Inspection on 24/08/06 for The Laurels - Winsford

This inspection was carried out on 24th August 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 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 01/03/06

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 24th August 2006 09:30 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.V303445.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Laurels - Winsford DS0000006519.V303445.R01.S.doc Version 5.2 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 June Lomas 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.V303445.R01.S.doc Version 5.2 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) * Up to 5 service users in the category of DE (Dementia under 65 years of age) 1st March 2006 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 current weekly fees range from £410 00 to £475.00. Further details regarding fees are available from the manager. Additional charges are made for newspapers, hairdressing and toiletries. Prospective residents are able to read the latest CSCI inspection report, which is available in a copy of the Service User Guide in the entrance hall. A copy of this guide is also available in each resident’s bedroom. Other information about the home and CLS is available in leaflets on display in the hall. These outline the lifestyle that residents can expect when they move into the home. The Laurels - Winsford DS0000006519.V303445.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection process of The Laurels included a site visit to the home which was unannounced and completed in one day. Time was spent sitting and taking with people who use the service and observing the day-to-day routines of the home and care staff as they provided support. Time was also spent looking around the building to assess its suitability to provide a comfortable, safe and homely environment for the enjoyment of everyone. As well as the views of the residents that live in the home, five visitors to the home were spoken with. Their comments have been included in the report. The views of the staff on duty were also listened to. A number of CSCI survey questionnaires for residents and visitors were posted to the home prior to the visit. Three relatives and nine residents returned completed questionnaires. Comments from these have been included in the report. What the service does well: Residents spoken with in the home all said they were well cared for, and visitors also gave positive comments about the care. One visitor wrote on a comment card, “The staff here are wonderful. The care and attention that is given to not just my father but all the residents is second to none and everyone is treated as a family”. Another relative wrote, “There is a friendly atmosphere in the home and the residents are well looked after”. Some comments received from residents include: • “The food is always good and my room is always clean and tidy”. • “I like it here very much”. • “I feel I am well cared for”. • “Can’t fault it”. Residents have a comfortable home in which to live, with a choice of lounges and sitting areas with plenty of garden space to sit outside or walk. The atmosphere in the home is warm and welcoming and there is evidence of good relationships between residents, relatives and the staff group. Various activities and outings take place, which residents can join in with if they wish. The Laurels - Winsford DS0000006519.V303445.R01.S.doc Version 5.2 Page 6 The staff team is a happy group, with staff who are well trained and able to meet the needs of the residents, ensuring the standard of care is good. CSCI has not received any complaints about The Laurels in the last twelve months. 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 - Winsford DS0000006519.V303445.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection The Laurels - Winsford DS0000006519.V303445.R01.S.doc Version 5.2 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 the following standard(s): 3. Standard 6 does not apply, as intermediate care is not provided Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are assessed before they move into the home. This ensures that each resident and their family know that these needs can be met when they move into The Laurels. EVIDENCE: The admission procedure ensures that new residents are fully assessed prior to moving into the home. Either the 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 files of four residents were checked, including one of a resident who had recently moved into the home. Completed assessment forms were available on each care plan. When the resident moves into the home, this information is used to develop a plan of care. The Laurels - Winsford DS0000006519.V303445.R01.S.doc Version 5.2 Page 9 One relative, who visited The Laurels whilst looking for a home for his mother wrote in a comment card, “We were given detailed information and shown around the home by the manager. She spent a lot of time with us, especially considering we arrived without having arranged a meeting”. The Laurels - Winsford DS0000006519.V303445.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are well looked after so their health and social care needs are 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, reviewed on a regular basis and care plans updated. This ensured that residents’ changing needs were always recorded in the plans of care. All contained risk assessments, moving and handling information, information about contact with medical professionals, nutritional records and a variety of other records to ensure the residents’ wellbeing. Residents’ interests, hobbies and previous lifestyle were also recorded in a ‘life profile’ document. Residents are involved in the preparation of care plans whenever possible, which are audited by the manager on a regular basis. The Laurels - Winsford DS0000006519.V303445.R01.S.doc Version 5.2 Page 11 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 who give out medication have attended a medication training course. The home has a medication policy and the manager regularly audits that the medication procedures are followed. The storage, returns and recording of medication was all in good order, ensuring safe working practices for the residents The Laurels - Winsford DS0000006519.V303445.R01.S.doc Version 5.2 Page 12 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, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have choice in how they spend their days in the home so they have some control over their lives. EVIDENCE: An activities co-ordinator is employed and she has developed a range of social activities with residents. There is an activities lounge which has the addition of a bar and shop. Recent events have included a trip out for a pub lunch and inhouse activities include musical events, craft, discussion groups and bingo. Fund raising activities for the residents’ Comforts Fund are taking place and bingo is held in a local club for the home on a regular basis. Good links with the local church have been established. 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 activities co-ordinator is developing her role in this unit. The kitchen area in Willow has been enlarged and staff plan to be more involved with food preparation, with residents participating. There was evidence that the staff in this unit had formed good relationships with the residents and their families. The Laurels - Winsford DS0000006519.V303445.R01.S.doc Version 5.2 Page 13 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 regularly. Visitors spoken with said they are welcomed into the home at any time. The daily menus each have two or three choices at each meal, and the cook confirmed that she has flexibility within the menu choices to meet the individual needs of residents. The menus seen provided a good variety of food, using fresh fruit and vegetables. Special diets are also catered for. There is one main dining area in the home and food is served through a hatch from the kitchen. A hot trolley is used for Willow unit. Some residents were enjoying homemade bacon and leek pie with potatoes, broccoli and carrots, while others had chosen fish cakes or salad. The food served for lunch looked appetising and well cooked, with plenty available for second helpings for those who wanted some more. The residents spoken with said the food was very good. Cooked breakfasts are available and thoroughly enjoyed by some residents. Some comments received from the residents about the food include: • “Couldn’t complain about the food – lots of fresh vegetables”. • “Food edible and good”. • “The food is very good. We get very well fed”. • “I used to be a cook, so I know about food - it is very nice”. • “I am not a big eater, but the food is very nice”. The Laurels - Winsford DS0000006519.V303445.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a clear and accessible complaints procedure ensuring that any concerns of residents or their families are dealt with promptly and correctly. There are good procedures for protecting residents from abuse so that they are not at risk from harm or poor practice. EVIDENCE: The complaints procedure is available in the service user’s guide, a copy of which is in the hall and information regarding how to contact the CSCI is displayed. CLS encourages residents and visitors to express any comments they have about the service provided, and comment cards are on display in the entrance hall. CSCI has not received any complaints about the home since the last inspection. The pre inspection questionnaire indicated that the home has not received any complaints in the past year. The manager encourages families to discuss any issues or concerns they have with her and the staff, so that these can be put right immediately. None of the residents spoken with has made any complaints, but all knew who to speak to if they had any concerns. One visitor said: • “If I have any concerns I speak to the manager and it is actioned”. • “We come regularly to the home and have never seen anything to cause us concern”. The Laurels - Winsford DS0000006519.V303445.R01.S.doc Version 5.2 Page 15 The staff spoken with displayed an understanding of adult protection procedures. A training course on adult abuse and has been recently arranged for staff to update their knowledge. These training sessions will continue for new staff. There are policies and procedures in place for the protection of residents. The Laurels - Winsford DS0000006519.V303445.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, comfortable environment, which meets their needs and encourages independence. 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 and these include the dining room, one of the corridors and the main staircase. Since the last inspection, the staff have made good efforts to make the bathrooms more homely and comfortable. Residents spoken with appreciated this. The communal space in Willow unit is open plan, spacious, light and airy, providing very comfortable accommodation. There is also a second smaller The Laurels - Winsford DS0000006519.V303445.R01.S.doc Version 5.2 Page 17 quiet lounge available for residents. The kitchen area has been enlarged, encouraging residents to watch or be involved in the preparation of meals. A secure and private garden area has been created at the rear of the home for the residents living in Willow unit. This provides more independence, safety 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 are keeping the home supplied with tomatoes. A number of bedrooms were seen, and all were in good order and reflected the individual tastes of residents. Various aids and equipment are available in the home to promote independence. 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. One very regular visitor to Willow unit said, “We would definitely recommend this unit – it never smells”. The Laurels - Winsford DS0000006519.V303445.R01.S.doc Version 5.2 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): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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: Due to staff sickness, holidays and vacancies, a number of agency staff have been working at The Laurels over the past few months. One resident raised minor concerns, but some of the permanent staff group have found this difficult. One staff member said that in spite of the staff shortages, it is “still a good place to work in”. The manager is in the process of filling the vacancies. 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, 11 of the 28 care staff group (39 ) hold a minimum of NVQ level 2. Eleven care staff have commenced their training. In-house training for staff continues on a regular basis according to need. The staff spoken with said their training was updated as required and all felt there was sufficient training available. The staff group felt well supported by the management of the home. Residents spoken with said the staff are kind and caring, and some of the comments received are: • “I love it here – the staff will do anything for you”. The Laurels - Winsford DS0000006519.V303445.R01.S.doc Version 5.2 Page 19 • • “The staff are good fun – we have a laugh and a joke”. “The staff are smashing – I get on famous with them”. Good policies and procedures are in place for the recruitment of staff. Four staff files were seen and each contained evidence of an interview, two references and the necessary CRB checks having been obtained before the staff member commenced duties. Equality and diversity within the home can be seen in the way the residents are treated as individuals with different needs. The home strives to meet these needs as appropriate, and provide the necessary care to enable the resident to live their chosen lifestyle. The Laurels - Winsford DS0000006519.V303445.R01.S.doc Version 5.2 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, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is experienced and supported by senior staff, ensuring the residents live in a well run home. Various opportunities are given to residents and their families so they can express a view on the running of the home and services received. EVIDENCE: The manager at The Laurels has a number of years experience as care team leader at the home. She has been registered as a manager with CSCI this year and has commenced training towards the Registered Managers Award. A quality assurance system is in place, and residents and/or their families completed a satisfaction questionnaire last year. The results of this survey have been collated and a summary is available in the service users’ guide. A new quality survey is planned for the near future. Residents’ meetings are The Laurels - Winsford DS0000006519.V303445.R01.S.doc Version 5.2 Page 21 also held on a regular basis, enabling them to voice an opinion about their lives at The Laurels. As mentioned under standard 16, the home encourages comments or suggestions from visitors to the home, and forms for this are available in the entrance hall. The home works to a good system for safeguarding residents’ money, and clear records with receipts are kept. Policies and procedures for safeguarding residents’ money provide security. Some of the care staff spoken with said that one-to-one supervision with their line manager was not taking place as often as it should. Records in staff files confirmed this. A recommendation was made at the previous inspection that supervision for all care staff should take place at least six times a year. The pre inspection questionnaire provided information to confirm that equipment and installations at the home are serviced on a regular basis. The home employs a handyman who attends to maintenance issues such as checking fire equipment, water temperatures and other health and safety matters, providing a safe environment for staff and residents. The Laurels - Winsford DS0000006519.V303445.R01.S.doc Version 5.2 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 X 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 3 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 X 3 X 3 2 X 3 The Laurels - Winsford DS0000006519.V303445.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 Refer to Standard OP36 Good Practice Recommendations All care staff should receive formal supervision at least six times a year. The Laurels - Winsford DS0000006519.V303445.R01.S.doc Version 5.2 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.V303445.R01.S.doc Version 5.2 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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