Archived: The Laurels Care Home with Nursing

Updated 28 July 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 27 June 2017 and was unannounced. The inspection team consisted of three adult social care inspectors 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.

On the day of our inspection there were 17 people living at the home. We spoke with the registered provider, the registered manager, one nurse, two care workers and one domestic assistant. We also spoke with four people who used the service and two visiting relatives. This helped us evaluate the quality of interactions that took place between people living in the home and the staff who supported them.

We spent time observing care throughout the service. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Prior to the inspection we gathered information from a number of sources. We looked at the information received about the service from notifications sent to the Care Quality Commission by the manager. We spoke with the local authority quality assurance officer who also undertakes periodic visits to the home.

Before our inspection we reviewed all the information we held about the service. The provider had completed a provider information return (PIR). This is a document that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make.

We looked at documents relating to people who used the service, staff and how the service was managed. We looked at four people’s written records, including care plans and risk assessments. We looked at the medication management systems, including medication records and systems in place for the storage of medicines. We checked the quality assurance systems that were in place to see if they were robust and effective in identified areas for improvement.

Updated 28 July 2017

The inspection took place on 27 June 2017 and was unannounced. The home was previously inspected in April 2015. It was overall rated good.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘The Laurels Care Home with Nursing’ on our website at ‘www.cqc.org.uk’.

The service had a registered manager who had been registered with the Care Quality Commission since January 2015. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The Laurels Care Home with Nursing is registered to provide nursing care for up to 20 people. On the day of our inspection, there were 17 people living at the home.

We found improvements were needed to the systems in place for supporting people with ‘as and when required’ (PRN) medicines. The registered manager told us they would ensure PRN protocols were updated, and that the medications policy would be updated to include information on how to support people with PRN medicines. We also found improvements were needed to the system for the ordering, storing and disposing of medicines. We found stock levels did not always tally with amounts recorded. During our inspection, the registered manager acted swiftly to make improvements. This included a full stock check of medication and an audit of the system, with changes being made to assist staff in future.

Systems were in place to protect people from the risk of harm and staff were knowledgeable about how to keep people safe. Staff could explain safeguarding policies and procedures, and actions they would take if they suspected abuse. There were enough staff employed, and on shift to keep people safe and meet their needs. Pre-employment checks had been carried out on staff before they started working at the home.

The requirements of the Mental Capacity Act 2005 were in place to protect people who may not have the capacity to make decisions for themselves. Care records we looked at contained risk assessments to identify risks associated with people’s care and to help monitor and reduce these risks without placing undue restrictions on people.

Appropriate referrals were made to healthcare professionals when required and the home was proactive in identifying changing needs. A GP clinic held weekly at the home meant people’s health conditions could be regularly monitored, which had resulted in a reduced number of admissions to hospitals.

Care and support records were personalised to people, and contained details of their life histories, preferences and favourite activities. The home enabled people to be involved in the local and wider community, by supporting people to attend local events, taking trips away to the coast and inviting the public into the home for the summer fayre. People we spoke with told us they were excited for the summer fayre that weekend.

Staff were kind and caring, and people who lived at the home said they felt staff knew them well. People said they were able to bring their own possessions into the home to make it feel more homely and familiar.

There was a complaints policy in place, which informed people how to raise a concern. Complaints were encouraged, even after initial concerns had been addressed and resolved. People said they felt able and confident to complain and knew how to.

There were effective systems in place to monitor and improve the quality of the service provided. Regular checks and audits were undertaken to make sure full and safe procedures were adhered to. People using the service and their relatives had been asked for their feedback through questionnaires, the results of these had been audited to identify any areas for improvement and any actions were addressed.