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Inspection carried out on 17 November 2015

During a routine inspection

Laburnum Lodge is a purpose built two storey intermediate care facility in the Breightmet area of Bolton. There is car parking at the front of the service and public transport stops immediately outside. The service is owned by Bolton Council and is registered with the Care Quality Commission (CQC).

The service can accommodate 32 people with one community bed reserved. Laburnum Lodge provides a step down provision, which enables people to make an easier transition from hospital back to home, as a well as a step up provision, to help fragile people avoid admission to hospital. The length of stay at the service depends on the individuals needs and on average it will be six weeks or less. There is no charge for this service. On leaving the service an ongoing support or a care package to assist you at home is discussed and planned as required. The service provides residential rehabilitation seven days a week and day time nursing and therapy support Monday to Friday.

There is a ‘sister’ intermediate unit in Bolton based at Darley Court in the Halliwell area. Darley Court provides 24 hour nursing support as well as therapy based rehabilitation. People who require intermediate care would be assessed and admitted to the unit most appropriate to meet their needs.

This unannounced inspection of Laburnum Lodge was carried out on 17 November 2015. Since our last inspection in August 2013 of Laburnum Lodge the service has changed the criteria for admission. There are no long stay beds providing care for the elderly.

The service had a registered manager in post who was 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 and associated Regulations about how the service is run.

Care is provided during the day by an onsite team of nurses, physiotherapists, occupational therapists, pharmacists, social workers, carers and specialist support staff. There are no nurses on duty during the night or at weekends. The night shift is covered by a senor carer and care staff.

People spoken with were extremely complimentary about the service they were receiving.

Staff had received safeguarding vulnerable adults training and knew what action to take of they suspected or witnessed abuse or poor practice. The service had a robust recruitment and selection process to protect vulnerable people from staff who were unsuitable.

There were sufficient staff available to support people safely and effectively during their stay at Laburnum Lodge. We saw that staff received the essential training to enable them to do their job efficiently.

We saw that risk assessments were in place for the safety of the building. All areas of the home were clean and well maintained. Procedures were in place to prevent and control the spread of infection.

Systems were in place to deal with any emergency that could affect the provision of care, such as a failure of the electricity and gas supply.

People’s care records contained detailed information to guide staff and other professionals involved in the care and rehabilitation people required. The care records showed that risks to people’s health and wellbeing had been identified and plans were in place to eliminate or reduce the risk.

Appropriate arrangements were in place to assess whether people were able to give consent to their care and treatment. Where appropriate family and friends were involved in a person’s post care and future goals and plans were discussed.

We observed that a ‘board round’ meeting took place four days a week with all the teams being involved. This meeting was to discuss any admissions or discharges, people’s health and wellbeing and what input from staff was needed for example a home visit to check the environment was ready for a person when discharged from the service.

A healthy, well balanced and varied diet was provided and dietary needs catered for. People spoken with told us the food was good and they enjoyed their meals.

To help ensure that people received safe and effective care and support, systems were in place to monitor and assess the quality of the service provided. Regular checks were undertaken on all aspects of monitoring the service.

Inspection carried out on 27 August 2013

During a routine inspection

We visited Laburnum Lodge on 27 August 2013 and found the home to be warm, clean and bright. At the time of our visit the manager was on annual leave. We conducted this inspection with the senior member of staff on duty who was offered supported by a manager from another of Bolton Council run homes.

We saw people who used the service were well presented and we observed staff interacting with them in a friendly, polite manner and respecting their dignity and privacy.

We looked at two care records and other information that need to be kept ensuring the home is properly managed.

People who used the service were unable to communicate with us due to the nature of their illness. However we did observe that their body language was favourable when staff approached them and spoke with them.

We saw staff had access to relevant policies and procedures including safeguarding procedures and contact details.

We saw a number of compliment cards from relatives, some comments included: ‘Thank you for all your kindness’. Another said, ‘Thank you for the love and care you afforded to my X. We will be for ever grateful’.

We were shown the latest satisfaction survey completed by relatives in June 2013. Feedback was positive and comments included: ‘We are always kept informed about any changes’. ‘The home is always warm and clean’ and ‘you always get a warm and friendly welcome’.

Inspection carried out on 23 July 2012

During a routine inspection

“I like it here, they look after me well”.

“I like the food, it’s very good”.

A visiting health care worker told us, “I have never encountered any problems. The staff are always helpful and kind, they care for people really well and peoples dignity and privacy is always respected”.

People who use the service all had a diagnosis of dementia; therefore it was difficult for them to engage in conversation. However we observed that people reacted well with staff when they approached them and no one appeared distressed or unhappy.

Staff told us:

“I love working here”.

“All the staff are really nice”.

“The manager is really supportive and approachable”.

We were shown the results of a satisfaction questionnaire from April 2012. Relatives comments were positive and included:

“When I visit everything is satisfactory”.

“We are always given explanations of how and why things are done”.

“A very pleasant place and very caring staff”.

“I think you guys are the best, keep up your good work”.

Reports under our old system of regulation (including those from before CQC was created)