The Laurels Care Centre

Updated 11 August 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This was a focussed inspection due to concerns we had about people's safety, staffing levels, delivery of safe care and the leadership in the home.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team consisted of an inspector.

Service and service type

The Laurels Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager who was in the process of being registered with the Care Quality Commission. This means the provider is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed the information we held about the service and the service provider, including the previous inspection report.

We looked at notifications and any safeguarding alerts we had received for this service. We sought feedback from the local authority and professionals who work with the service. Notifications are information about important events the service is required to send us by law.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We acknowledged that the management team had changed since the submission of the provider information return and therefore we took this into account during the inspection process.

During the inspection

We looked around the service and met with the people who lived there. We used the Short Observational Framework for Inspection (SOFI) during the morning of our inspection. SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with six people in detail to understand their views and experiences of the service and we observed how staff supported people. We spoke with the manager, and seven members of staff, including the directors of the service. We were able to speak with one visitor during the inspection.

We reviewed the care records of four people and a range of other documents. For example, medicine records. We sampled staff recruitment files; staff training records and records relating to the management of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at recorded staff meetings, training and supervision data. We spoke with three professionals who regularly visit the service and two family members.

Updated 11 August 2021

The Laurels Nursing Home is a residential care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The Laurels Nursing home supports up to 52 older people, who have nursing needs, including poor mobility, strokes, Parkinson's disease, diabetes, and people who were receiving end of life care. They also provide emergency respite for people who have live-in care at home. There were 36 people living in the home during our inspection. Accommodation was provided over two floors with communal areas on each floor.

People’s experience of using this service and what we found

Quality systems were being further established and embedded into daily practice to support quality care and record keeping in all areas. Whilst we identified some areas in record keeping for improvement this had already been identified by the manager and an action plan had been developed and risk therefore was mitigated.

Staffing arrangements were safe and ensured people’s needs were met in a timely way. Staff had received training and regular updates on safeguarding people. They understood how to respond to any suspicion or allegation of abuse or discrimination. Staff were recruited safely. People's medicines were handled safely. There were suitable arrangements in place to assess and respond to any risk to people. The service was clean and well maintained. New flooring and redecoration was in progress.

Visitors were welcomed at the home. People were able to receive visits from their named visitors. Some people received visits from relatives who were essential care givers. Essential care givers are relatives or friends who are able to spend more time with the person to help meet their physical and emotional needs. Visiting took place in a lounge which had been converted to a visiting room with a room divider. Dependant on people’s needs, some visits took place in the person’s room. Garden visits were also available. Throughout the pandemic, where people were receiving support with end of life care, they had been able to receive regular visits from family in their bedrooms. Visiting was on an appointment system to allow time for appropriate cleaning between visits and keep the home safe from the risk of infection. All visitors were required to have a rapid Covid-19 test before the visit. During the visit they wore the appropriate personal protective equipment (PPE).

The registered manager knew people and staff well and promoted an open culture where people and staff felt they could share their views. They understood their responsibilities and were passionate and committed to delivering a high standard of care to each individual person in the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 09 August 2018). We also undertook an Infection Control Inspection (IPC) (published 05 March 2021)

Why we inspected

This inspection was prompted due to information of risk and concern. CQC received concerns in respect of staffing levels, which had impacted on care delivery and lack of leadership. The concerns raised were looked at during this inspection and have been reflected in the report.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.