Background to this inspection
Updated
9 November 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.
This inspection took place on 13 September 2017 and was unannounced.
The inspection team consisted of an inspector, a specialist advisor, and an expert by experience. A specialist adviser is a person with professional expertise in care and nursing. Our specialist advisor had dementia nursing expertise. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. Our expert by experience had expertise in caring for people living with dementia.
We looked at information received from local authority and health authority commissioners. Commissioners are people who work to find appropriate care and support services for people and fund the care provided.
We reviewed the provider’s statement of purpose and the notifications we had been sent. A statement of purpose is a document which includes a standard required set of information about a service. Notifications are changes, events or incidents that providers must tell us about.
We spoke with six people using the service and four relatives. We spoke with the registered manager, the regional manager, two nurses, and four care workers. We observed people being supported in communal areas. We looked at records relating to all aspects of the service including care, staffing, and quality assurance. We also looked at four people’s care and nursing records.
Updated
9 November 2017
This was an unannounced inspection that took place on 13 September 2017.
The Laurels is registered to provide accommodation, personal care and nursing care for up to 45 older people, including people living with a physical disabilities and/or dementia. The service is situated in Spondon village and is on two floors with a passenger lift for access. There is a secure garden at the rear of the premises and a patio area for most ground floor rooms.
At the time of our inspection there were 34 people using the service.
The service has a registered manager. This 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.
People and relatives told us the service was well-managed and provided a high standard of care. They said they had confidence in the registered manager who was approachable and helpful. They told us the care and nursing staff were kind, thoughtful and caring.
There was an established staff team and staff turnover was low with some staff having worked at the service for a number of years. This meant staff had the opportunity to get to know the people they supported well. All the staff we spoke with were knowledgeable about the people at the service, their personalities, and what was important to them.
People were encouraged to make choices about all aspects of their care and support including getting up and going to bed times, activities, personal care routines, and menu choices. Staff consulted with people and their relatives about how they wanted their care provided and ensured this was recorded in people’s care plans.
Staff knew how to keep people safe. They managed risk well by providing good quality and consistent care. The service was well-staffed. During our inspection visit call bells were answered promptly and if people needed support they didn’t have to wait for long. People had their medicines on time. Staff met people’s healthcare needs promptly and effectively and knew when to call in a doctor if they were concerned about a person’s well-being.
Staff were well-trained and had the skills and knowledge they needed to provide effective care. They understood the importance of obtaining people’s consent before carrying out care tasks and how to make decisions in their best interests where necessary.
People said the food served was good quality and the menu varied giving them plenty of choice. During our inspection visit we spent time in the dining room with some people who were having a late breakfast. There was a leisurely atmosphere. Staff asked people what they wanted and brought it to them promptly. A relative told us mealtimes were flexible as people preferred this.
People had the opportunity to take part in group and one-to-one activities. We saw one activity take place that involved throwing a soft ball onto a large bullseye on the floor. All those involved had turns and there were smiles and laughter as the activity progressed. At the end the tea trolley arrived and people had tea and biscuits. The atmosphere was lively and friendly and everyone present appeared to enjoy the activity and the socialising afterwards.
People and relatives also had the opportunity to comment on the service through completing surveys and attending meetings where activities, menus, and complaints were discussed and those present were asked for their views and suggestions. During the course of our inspection visit we saw the registered manager continually interacting with people and checking the quality of their care.
The regional manager, registered manager, and staff carried out quality audits to ensure the service was running effectively. Records showed they listened to people, relatives and staff and made improvements where necessary.