Lauren Court Residential Care Home

Lauren Court Residential care home is a care home providing accommodation and personal care to up to 48 people. At the time of the inspection there were 36 people living in the home.

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

Systems to monitor the environment and the quality of care within the home were not always effective, they did not identify some of the concerns we found during this inspection.

Care plans and risk assessments were not always being followed, there was no evidence people were receiving oral care. There were gaps in the recording of information which meant we were not always assured people were getting the care they required in line with their assessed need.

The deployment of staff within the home was not always appropriate, we observed people being left for long periods of time without their assessed level of support. People told us they were not able to have a shower or bath when they wanted due to staffing levels.

People told us they felt safe and supported within the home and positive staff interaction was observed. People told us permanent staff knew their needs and supported them with dignity and respect. Some concerns were raised in relation to the use of agency staff and their lack of understanding of people’s needs. The provider had recruited more staff who were undergoing their induction and continued to recruit further staff, to ensure there is enough permanent staff to cover holiday leave or any periods of sickness.

Medicines were not always managed safely to ensure people had taken the medicines they needed.

Systems were in place to gather feedback from people regarding the service and some identified actions were acted on although some concerns still remain a concern for some people.

Policies and procedures were in place to safeguard people from abuse and staff were aware of their own roles and responsibilities.

People were offered a choice at mealtimes and were provided with serviettes and condiments.

Health and safety checks were in place and were being monitored.

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 policies and systems in the service supported this practice.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 08 June 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations 11 and 12 of the Health and Social Care Act 2014. However, we found the provider remained in breach of regulation 17.

The service remains rated requires improvement. This service has been rated requires improvement for two consecutive inspections.

Why we inspected

We received concerns in relation to quality of care. As a result, we undertook a focused inspection to review the key questions of Safe, Effective, Responsive, and Well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For the key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well led sections of this report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lauren Court Residential care home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified an ongoing breach in relation to the governance systems and management within the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

We have also made recommendations in relation to medicines, the environment and engaging with people.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Lauren Court is a care home providing accommodation and personal care to up to 48 people. At the time of the inspection there were 43 people living in the home.

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

The systems in place to monitor the quality and safety of the service were not effective, as audits completed did not identify all the issues we highlighted during the inspection. Risks were not always assessed and mitigated robustly to ensure people’s safety. For instance, care plans and risk assessments were not all in place regarding people’s health needs, and some plans did not provide enough detail to ensure staff knew how to best support people. Regular internal checks on the building and equipment were not maintained to ensure safety.

Systems in place to manage applications to deprive people of their liberty were not effective. People were not supported to have maximum choice and control of their lives; the policies and systems in the service did not support this practice. Tools used to assess people’s capacity were not clear, decision specific and best interest decisions were not always recorded.

We have made a recommendation about staffing levels and the safe recruitment of staff. The feedback regarding staffing levels was mixed and the registered manager told us they were trying to recruit to increase the staffing levels. Although safe recruitment checks were mostly evident, this process could be further improved.

Cleaning schedules were not robustly completed, however the home appeared to be clean overall and additional domestic staff were being recruited. Staff had access to adequate supplies of PPE, took regular COVID-19 tests and had completed training in infection prevention and control. People’s friends and relatives were supported to visit in line with government guidance.

People and their relatives told us they felt Lauren Court was a safe place to live. Staff were aware of their responsibilities with regards to safeguarding and whistleblowing and told us they would not hesitate to raise any concerns they had. Staff had completed training to help ensure they had the necessary skills to support people safely. The GP or other health professionals were contacted for advice when required.

People told us they were treated well, and their dignity and privacy were respected. We observed staff engaging with people during the inspection, in a caring and warm manner. People’s nutritional risks had been assessed and kitchen staff knew people’s specific dietary requirements. People told us they had enough to eat and drink and there was always choice available.

Systems were in place to gather feedback from people regarding the service, including regular meetings and a complaints process. Relatives were kept updated with any changes and people were supported to keep in touch with friends and family, including during the COVID-19 pandemic. The provider took action following the inspection to address the concerns raised and to share and promote learning across their other locations.

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

Rating at last inspection

HC-One Limited were registered as the provider of this service on 27 August 2021. The last rating for the service under the previous provider was good, published on 29 May 2019.

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment, consent and the governance of the service.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.