- Care home
Laurel Grove
Report from 19 February 2024 assessment
Contents
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
Well-led
It was identified that governance systems were not robust in identifying risks and sufficient actions had not always been taken to mitigate risks. This is an ongoing breach of Regulation 17 (Good governance) and placed people at risk. Whilst systems had not been fully embedded at the service, staff and managers told us of improvements which they intended to make.
This service scored 50 (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 Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.
Capable, compassionate and inclusive leaders
We did not look at Capable, compassionate and inclusive leaders during this assessment. The score for this quality statement is based on the previous rating for Well-led.
Freedom to speak up
We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.
Workforce equality, diversity and inclusion
We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.
Governance, management and sustainability
The provider had not ensured known risks to people were mitigated. Audits completed had identified compromises in safety and quality, however these had not been actioned in a timely manner. The provider told us how they had a plan to improve oversight of performance and risk, this had not yet been fully implemented and embedded. The provider told us they were in the process of reviewing their policies. However, all of the providers policies and procedures which were on-site and accessible to staff had surpassed their review dates. The provider's service improvement plans contained issues assessed as high risk but these had not been actioned in a timely manner.
People had regular opportunities to share their feedback. Staff told us there appeared to have been some improvement since the new manager was appointed. They confirmed prior to this there was a time where there was a lack of management presence on-site.
Partnerships and communities
We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.
Learning, improvement and innovation
We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.