We carried out a review of the data available to us about Laburnum Lodge on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Laburnum Lodge, you can give feedback on this service.
Laburnum Lodge is a residential care home providing personal care to 18 which increased to 20 older and younger adults by the end of the inspection. The service can support up to 22 people. The service provides support mainly to people over 65 years of age some of whom are living with dementia. The care home accommodates people in one adapted building, over two floors accessed by stairs or a stair lift.
People’s experience of using this service and what we found
The registered manager and staff had made improvements to people’s care records. Care plans contained individualised information to guide staff on how to monitor people’s known risks and to support people’s wellbeing. People and their relatives were involved in decisions around their or their family members care. Staffs communication with people’s relatives was good. Relatives told us they knew how to raise concerns and were confident they would be listened to.
The provider and registered manager had introduced a new system of policies and procedures and audit forms to help improve the monitoring of the service provided. The registered manager notified the CQC of incidents they were required to. People and staff were able to formally feedback on the service by completing a survey.
The registered manager and staff promoted satisfactory infection control and cross contamination processes. Where improvements were noted to be needed during the site visit the registered manager was signposted to current guidance. The provider and registered manager were working with the local authority care home support team and they also worked with health and social care professionals. This was when people’s wellbeing required this joined up working.
Staff were trained in safeguarding and told us they would raise any concerns around poor care and harm. Staff administered people’s prescribed medicines safely. Some improvements in medication recording were found and staff confirmed that this would be dealt with during supervision by the registered manager. This staff learning would help reduce the risk of recurrence.
Potential new staff had checks completed on them to try to make sure they were of good character. There were enough staff available to meet people's needs. Staff promoted people’s wellbeing by offering different activities for people to join in should they wish to.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 11 March 2020) and there were two breaches of regulation. The provider had not completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 12 March 2020 and breaches of legal requirements were found. The breaches were Regulation 9 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Person-centred care), and Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Good governance).
We undertook this focused inspection to check they had made the necessary improvements and to confirm they now met legal requirements. The inspection was also prompted in part due to whistle-blowing concerns received about poor infection control procedures, and poor maintenance. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
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.
Please see the safe, responsive and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Laburnum Lodge on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We found the following examples of good practice.
Procedures were in place to prevent the transmission of infection to and from visitors. The manager had converted a lounge into a ‘visiting pod’ so that people could sit in a lounge with their relatives, separated by a see-through panel.
Whole home testing was carried out on both people and staff.
The cleaning of the home, including frequently touched surfaces, had increased to reduce the risk of transmission of infection.
The manager did not use temporary staff to cover shifts, however operated an on-call system with permanent staff. This ensured that shifts were always covered with regular staff.
About the service
Laburnum Lodge is a residential care home providing personal and nursing care to 20 people at the time of the inspection. The service can support up to 22 people. The service provides support mainly to people over 65 years of age some of which are living with dementia. The care home accommodates people in one adapted building.
People’s experience of using this service and what we found
Risk assessments and care plans did not always provide staff with all of the information they required to keep people safe. The quality assurance systems in place had not ensured that these issues were identified and the necessary action taken in a timely manner.
The recruitment procedure had been followed to ensure that the right staff were employed. There were enough staff available to meet people’s needs in a timely manner. Staff received the training and support they required to carry out their roles effectively. Staff were aware of what to do if they thought anyone had been harmed.
Staff treated people with kindness, respect and upheld their dignity. There was a choice of food and drink and when needed people were supported to eat. People were involved in decisions about their care. People enjoyed the entertainers that came into the home, but other planned activities were limited.
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.
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 (report published 01 August 2018).
Why we inspected
The inspection was prompted in part due to concerns received about the staff culture. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern.
Enforcement
We have identified breaches in relation to the management overview of the service. Areas for improvement had not been identified or action taken in a timely manner to make the improvements needed.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
This unannounced inspection was carried out on the 3 May 2018.
At the time of the inspection there was not a registered manager in place. However, the manager was submitting an application to become registered. A registered manager 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 are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.
There was a quality assurance process in place which included obtaining the views of people that lived in the home, their relatives and the staff. However the system had not always been effective in identifying areas for improvement.
Medicines were in the main managed safely. Staff received training and competency checks before administering medicines unsupervised. Medicines were stored securely. The records were not always an accurate reflection of medicines people had received.
Staff were aware of how to keep people safe from harm and what procedures they should follow to report any harm. Action had been taken to minimise the risks to people. Risk assessments identified risks and mainly provided staff with the information they needed to reduce risks were possible.
Staff were only employed after they had completed a thorough recruitment procedure. There were enough staff on shift to ensure that people had their needs met in a timely manner. Staff received the training they required to meet people's needs and were supported in their roles.
Staff were motivated to provide care that was kind and compassionate. They knew people well and were aware of their history, preferences, likes and dislikes. People's privacy and dignity were respected.
People were supported to maintain good health as staff had the knowledge and skills to support them. There was prompt access to external healthcare professionals when needed.
People were provided with a choice of food and drink that they enjoyed. When needed staff supported people to eat and drink.
There was a varied programme of activities including activities held in the service, trips out and entertainers that came into the home.
Care plans gave staff the information they required to meet people’s basic care and support needs. Some areas of the care plans would benefit from more detailed information. People received support in the way that they preferred and met their individual needs.
There was a complaints procedure in place. People and their relatives felt confident to raise any concerns either with the staff or manager. Complaints had been dealt with appropriately.