Archived: Laurel House

Updated 25 August 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection team consisted of an inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service provides care and support to people living in two ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was announced. We gave a short period notice of the inspection because some of the people using it could not consent to a home visit from an inspector. This meant that we had to arrange for a ‘best interests’ decision about this.

Inspection activity started on 19 July 2022 and ended on 2 August 2022. We visited the location’s office and supported living settings on 26 July 2022 and 2 August 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used information gathered as part of monitoring activity that took place on 10 March 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.

During the inspection

We met eight out of nine people who used the service, however not all people due to their complex communication styles were able to feedback verbally. We were able to speak with one person, four relatives, a social worker and a care leaver advisor about their experience of the care provided. We also observed how people were being cared for and supported.

We spoke with five members of staff including the nominated individual who is also a director of the service. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with the registered manager, deputy manager, and two care workers.

We reviewed a range of records. This included three people’s care records and three people’s medication records. We looked at records in relation to tenancy and care agreements, complaints, incident and accidents, unannounced spot checks, and safeguarding. We also looked at staff rotas, staff training, and staff supervision. A variety of governance records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider around people’s personal expenditure financial audits and people’s feedback on the service. This was to validate evidence found.

Updated 25 August 2022

About the service

Laurel House is a supported living service providing personal care and support to nine younger adults at the time of the inspection at two houses. The houses have a shared lounge area, dining room, bathroom and toilet facilities and a shared garden. One of the houses has the services office from which the regulated activity of personal care is carried out from. The office will be moving outside of this supported living address.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence. We also expect good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

People’s experience of using this service and what we found

Right Support:

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the systems in the service supported this practice. Staff empowered people to be as independent as possible. People were encouraged to have as much control over their own lives as practicable. Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. Staff supported people to pursue their hobbies and leisure pursuits and to achieve their aspirations and goals. This included living as independent a life as possible.

Staff worked with people to plan for when they experienced periods of anxiety. This was so people’s freedoms were restricted only if there was no alternative. Staff learned from those incidents and how they might be avoided or reduced. People had a choice about their living environment and were able to personalise their rooms. Staff enabled people to access specialist health and social care support in the community. Staff supported people with their medicines in a way that achieved the best possible health outcome.

Right Care:

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. Staff understood and responded to people’s individual needs. Staff knew how to protect people from poor care and harm. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. The service had enough appropriately skilled staff to meet people’s needs and keep them safe. People could communicate with staff and understand information given to them because staff supported them consistently. Staff understood people’s individual communication needs. People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life. Where appropriate, staff encouraged and enabled people to take positive risks.

Right Culture:

People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. People received good quality care, support and treatment because trained staff could meet their needs and wishes. Staff placed people’s wishes, needs and rights at the heart of everything they did. People and those important to them, including advocates, were involved in planning their care. Staff enabled people and those important to them worked with staff to develop the service. Staff valued and acted upon people’s views. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 18 June 2021 and this is the first inspection. The last rating for the service under the previous provider was Good, published on 15 March 2019.

Why we inspected

This is the first rating of this service under the new provider. This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.