Care Home: Laurel Bank

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What the care home does well Those residents and visitors who spoke with us said they thought they received a good level of service. One person particularly mentioned the caring staff and the accessibility of the managers. A relative wrote in the survey "overall cleanliness, good food and caring" was what the service does well. One visitor told us said she liked the fact she could visit her relative in private whenever she chose to. We could see and some visitors told us that Laurel bank provides a good standard of care from a well-trained, enthusiastic and committed staff team. They are lead by an experienced and qualified manager who in turn is supported by a confident team of senior carers. What has improved since the last inspection? We saw that the home now provides a programme of activities and trips out. We could see photographs of the most recent trip on a local canal, displayed in the hallway. We were shown the garden that had recently been landscaped. This now provides the residents with a safe and pleasant area place to sit in the better weather. We were told that this improvement was in response to the annual satisfaction questionnaire. We could see that the programme of re decoration in some bedrooms and communal areas was continuing. What the care home could do better: We could see that some aspects of the resident`s person accommodation continued to look shabby. CARE HOMES FOR OLDER PEOPLE Laurel Bank Knott Lane Gee Cross Hyde Tameside SK14 5HZ Lead Inspector Janet Ranson Unannounced Inspection 10:00 10 October 2007 th 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 Laurel Bank DS0000005574.V342468.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. Laurel Bank DS0000005574.V342468.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Laurel Bank Address Knott Lane Gee Cross Hyde Tameside SK14 5HZ 0161 368 4719 0161 367 8950 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) Laurel Bank Residential Care Home Limited Mrs Patricia Connell Care Home 41 Category(ies) of Dementia - over 65 years of age (41), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (3), Old age, not falling within any other category (41), Physical disability over 65 years of age (40), Sensory Impairment over 65 years of age (3) Laurel Bank DS0000005574.V342468.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 41 service users to include: *up to 41 service users in the category OP (Old Age, not falling within any other category). *up to 3 service users in the category MD(E) (Mental Disorder, excluding learning disability or dementia over 65) *up to 40 service users in the category PD(E) (Physical Disability over 65 years of age). *up to 3 service users in the category SI(E) (Sensory Impairment over 65 years of age). *up to 41 service users in the category DE(E) (Dementia over 65 years of age). 1st November 2006 Date of last inspection Brief Description of the Service: Laurel Bank is a care home adapted to meet the needs of 41 older people. Previously a Victorian church school, the adaptations now provide accommodation on three floors. There are 35 single bedrooms, 15 of which have en-suite facilities, and three double en-suite rooms. The bedrooms are located on all three floors and there is a full passenger lift. There are a total of six day/quiet rooms on all floors. A conservatory has been built to provide additional lounge space. In addition, there are two dining rooms, one on the ground floor and a further one on the third floor. Adapted baths and toilets are also located and clearly signed throughout the home. There is a small secure garden available to the service users, at the side of the building. Car parking is available at the front of the building, in addition to planted areas. The home is situated in a residential area, close to the centre of Gee Cross. There is a small shopping area within walking distance. The market towns of Hyde and Stockport are accessible by public transport. The people who live at Laurel Bank have been assessed as requiring residential care. The Commission for Social Care Inspection has registered the home to provide care for older people who may have dementia and/or physical disability. The fees for accommodation and care at the home range from £380 to £450 per week. Additional charges are also made for hairdressing and chiropody services, newspapers and personal toiletries. Laurel Bank DS0000005574.V342468.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key inspection, which included an unannounced visit to the home, was carried out on the 10th October 2007. We (the Commission) arrived at 10:45 and stayed until 18:15. The registered manager was on leave at this time so the inspection was carried out with the assistance of team leaders. The manager had previously sent us an annual quality assurance assessment (AQAA) and a data set that gave us certain information about the service. From these details a selection of service users and their relatives were invited to complete a small survey so they could have the option to provide information about the service they receive. We also took a random tour of the building and looked at a selection of residents and staff records as well as other documentation including duty rotas, medication records and the staff recruitment process. What the service does well: What has improved since the last inspection? We saw that the home now provides a programme of activities and trips out. We could see photographs of the most recent trip on a local canal, displayed in the hallway. We were shown the garden that had recently been landscaped. This now provides the residents with a safe and pleasant area place to sit in the better weather. We were told that this improvement was in response to the annual satisfaction questionnaire. Laurel Bank DS0000005574.V342468.R01.S.doc Version 5.2 Page 6 We could see that the programme of re decoration in some bedrooms and communal areas was continuing. 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 summary of this inspection report can be made available in other formats on request. Laurel Bank DS0000005574.V342468.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 Laurel Bank DS0000005574.V342468.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (standard 6 intermediate care is not provided at this home.) Quality in this outcome area is good. The residents have an assessment carried out by a senior member of staff before they move into the home. This means that the resident can be sure the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We examined a selection of resident’s files. They showed us that an assessment of need had been completed prior to them being offered a place in the home. The team leader confirmed that either herself or the manager usually visited the potential resident at their current place. The purpose of the visit was to introduce themselves and explain what the home had to offer. Laurel Bank DS0000005574.V342468.R01.S.doc Version 5.2 Page 9 A visitor told us that he had looked around the home on behalf of his relative. He also told us that he and his relative had received written information about the home and the services they could offer. Laurel Bank DS0000005574.V342468.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. The residents’ individual health and social requirements are identified and met through the care planning process. The care plans provide the carers with action to be taken so that the residents to benefit from the individual care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We looked at four care plans in detail from admission to the present day. They were all quite detailed and showed where health care professionals had also been involved in the individual care. The care plans set out the action to be taken each day to meet with the individual care needs. Some of the written process had been improved since the last inspection. They now place the person at the centre of the care so their direct wishes and preferences are clearly documented. We had one Laurel Bank DS0000005574.V342468.R01.S.doc Version 5.2 Page 11 observation to make concerning the new format. This concerned the way they recorded any changes to the person’s condition. The team leader told us that they had recognised this and were considering options whilst still keeping the system “user friendly”. A visitor said he was involved in the care planning process on behalf of his relative. We saw there was involvement from other healthcare professionals including; • • • • • • Chiropody District nursing service Optician General practitioner Audiologist Dietician Individual outcomes were clearly documented in the care files. We were told that the home contacts relatives to tell them of any changes in a resident’s condition. This was confirmed by a visitor who also told us he felt fully involved in his relatives care. A survey from a relative responded to the question, “Are you kept up to date with important issues affecting your friend/relative?” “They phone me least little thing that happens to him.” All senior staff responsible for the administration of medication has received the appropriate training. Records are retained to show changes to medications and medical interventions. There is a policy and procedure in place to ensure all medications are administered and stored in the correct manner. Based on observation and discussion with the residents and their visitors, we can conclude that individual dignity and respect for privacy is promoted within the home. Laurel Bank DS0000005574.V342468.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. The residents are helped maintain their links with families and friends, and are provided with a balanced and nutritional menu. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A notice board located at the front entrance now shows us what is going on at the home. Photographs have also been displayed of those people who have enjoyed organised trips out. This is an improvement from the last inspection where we recommended that the residents would benefit from a more structured activities programme. The AQAA told us that entertainers visit the home at least twice a month. Records are kept of all activities undertaken. We saw that the care files contain a resident’s profile. This details the individual’s previous interests, occupation, their religion and life style. We thought this was a particularly good way of helping those residents who have dementia. Laurel Bank DS0000005574.V342468.R01.S.doc Version 5.2 Page 13 Visitors told us they felt welcome when they visited the home. One person said he had particularly appreciated being invited to stay for a meal with his relative. He told us the meal was very good, tasty and nicely presented. The daily menu could be seen in the home. It showed the options available at eat mealtime. The content of the menu appeared nutritious and well balanced. We saw that the dining room was well presented and the residents had specialist equipment to help them to eat independently. Laurel Bank DS0000005574.V342468.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. The residents benefit from a culture that values their comments, that listens to any complaints, and acts upon them. Staff knowledge and understanding of adult protection issues provides a safe environment to protect residents from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We could see that the complaints procedure was displayed about the home. We were also told it could be seen in the service users guide. Two visitors said they had received the service users guide and were familiar with the way to make a complaint. One person said they would not bother with this but would not hesitate to speak to one of the senior staff if they had a concern about the care of their relative. They felt certain that they would be taken seriously and that the problem would be sorted out. We were told that all complaints and compliments were recorded along with the outcomes. Several cards of appreciation from residents and relatives were on display. Laurel Bank DS0000005574.V342468.R01.S.doc Version 5.2 Page 15 The home has a policy and procedure to respond to allegations of abuse. The senior carers have training in safeguarding adults. The training enables them to “cascade” the knowledge to other carers. A carer told us they had received the training and demonstrated her understanding of their responsibilities. The commission have received no concerns about the service and there has been no safeguarding adults investigations carried out since the last inspection. Laurel Bank DS0000005574.V342468.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. The residents and their visitors are provided with a safe, warm and welcoming environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We have made requirements at previous inspections, to make improvements to the environment within the home. This was specifically with regard to the communal areas and the resident’s bedrooms. Re decoration work has now been completed in the main hallway, staircase and landings. This creates a pleasant entrance to the home. Elsewhere there was evidence to show that bedrooms continue to be decorated and new carpet fitted, when they become vacant. Laurel Bank DS0000005574.V342468.R01.S.doc Version 5.2 Page 17 We could see that the décor in some of the double rooms remains very shabby, as does some of the bedroom furniture. There was evidence that the residents and their families had been encouraged to personalise their rooms. Generally we thought the standard of hygiene was high and there were no offensive smells. Two visitors and one resident commented favourably to this effect. One visitor did say she had reservations about the environment her relative was living in, but not about the standard of care. This comment was discussed with the team leader at the time. We were told the home shares a maintenance person with Polebank (the sister home). There were no hazards to affect health and safety of the residents, staff or visitors noted. The garden to the side of the building had been landscaped since the last visit to the home. This now gives the residents a nice outlook and the addition of a water feature created a further interest. Laurel Bank DS0000005574.V342468.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. The residents receive care from well-trained staff that responds to the residents and visitors in a respectful manner. The homes recruitment policy and procedure provides protection to the residents from potential abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We observed during the inspection the numbers of staff on duty met with the residents’ assessed needs. A duty rota was available for inspection purposes. The manager told us in the AQAA that there had been a small staff turnover since the last inspection. This means that the residents benefit from continuity of care. We were told that all the mandatory training had been carried out and some specialist courses have been completed via the training consortium. During the inspection a team leader, who is accredited to teach, was taking a group of staff through the moving and handling training. This included the current legislation and practical exercises. Laurel Bank DS0000005574.V342468.R01.S.doc Version 5.2 Page 19 The home is committed to the National Vocational Qualification (NVQ) with a high ratio of carers achieving level two or above. Training records are retained along with the certificates as evidence of attendance. A carer told us she enjoyed the training courses provided at the home and elsewhere. She also told us that the management was approachable and supportive. We examined a small number of staff files. We saw they contained the required documentation with evidence of satisfactory references including checks with the Criminal Record Bureau. This means that the people who live at Laurel Bank a protected from those people who may want to harm them. Laurel Bank DS0000005574.V342468.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. The manager of the home has the skills, experience and qualifications to run the home in the resident’s best interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We know the registered manager has the appropriate skills and experience to manage Laurel Bank, where she has worked for many years. She has achieved her National Vocational Qualification at level four and the required Registered Managers Award. There was further evidence to show that she continues to update her knowledge and skills by attending various courses. Laurel Bank DS0000005574.V342468.R01.S.doc Version 5.2 Page 21 The manager is supported by a mature team of senior staff. We thought in the absence of the manager, that they fulfilled their duties to the commission during the inspection with confidence. A visitor told us that the home continues to run in an efficient and seamless manner despite the manager being on leave. The home has a system to protect the financial interests for those residents who are no longer able to deal with their money. Satisfactory records with receipts covering all expenses are retained for auditing and inspection purposes. The managing director audits the records at regular intervals. We could see that the care plans and risk assessments were up to date and regularly reviewed as are the homes policies and procedures. The home uses part of a quality assurance system that is specifically designed for care homes purposes. We were told that satisfaction surveys are sent out to the residents or their representatives, annually. There was evidence that comments contained within the surveys were acted up wherever possible. We know that the service provider (through the general manager) carries out the requirements in regulation 26 of the Care Homes Regulations. The commission holds copies of her reports. No hazards to health were noted during the inspection. The health, safety and welfare are further ensured by the systems in place to report any accidents and incidents. We were told that all equipment and appliances in the home were maintained under contract, in safe working order Laurel Bank DS0000005574.V342468.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 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Laurel Bank DS0000005574.V342468.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 OP19 Good Practice Recommendations The programme to upgrade the environment, particularly the shared bedrooms, should continue. Laurel Bank DS0000005574.V342468.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Manchester M16 9HU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Laurel Bank DS0000005574.V342468.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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