Archived: The Laurels Nursing Home

Updated 15 June 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 is 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.

The inspection took place on 22 March 2017. This was an unannounced inspection, and was carried out by two 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.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form the provider completes to give some key information about the service, what the service does well and improvements they plan to make. The provider returned the PIR and we took this into account when we made the judgements in this report.

Prior to the inspection, we reviewed information we held about the service including statutory notifications. Statutory notifications are information about specific important events the service is legally required to send to us.

Some people at the home were not able to tell us about their experiences. We used a number of different methods such as undertaking observations to help us understand people's experiences of the home. As part of our observations we used the Short Observational Tool for Inspection (SOFI). SOFI is a way of observing care to help us understand the needs of people who could not talk with us.

As part of our inspection, we spoke to 13 people who used the service, the registered manager, two relatives, seven members of staff and a visiting professional.

We tracked the care and support provided to people and reviewed care plans relating to this. We also looked at records relating to the management of the home, such as the staffing rota, policies, recruitment and training records, meeting minutes and audit reports.

Updated 15 June 2017

We carried out this inspection on 22 March 2017. When the service was last inspected in January 2016 there were two breaches of the legal requirements in relation to ‘person centred care’ and ‘need for consent’. Following the inspection in January 2016 the provider wrote to us to say what they would do to meet the legal requirements. At this inspection we checked that the provider had made sufficient improvements. Although they were meeting the legal requirements in relation to the regulations breached at the last inspection there had been a decline in the standard of service. We found breaches of other regulations at this inspection.

The service is a nursing home and is registered to provide care and support for up to 36 older people. On the day of our inspection there were 27 people living at the service.

The service has a registered manager. 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 provider had quality monitoring systems in place which were used to bring about improvements to the service. These systems had been ineffective in ensuring that the service was meeting the regulatory standards.

Staffing was not organised in a way to meet people’s individual needs. Whilst we observed staff working with people in a kind and compassionate way, people told us that this was not always reflective of care provided to them. People did not receive adequate person centred personal care.

The home was not suitably clean and maintained. Equipment was not stored safely. Fire risk was not effectively managed.

Records containing confidential information were stored inappropriately.

The staff had received training regarding how to keep people safe and they were aware of the service safeguarding and whistle-blowing policy and procedures.

People’s needs were regularly assessed and care plans provided guidance to staff on how people were to be supported; however not all care plans contained sufficient information about people's needs. People’s care, treatment and support was personalised to reflect people’s preferences.

The staff had a clear knowledge of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). These safeguards aim to protect people living in care homes from being inappropriately deprived of their liberty. These safeguards can only be used when a person lacks the mental capacity to make certain decisions and there is no other way of supporting the person safely. Meetings had been arranged in order to enable people’s best interest to be assessed when it had been identified that they lacked the capacity to consent to their care and treatment.

There was a robust staff recruitment process in operation designed to employ staff that would have or be able to develop the skills to keep people safe and support people to meet their needs.

Staff demonstrated a detailed knowledge of people’s needs and had received training to support people to be safe and respond to their support needs.

The service maintained daily records of how peoples support needs were met and this included information about medical appointments for example with GP’s and dentists.

There was a complaints procedure for people, families and friends to use and compliments could also be recorded.

We saw that the service took time to work with and understand people’s individual way of communicating in order that the service staff could respond appropriately to the person.

We found four breaches of regulations at this inspection and will be asking the provider to send us a report of the improvements they will make.