The Laurels

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question Good. At this assessment the rating has remained the same.This meant people’s needs were met through good organisation and delivery.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people were at the centre of their care and treatment choices because regular and meaningful reviews were not always undertaken in relation to people’s care plans and associated documents, such as assessments of risk and mental capacity assessments.

Records did not always reflect that staff maximised people’s involvement in decision making. Care plans lacked detail around goal setting and longer-term aspirations. We did however observe person-centred interactions between staff and people. Most relatives told us they were involved in updating care plans, or when they weren’t, the service advised them of any changes.The registered manager told us they intended to improve this by holding more regular meetings and contact with relatives.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

There was a regular staff team offering consistency of care so people were familiar with staff providing their care. Staff demonstrated an understanding of people’s specific needs. For example, where people were experiencing periods of distress, staff demonstrated an understanding of their specific emotional support needs and communication. This meant staff responded in a considerate, positive and proactive way.

The service worked with commissioners to ensure that care was being provided in line with the hours funded for people’s needs, such as accessing the community. The registered manager was implementing an improved system to evidence this going forward. Some improvements were needed to ensure records consistently included the outcome of referrals to other professionals and the guidance provided.

The provide rmostly supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People’s care records contained information on how to effectively communicate with them, but the quality of these varied. Some held detailed guidance, whilst others only contained limited guidance. However, staff understood people’s communication needs in practice. There was a service user guide in easy read format, and different communication aids were used to ensure people understood relevant information, such as picture exchange communication systems (PECS) and computerised applications.

People’s records were stored securely on an electronic system.

The provider did not always ensure that people were able to share feedback and ideas, or raise complaints about their care, treatment and support.

Relatives we spoke with felt they would be listened to if they raised complaints. One relative told us, “I have raised concerns before, I did feel listened to, and the concerns never happened again.” The registered manager told us, “We gather feedback through regular family and residents’ meetings. Residents are invited to these meetings however as yet we haven't had any involvement from them. We do surveys with the residents.” We reviewed these and found the feedback to be positive. However, processes could be further improved by promoting more frequent feedback from people to continually improve how they experience their care.

There was a complaints file in place, however, there was limited information on the content of the complaint or actions taken. The provider told us any complaints were discussed in monthly governance meetings, however the log we reviewed needed fuller detail to understand where actions were taken to aid learning.

The provider made sure that people could access the care, support and treatment they needed when they needed it. The service was accessible to people,and people were provided with equipment to promote their access to all areas of the service and the community. Staff supported people to access care and treatment to minimise delays in their care and breakdown barriers they encountered in relation to their physical and learning disability. People had equal access to the shared environment which was accessible to them.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. People were supported to do things they enjoyed doing outside of the service.

During our site visits we observed people being supporting on an individual basis, to access various places in the local community, such as shops, cafes, and garden centres. Staff we spoke with reflected values in relation to advocating for people to ensure they were not discriminated against and were valued in the wider community. One staff member told us, “The daily activities are tailored to each individual and their interests, but they are all encouraged and supported to do what they like to do each day whether together or on their own with support.”

Staff had completed training in dignity and respect, and equality and diversity. This helped staff to understand the importance of equality, diversity, inclusion, stereotypes, and discrimination, and how to treat everyone with dignity. 

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

People’s end of life care plans did not always include or fully detail information in relation to their spiritual and cultural needs, involvement of family and friends, or consider the use of explicit pain assessment protocols given those with limited communication. Where people did not wish to discuss their end of life plans, it was important to ensure steps were taken to establish what to do in an emergency medical situation, with a plan to revisit the subject in the future.

Staff received end of life training to ensure they were equipped with the skills to deal with this area of people’s care. The registered manager told us they were planning to implement the Gold Standards Framework (GSF) for end of life care which is a practical and evidence-based end of life care service improvement programme.