29 November 2022
During an inspection looking at part of the service
The Laurels and The Limes Care Home is a care home providing personal and nursing care to up to 88 people. The service provides support to older adults with a range of support needs, including people living with dementia. The service has 2 separate buildings within the same grounds; The Laurels and The Limes. The Laurels predominantly supports people living with dementia. The Limes is the larger building and supports people who require nursing or residential care. At the time of our inspection there were 60 people using the service.
People’s experience of using this service and what we found
Risks to people were assessed, however the records made by staff did not always evidence risks were managed effectively. People received safe support with their medicines and infection risks were mostly well-managed. Staff understood their responsibility to protect people from the risk of abuse.
There were enough staff deployed to keep people safe and staff were recruited safely. The provider used agency staff to ensure there were enough staff on each shift, but this had placed pressure on the regular staff team who had to spend time supporting agency staff to get to know people.
People were not always meaningfully occupied or stimulated. People told us they were often bored as there was not enough to do. Improvements were therefore needed to ensure people consistently experienced a good quality of life whilst using the service. We have made a recommendation about daily activity provision.
People’s care plans described people’s preferences for receiving care, however their care plans were not consistently updated when people’s needs changed. Staff worked alongside the GP and district nurses to manage people’s health needs. People received effective support with their nutrition and hydration needs.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice.
The provider’s audit system had not identified all the issues we found during this inspection. However, some audits completed by the provider and managers had identified concerns and ensured issues were resolved.
We received mixed feedback about the culture of the service. Staff morale was not positive, and most staff told us there were not supported to do their jobs effectively. Staff had not received one to one supervision meetings recently and many staff were not up to date with the training the provider expected them to complete.
People and their relatives had opportunities to provide feedback about the service. Most people were happy with the care they received and felt they could approach the managers if they had any concerns.
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 25 February 2020).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We looked at infection prevention and control measures under the key question ‘is the service safe?’. 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.
We undertook a focused inspection to review the key questions of ‘is the service safe?’, ‘is the service effective?’ and ‘is the service well-led?’ only. For those key questions not inspected at this inspection, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Laurels and The Limes Care Home on our website at www.cqc.org.uk.
Enforcement and recommendations
We have identified a breach of regulation in relation to the provider’s governance system. Please see the action we have told the provider to take at the end of this report.
We have made a recommendation about the daily activity provision in the service.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.