Laurel Grove

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Effective action to mitigate risks to people was not always undertaken promptly. For example, it was identified that a person did not have care plans in place for continence, tissue viability and constipation. As and when required medicine records were not identifying the efficacy of the medicine. People's care records did not always show they were supported in line with their care plans. There were enough staff deployed, however during our on-site inspection we observed people to not always receive support in a timely manner. For example, the staff member on duty was not available to support a person who was requesting support. This was raised with the manager who arranged for additional staffing to be put in place. People told us they felt safe living at Laurel Grove, people told us they were happy, and they knew who they could speak to if they were worried about anything. Staff demonstrated an understanding of what safeguarding was and the actions they would take if they had any concerns.

This service scored 56 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us they felt safe living at Laurel Grove, people told us they were happy, and they knew who they could speak to if they were worried about anything.

Staff demonstrated an understanding of what safeguarding was and the actions they would take if they had any concerns. Staff told us that they had received adequate training to do their job effectively. A staff member told us, “I have a good relationship with the service users, and I have built trust with them. I feel if they had any concerns, they would approach us and feel confident to do so”.

Staff had not followed the provider’s systems in place to record when people have shown signs of increased feelings of distress. This meant that follow up actions had not been identified and steps to mitigate risk were not in place. The manager told us that they had identified this, and this was implemented prior to our second visit to the service. There was a safeguarding policy at the service, however this had not reviewed within the providers expected review date.

We observed staff interact with people in a kind and respectful manner. People were witnessed to be comfortable at the home and they felt at ease with staff.

People told us about their interests and about the choices they made. We found guidance in place for staff to support people safely when they were going out to the shops or had other engagements. A relative told us “[Family member] can make their own decisions and they do their best to accommodate these.”

People were observed to be independently carrying out tasks such as making and serving drinks. People were observed to make decisions such as when they wanted to go to bed and how they wished to spend their evening.

The manager told us people were involved in planning their care by giving examples of how people had recently worked together to create a new menu and how people went shopping. Staff told us how they involved people in all tasks, talking to them and asking for their consent.

We identified known risks to people whereby care plans were not in place. Therefore, people were at risk of receiving inconsistent care as there was no guidance in place for staff to follow. We found care plans were evaluated monthly, however we could not see people's involvement recorded in these evaluations or any explanation showing why they had chosen not to be involved in the evaluation. The service had previously identified within quality monitoring systems that there were gaps identified in people’s care plans. This had failed to be actioned.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

People and relatives told us that staff were available when they needed them, and that staff supported them when they requested.

The provider has processes in place to monitor staffing levels, training, and development. There were some staff who were not fully compliant with the mandatory training. This meant that staff were not always up to date with current guidelines.

People were observed to not always receive support when they needed. For example, the staff member on duty was not available to the person who was requesting support. We spoke with the manager who arranged for an additional staff member to come on duty. We were informed plans were in place to increase staffing levels at the service and this was in discussion with senior management.

The manager told us that there were plans to increase staffing levels at the service to increase community involvement for the people who use the service. This had not yet been actioned. One staff member told us “We have had talks with [manager] about having two staff members at Laurel Grove – It would be a lot better so the service users can do more activities”.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us staff supported them with their medicines and they received them when they needed.

Staff told us that they felt appropriate arrangements were in place for safe management and use of medicines and they had received training in medicines. The provider shared that the medicines policy has recently been reviewed. Plans are in place to introduce new processes outlined within the medicines policy to the service, with additional training being provided to managers.

The provider was found to have met the warning notice for a breach of Regulation 12 (Safe care and treatment) issued following our last inspection. Although some improvements had been made, there were some shortfalls identified. The medicine policy for the service had been reviewed, however the new policy was not accessible to staff and this was due to be implemented. As and when required medicine records were not identifying the efficacy of the medicine. Staff had not always recorded the dates some medicines went into use.