We carried out a review of the data available to us about Laburnum House 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 House, you can give feedback on this service.
Laburnum House is a residential care home that provides personal care for up to six people who may have a learning disability. At the time of our inspection there were five people living there.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
People’s experience of using this service:
• The home applied the principles and values of Registering the Right Support and other best practice guidance. These ensured people who live at the home can live as full a life as possible and achieve the best possible outcomes that include control, choice, inclusion and independence.
• People were supported to meet goals they set which included going on holiday within the UK and abroad.
• When people’s needs changed, staff supported them in reviews with healthcare professionals to support the best outcomes possible for them.
• People were supported to gain confidence, and take positive risks, including visiting places or being involved with activities which would have previously not been possible due to anxieties.
• People were treated with kindness, respect and compassion. Staff had formed positive relationships with people.
• People used a variety of communication methods, which were understood by staff. Some people were supported in decision making with picture cards or photographs for references.
• People were supported to be as independent as possible. Staff worked with people to re-gain confidence and gain independence.
• People were involved in their care planning and reviews.
Rating at last inspection:
At the last inspection the service was rated Good. (14 and 15 September 2016)
The home continued to meet the characteristics of Good in all areas.
Why we inspected:
This was a planned inspection based on the rating at the last inspection.
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.
Although a manager was registered with the Commission they had left the service in 2015. The deputy manager and an interim manager had been managing the service between the time the registered manager left, and June 2016 when a new manager had been appointed. The new manager planned to apply for registration with the Commission. 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.
Some care files contained documentation which was duplicated and unnecessary. However, staff could demonstrate a good knowledge and understanding or people’s individual needs, meaning the impact this had on people was minimal. The provider had highlighted this as an area that needed to improve in their internal audits.
There were enough staff with the right skills and knowledge to support people. They had good support and supervision to fulfil their role effectively and felt confident in approaching the manager if they needed extra guidance.
Staff were trained in safeguarding and understood the processes for reporting abuse or suspected abuse. They were aware of the procedures for whistle blowing and felt confident that the management of the service would respond appropriately to any incidents of abuse.
There were safe processes for storing, administering and returning medicines. Medicines were administered by trained staff who were regularly competency checked by the manager and team leader. When errors occurred this was used as an opportunity to learn and additional safety checks were introduced.
Incidents were recorded and audited to identify patterns and the manager used this as an opportunity to learn and improve outcomes for people
Appropriate checks were made to keep people safe. Safety checks had been made regularly on equipment and the environment.
The service was good at responding to people who needed help to manage their health needs. People were supported to access outside health professionals.
The manager had a clear understanding of the principles of the Mental Capacity Act 2005 (MCA). People were offered advocacy services and the service had taken the appropriate steps to meet the requirements of the legislation.
People were supported to take part in activities which were suitable for their individual needs and had the opportunity to discuss activities they wished to undertake in the future. People discussed their aspirations with their key workers and action was taken to achieve them. People were supported to maintain relationships with their relatives and other important people.
Staff demonstrated caring attitudes towards people. People felt confident and comfortable in their home and staff were easily approachable. Interactions between people and staff were positive and encouraged engagement.
People and their representatives were encouraged to express their views and provide feedback so the service could continuously improve.
People were helped to complain and staff supported people who were unable to use the easy read complaints policy by understanding what their body language meant if they were unhappy.
The manager understood the key challenges of the service and had started to make changes to improve the service people received. The manager had the right skills, experience and knowledge to lead the rest of the staff team to provide support in a way which improved people’s lives. Staff said they felt well supported by the manager and able to talk to them at any time for support and guidance.
At this inspection we spoke with most of the people who lived at the service, some of the staff and the area manager. People who lived at the service were satisfied with the support they received. One person told us '(Staff name) often asks me about what I want to do and how I am'. Staff recognised that positive changes had occurred within the service and felt more involved in how care and support was planned and delivered.
We found that care plans had been revised and reflected the needs of the people they were intended to support. Some care reviews had been completed and we saw that people who used the service and some of their representatives had been involved in these processes. Key worker reviews had taken place with the people who used the service. Appropriate records had been maintained, which were accurate and reflected people's circumstances.
People told us that staff sometimes discussed their care and support needs with them and that there were enough staff on duty who came when they needed them. They said all of the staff were friendly and helpful.
During this inspection we looked at some care plans and risk assessments. We found that most had not been recently reviewed. Past reviews of people's goals and aspirations lacked detail and meaning, they had not been reviewed recently and meetings between people and staff to talk about their care had not always taken place. Other records such as personal emergency evacuation plans had not been reviewed since 2010. Potentially, information intended to support people may not meet their current needs because it was not up to date.
Staff training was up to date and staff numbers and rotas had recently been reviewed. Staff supervision had lapsed but been reintroduced. Some staff felt unsettled by recent changes, but considered that improvement within the service was visible.
Safety checks were in place and the service was provided within safe and maintained premises. There was a complaints procedure. This was published in an easy read format but it was not displayed within the home and therefore not accessible to people living there.
People we spoke with told us they felt safe living at Laburnum House. They said staff were always kind and caring and helped them when they needed support. People said they did not have any concerns, but if they did they would talk to staff or raise them with family or at house meetings.
People knew about their care plans and were involved in making decisions about the care and support they received. The people we spoke with said they were given choices about their daily routines and had opportunities to choose and take part in activities, events and join in with household chores.
People said they were happy with their bedrooms and could choose the carpets or floor coverings and how they wanted the room decorated. All of the bedrooms were comfortably furnished, most had televisions and contained lots of personal items such as photographs, toys and posters. One person had a disco glitter ball fitted in their bedroom.
We saw that staff were supportive and considerate of people's different needs, their dignity and independence was respected.
During this inspection we noted minor concerns which the provider may find useful to consider. They relate to the review and evaluation of some of the goals for people at the service.