Care Home: Laurels Retirement Home

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What the care home does well We found that the home makes sure they only admit people for residential care through thorough assessment of prospective residents` needs prior to being offered a placement at the home. Once a person has been admitted, further assessments are carried out, from which a care plan is developed with the resident concerned. We saw that the care plans were up to date and fully informed staff of how to care for each resident. The health and social care needs of the residents we tracked through the inspection were being met. Medication was being administered by trained members of staff and there were suitable storage facilities within the home. The premises were clean, in good decorative order and furniture and fittings in good repair. There were no hazards identified during our inspection. Generally we found the home to be well-managed and run in the interests of the residents. Accidents were being recorded and the Commission has been notified as required of events, incidents and accidents that have occurred in the home. What the care home could do better: Medicines must be administered in accordance with the doctors directions. All staff must be recruited in accordance with the Care Homes Regulations 2001. The home`s laundry facilities could be improved. There could be better analysis of accidents resulting in falls in the home. Random inspection report Care homes for older people Name: Address: Laurels Retirement Home 195 Barrack Road Christchurch Dorset BH23 2AR one star adequate service 27/08/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Martin Bayne Date: 1 5 0 6 2 0 1 0 Information about the care home Name of care home: Address: Laurels Retirement Home 195 Barrack Road Christchurch Dorset BH23 2AR 01202470179 01202485200 laurels.rch@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Heidi Lambert Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Richard Kitchen,Mrs Elizabeth Kitchen care home 20 Number of places (if applicable): Under 65 Over 65 20 20 dementia old age, not falling within any other category Conditions of registration: 0 0 The maximum number of service users that can be accommodated is 20. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) Dementia aged 65 years or over (Code DE(E)) Date of last inspection 2 7 0 8 2 0 0 9 Care Homes for Older People Page 2 of 9 Brief description of the care home Laurels Retirement Home is a residential care home registered for twenty places under the category of OP (Old Age) and DE(E). It is an older style property, with a more recent extension, situated on one of the main roads into Christchurch town centre. Mr and Mrs Kitchen took over as proprietors of the home in September 2004. The majority of bedrooms are for single occupancy with two providing en-suite facilities. One of the four double rooms is also en-suite. The home has a lounge and a dining room, which also has a small seating area that looks out onto the patio. There are stair lifts to the upper floors. To the rear of the property is a secure, private patio area with seating where service users can entertain visitors. The fees for the home are detailed within the Service User Guide. Care Homes for Older People Page 3 of 9 What we found: At this random inspection we reviewed the records relating to the last two people admitted to the home. We were able to speak with one of these residents, the other being in hospital at the time of our visit. As part of this review we also looked at how their medication was administered and managed. We reviewed the recruitment records for the last two members of staff to be appointed to work at the home. We also carried out a tour of the premises and reviewed accidents and notices sent to the Commission. The Registered Manager had notified us that they would cease working at the home in May of this year. We were therefore assisted at this inspection by the homes deputy manager and we also met with the companys area manager and one of the owners of the home. At this inspection we were told of the interim management arrangements. The deputy manager is being supported to manage the home by the area manager until such time as a new manager can be appointed. Recruitment procedures have been instigated. The two residents we tracked through the inspection had had their needs assessed before a decision was made to offer a placement at the home. We saw that a copy of the care management assessment had been obtained on behalf of one of the residents who was being funded for respite care by the local council, the other person was privately funded. In respect of the privately funded resident, we saw that a pre-admission assessment had been recorded on a template that covered all of the topics within the National Minimum Standards and had been signed and dated. Concerning the resident staying at the home for respite care, we saw that the deputy manager had consulted their relative before admission to verify that the existing care plan reflected current needs. These procedures ensure that the home only admits those people whose needs can be met at the home. We found that on admission to the Laurels, further in-depth risk and other assessments were completed. These included, a falls risk assessment, general risk assessment, skin care assessment and medication assessment. The care files were well-ordered and the care plans reflected the needs of residents concerned, concisely informing staff on how to support each person. We saw that the care plans were being reviewed each month or when care needs changed. We also saw that a photograph of the resident concerned was placed at the front of their care plan so that they could be readily identified. We saw that both residents had been invited to sign their care plan to say that they had been involved in developing their care plan. We spoke with the resident accommodated at the home at the time of this inspection. Owing to their mental frailty they were not able to provide a full account of what it was like to live at the home, however they were presented in clean clothes and seemed relaxed and at ease with the staff and their environment. We looked at how medication was managed within the home by looking at the medication administration records, storage facilities and procedures for medication administration. The medication administration records for the two residents we tracked through the inspection were completed with no gaps within the recording; however on auditing one persons medication we found an extra tablet, indicating that on one administration, one tablet instead of two had been administered. The deputy manager agreed to investigate this and to report on the action taken. We saw that staff who administer medication had received training in safe administration and there was a list of sample signatures of staff trained to administer medication at the front of the administration records. There was Care Homes for Older People Page 4 of 9 also evidence of good practice of any known allergy from which a resident suffers being recorded at the front of their medication administration records; and that where hand entries were made to administration records, a second member of staff had checked and signed that the entries had been made correctly. We found that the home had suitable storage facilities for medicines held within the home. We saw that a new medication trolley had been purchased to assist staff in medication administration. At the time of our inspection there were no controlled drugs prescribed to residents. We saw that the home had a controlled drugs register, should such medications be prescribed. As part of this inspection we carried out a tour of the premises, which were clean and free from adverse odours with furniture and fittings in good repair. Since the last inspection of the home in August 2009, the downstairs area has been re-carpeted, new beds and curtains provided in most bedrooms, new vanity units installed in about half of the bedrooms and much of the interior re-decorated. A new call bell system and fire safety system have also been installed. At the last inspection we required window restrictors to be fitted on windows above ground floor. We saw at this inspection that the home had complied with this requirement. We also saw that residents were able to bring their own possessions and furniture to personalise their rooms. All radiators in the home have been covered to eliminate the risk of residents receiving burns from hot surfaces. Thermostatic mixer valves have been fitted to hot water outlets to also protect residents from scalding water. Free standing wardrobes have been risk assessed as to their potential for being pulled over and those that pose a risk, bracketed to the wall. We found at this inspection that laundry facilites could be improved. We saw that the sink in this area was being used to rinse soiled laundry and therefore there was no dedicated hand washing sink available, which could compromise infection control measures. The floor surface and walls were not sealed for easy cleaning. At the last key inspection of the home in Aug 2009 we had found the home had failed to fully comply with all the staff recruitment checks required under the Regulations. At this inspection we looked at the recruitment records for the last two members of staff recruited to the staff team. We found in respect of one of the staff that all of the recruitment checks had been carried out and the required records in place; such as, the taking up of appropriate references, criminal record bureau check and a check against the register of adults deemed unsuitable to work with vulnerable adults, a health declaration, full employment history with gaps explained and the reason why staff left positions of care. Concerning the other new member of staff we tracked, we found that there was only one personal reference in place; the one from their previous place of work in a care setting had not been returned to the Laurels, and their employment had gone ahead with no evidence of action to take up another reference or to pursue this matter. Further breaches may result in enforcement action, as there is a potential risk to residents should all the recruitment checks of new staff not be fully complied with. At the last inspection, a requirement was made for there to be two awake members of staff on duty during the nightime period. We found that the home had complied with this requirement. Two further requirements were made at the last key inspection. Namely, keeping accurate records where residents deposit small sums of money for safekeeping and reports being made following unannounced visits by the owners of the home. We found that the home had complied with both these requirements at this inspection. Care Homes for Older People Page 5 of 9 We looked at the homes accident book and found accidents had been recorded correctly and that notifications had been sent to the Commission as required. We also saw that there was a regular review of all accidents that occur in the home, however, there could be better analysis of falls by residents, to seek trends that could reduce the amount of these falls within the home. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 9 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 29 19 You are required to comply with all of the requirements of Schedule 2 of the Care Homes Regulations 2001. This is a repeated requirement. To make sure that suitable staff are employed. 05/07/2010 Care Homes for Older People Page 7 of 9 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 You are required to ensure that all medications are administered to residents in accordance with doctors instructions. In the interests of residents safety. 28/06/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 19 38 We recommend that plans are developed for the improvement of the laundry room. We recommend that there is better analysis of the incidence of falls within the home, seeking trends that could reduce the amount of falls. Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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