The Laurels and The Limes Care Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

During our assessment of this key question, we found the provider had not taken enough action to meet a breach in legal requirements we found at the last inspection of the service. Quality and safety audit systems were not always effective and did not always identify concerns we found during this assessment. These issues meant the provider continued to be in breach of regulation 17 of the HSCA 2008 (Regulated Activities) Regulations 2014. We received mixed feedback from external professionals about how the service worked with them. Improvements were required to ensure the provider continuously sought to improve the service. Most people told us the service was well led. Staff told us they felt supported in their roles and able to raise concerns. The new manager was committed to their own and the staff team’s professional development. People and staff told us the service had improved since the new manager had been in post.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff told us the culture in the service had improved. One staff said, "I feel fully supported by the managers, our ethos is to work as one big team, like a work family, it has been a positive step." Staff felt listened to. Staff were in involved in daily flash meetings, which had improved day to day communication between the team. Senior leaders undertook regular supervisions with staff, where they were able to raise concerns or suggestions.

The service had clear visions and values and these were displayed in reception areas and shared on social media groups. Star of the day initiatives were in place for both people using the service and staff, which celebrated people's achievements.

Staff understood their roles and responsibilities and told us they felt supported in their roles. Staff told us the service had improved and was well led. One staff said, "The manager is very approachable, they always listen to us and take action." However, we found some staff required support to develop better understanding of person-centred care.

There was a clear management structure in place, including a quality assurance team. However the leadership team were not always effective in identifying risks and providing tailored, person centred care. Staff deployment was not always effective in ensuring people had their needs met in a timely manner. The manager was undertaking leadership and management training and committed to their professional development. Business continuity plans were in place, for in the event of an emergency.

A clear whistleblowing policy was in place and available to staff. Staff felt comfortable to raise concerns with the management team and felt confident action would be taken. Regular staff meetings were held and evidenced action was taken when staff raised concerns and suggestions. For example, communication was raised as a concern and monthly newsletters and a staff group email had been created to improve this. However, our assessment showed the management of people’s risks by staff required improvement.

Records relating to complaints required improving. We found complaints logs were not up to date, meaning it could not be evidenced what action had been taken when people raised formal complaints or concerns. However, relatives told us they felt they had been listened to and action taken to address their concerns.

Where staff had been employed from overseas, they told us the service had supported them to integrate into a new country and culture and supported them in their role. Staff told us the providers were fair and no one had been subject to discrimination.

The provider was committed to promoting equality and diversity in their workforce. A dedicated staff was in place to support people who had been employed from overseas. Systems were in place to support all staff with their professional development. Group supervisions were undertaken with staff teams and nurses were provided with clinical supervisions.

Whilst staff told us the service was well led and they felt supported, they told us more staff were required. Staff observations of practice were in place, covering a range of subjects to monitor staff competency. One staff said, "I had my competencies assessed by the senior staff."

Quality and safety audit systems were not always effective and did not always identify concerns found during the inspection. For example, concerns found in relation to care records, complaints records, infection control, safe environments and risks were not identified or actioned. Weekly walk rounds were undertaken by the manager, with some concerns addressed, however these required strengthening. The service had Introduced a new online care planning system, however this required effectively auditing to ensure staff were recording appropriately and information is up to date. Senior leadership teams were implementing a new auditing tool, this required embedding into practice.

We received mixed feedback from people and relatives relating to how the service worked with them and operated. Most people told us the service was well led and had improved with the current manager in place. A relative said, "It is well run here and the manager is approachable." Whilst another person said, "I wouldn't know who to go to if I was worried about something." At the time of our assessment The Laurels area of the service had restrictions placed upon them by the local authority in regards to admissions. All new admissions were required to be discussed with the local authority.

The manager was part of registered manager forums, which shared learning and best practice. The provider and manager were open and honest, notifiable incidents were reported to external agencies as required. Feedback we received from staff did not raise any concerns in relation to working in partnership with others.

The local authority shared concerns about the safety of people and the quality of care provided. This was particularly regarding The Laurels are of the service. We received mixed feedback from external professionals regarding how the service worked with them. One professional said, "Sometimes staff haven't took on our advice, I have had to raise things with the manager in the past." Whilst another professional said, "I don't have any concerns regarding patient safety or quality of care."

New systems relating to care records and communication with partners had recently been implemented and partners told us communication was improving.

The leadership team were aware of the shortfalls in the service and told us they were committed to ensuring the service improved, and had taken action to address concerns. Feedback was sought from people, relatives and staff, and used to improve the quality of care people received. Lessons learned was shared with the staff team through supervisions and staff meetings.

Improvements were required to ensure systems in place effectively learned from accidents and incidents. Overall service development plans were in place, however these were not regularly updated, service action plans were required to ensure the provider could recognise shortfalls and make the necessary improvement in a timely manner. Refurbishment plans were ongoing for both The Laurels and The Limes, and some refurbishments had recently taken place, such as new flooring and chairs.