 6519 The LaurelsI V 236303 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 5 Residents’ needs are assessed before they move into the home to ensure they can be met. Residents and their families are encouraged to visit The Laurels, enabling an informed decision to be made about moving into the home. EVIDENCE: The admission procedure ensures that new residents are fully assessed prior to moving into the home and records of this are on residents’ files. Staff members confirmed that the acting manager and a care team leader visit each resident prior to them moving into the home. Two residents spoken with were able to recall that they had visited the home prior to moving in. Prospective residents are encouraged to visit The Laurels to check whether it is suitable for them, and visits are arranged to suit individual needs. These can be either a brief visit or for the whole day. All residents who decide to move into the home do so on a on a trial basis until confirmed by a review after six weeks. The Laurels F51 F01 S 6519 The LaurelsI V 236303 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, 8 and 9 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. Health care needs are identified and met. The medication system at the home is well managed so residents receive their medicines as prescribed. EVIDENCE: Five residents’ plans of care were seen and each clearly showed what staff need to do to meet all 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. 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 enable 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. The Laurels F51 F01 S 6519 The LaurelsI V 236303 Stage4.doc Version 1.40 Page 10 Senior staff in the home who give out medication have all attended a medication training course. The policies and procedures for dealing with medication are good. The Laurels F51 F01 S 6519 The LaurelsI V 236303 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) 12 and 15 The activities available in and out of the home meet the individual needs and choices of the majority of residents, but not all. The dietary needs of residents are well catered for with a balanced and varied selection of food that meets residents’ tastes and choices. EVIDENCE: The care staff undertake the task of arranging activities in The Laurels as there is no designated post of activities co-ordinator. Whilst residents appreciate arrangements made, the staff group felt that caring duties sometimes took priority over time that should have been spent on activities with residents. There was mixed comments from residents in reply to the question “Does the home provide suitable activities?” in the comment cards. Some were quite happy; others replied “Sometimes” and some implied that activities were only available when the staff had sufficient time. The acting manager is developing the range of social activities available for residents. An activities lounge is nearing completion, 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 a trip out for lunch, a theatre trip, birthday parties and barbecues in the garden. In-house activities include musical events and bingo. Fund raising activities for the residents’ Comfort Fund are taking place and a weekly bingo is held in a local club for the home. The Laurels F51 F01 S 6519 The LaurelsI V 236303 Stage4.doc Version 1.40 Page 12 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. Three care plans seen did not contain enough information regarding the social interests of residents and how these are met on a daily basis. There was evidence that the staff in this unit enjoyed their work and had formed good relationships with the residents and their families. The addition of a specialist person for activities may enhance the quality of life of those living in Willow unit. Residents are pleased with the food at The Laurels. In answer to the question “Do you like the food?” in the residents’ comment cards, all seven residents replied “Yes”. One resident said, “The food is very good – well cooked”. Another said “Brilliant”. There is a choice of menu at each meal and special diets are well catered for. The cook has flexibility in order to meet residents’ individual requirements regarding food where possible. A variety of ways are utilised in Willow unit to ensure that residents’ dietary needs are met, with food and snacks available in-between meals where necessary. The Laurels F51 F01 S 6519 The LaurelsI V 236303 Stage4.doc Version 1.40 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 18 The home has a satisfactory complaints procedure and a ‘comment card’ system, ensuring that any concerns of residents or their families are dealt with promptly. 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. The staff spoken with displayed a good understanding of adult protection procedures. The acting manager has just completed a training course on adult abuse. Following on from this, all staff are taking part in a video and training pack exercise to update their knowledge. One resident commented “It’s nice for my family to know that I am being well cared for”. The Laurels F51 F01 S 6519 The LaurelsI V 236303 Stage4.doc Version 1.40 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) 20, 25 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. There is evidence that the staff group are keen to improve the physical environment for the residents, and this improvement has been seen over the last few inspections. Since the last inspection, various corridors have been decorated and general improvements made to the standard of décor and furnishings throughout the home. This has provided the residents with a comfortable environment in which to live. Plans are underway to further improve the communal facilities in Willow unit. The Laurels F51 F01 S 6519 The LaurelsI V 236303 Stage4.doc Version 1.40 Page 15 The standard of cleanliness throughout the home was good, with no noticeable odours. One resident commented, “The standard of cleanliness is very good and I am a finicky person”. The gardens to the home provide residents with an attractive area to sit outside. A greenhouse is provided, and some residents have been supplying the home with tomatoes all summer. A secure garden area is being developed at the rear of the home. The Laurels F51 F01 S 6519 The LaurelsI V 236303 Stage4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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) 27and 30 Staff at the home are well trained and supported and employed in sufficient numbers to meet the needs of the residents most of the time. EVIDENCE: Three vacant posts and one long term sickness post has meant use of bank or agency staff. Most of the time this has worked reasonably well, but there have been a number of occasions since the last inspection when these agency staff have not turned up for work or cancelled at the last minute. This has meant that the number staff on duty have been below the agreed level. On two recent occasions, only one care staff has been on duty in Willow unit. This is not meeting the needs of the residents in this unit. Staff training continues to be encouraged and supported for staff, and the home is doing well towards meeting the qualified staff requirements of 50 before the end of the year. In house training in areas such as first aid, fire safety and moving and handling are continuing. Training in dementia care is planned in autumn for staff in Willow unit. The staff have good morale, and describe themselves as working as a ‘team’. On the morning of the inspection, two general assistants were helping the residents enjoy a game of bingo. This is an example of the flexibility of the staff team. One resident commented, “If you have a problem, you can talk to the staff – they will always help. I think that is very nice”. The Laurels F51 F01 S 6519 The LaurelsI V 236303 Stage4.doc Version 1.40 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 and 38 The registered manager has recently left, but staff and residents feel well supported by the acting manager. Opportunities are given to residents to express a view on the running of the home and services received. Regular supervision and training in health and safety matters ensures the safety and welfare of both staff and residents. EVIDENCE: The change of manager will mean there have been five managers in two years in post at The Laurels. This has caused some uncertainty for residents and staff. However, both staff and residents said they feel well supported in this interim period by the acting manager. Residents and their families have recently completed residents’ satisfaction questionnaires. The results are soon to be available in the service user guide. The Laurels F51 F01 S 6519 The LaurelsI V 236303 Stage4.doc Version 1.40 Page 18 Health and safety matters are given good attention. There are policies and procedure in place and evidence that staff work in ways to promote the well being of residents. The Laurels F51 F01 S 6519 The LaurelsI V 236303 Stage4.doc Version 1.40 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 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION x 3 x x x x 3 3 STAFFING Standard No Score 27 2 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x x x x 3 The Laurels F51 F01 S 6519 The LaurelsI V 236303 Stage4.doc Version 1.40 Page 20 no 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 27 Regulation 18(1)(a) Requirement The registered person must ensure that sufficient staff are on duty at all times to meet the needs of the residents. Timescale for action 08/09/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 12 Good Practice Recommendations The registered person should review the way in which social activities and outings are organised in the home and consider the appointment of a specialist person for this, paricularly in relation to Willow unit. 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