The Care Quality Commission

Archived: Laverstock Care Centre

London Road, Salisbury, Wiltshire, SP1 3YU (01722) 428210

Provided and run by:
Caring Homes Healthcare Group Limited

Important: The provider of this service changed. See new profile

All Inspections

20 June 2013

During a routine inspection

The manager had worked at the service for approximately six months. They had built relationships with people, their relatives and staff and were introducing a number of positive changes to service provision.

Many visitors and staff commented about the improvements which had been made to the service since the manager had started employment.

People looked well cared for with clean clothing, manicured nails and nicely brushed hair.

The majority of staff interacted well with people but this was not consistent throughout the whole home.

In one unit, staff were not always responsive to people’s needs. Some people were at risk of injury through inappropriate and unsafe manual handling techniques used by staff.

People generally enjoyed the food and the choices available. The lunch time meal looked appetising and was served in accordance to people’s individual wishes.

Staff administered people’s medicines in a safe manner.

Overall, our judgement was that there were enough staff available to meet people’s needs. The numbers of staff on duty had recently improved and there was less reliance on agency staff. Due to this very recent improvement some relatives remained concerned that staffing levels may not be sufficient at times. Staff felt well supported and had access to a range of training opportunities.

The manager was committed to further developing the home. Systems to gain feedback and a comprehensive range of audits to assess the quality of service provision were in place.

13 November 2012

During an inspection in response to concerns

Comments we had received about the home suggested staff were unclear about people's needs. We found staff were informed about care plans but not all people felt involved in their own or their relatives' care plans.

When people needed referral to external health professionals, this was documented and acted on quickly.

Records showed people received regular interaction through group activities and planned individual approaches.

A dementia care consultant had delivered dementia training to all staff. They supported the activities coordinator to run a memory support group.

Information we received suggested people were not given enough help to eat and that the provider did not respond adequately to concerns raised through relatives' meetings.

We observed provision of lunches throughout the home. We found no significant waiting time for meals although one person told us evening meals presented staff with more challenges. A visitor said they observed breakfast to be poorly organised for some people.

In the dementia units staff members sat at each lunch table providing encouragement and practical help to eat meals. Staff awareness and actions concerning nutritional planning were not well reflected in written records.

Relatives' meetings had highlighted issues about the service of food. There was evidence people's concerns had been, or were being, addressed. Visitors and people in the home told us they were satisfied with the arrangements for making complaints.

14, 24 July 2012

During an inspection looking at part of the service

We performed this inspection to follow up on our inspection of 25 April 2012, where we issued two Warning Notices about outcomes four and nine and two compliance actions about outcomes seven and eight. This inspection took place on Saturday, 14 July 2012 and included a pharmacist inspector as well as two compliance inspectors. We also returned to the home on 24 July 2012 to follow up on some issues relating to outcome 16: Assessing and monitoring the quality of service provision with the home manager.

During our inspection on 14 July 2012 we met with 23 people and the relatives of four people. We also spoke with four registered nurses, seven care workers and four ancillary workers, and the home manager. During the second inspection visit of 24 July 2012, we met with the home manager and a senior manager for the provider.

People told us a range of matters about the home. One person told us 'it's quite okay', another they were 'treated well' and another 'they are all friendly and they come if I call the buzzer'. Some people made less favourable comments, including 'there is nothing to do here' and another 'I'd love to know if there was a care plan about me'.

We found the home had made improvements in provision of care. This included staff who told us about people's individual care and treatment needs in detail and some clear care plans. Our pharmacist inspector found the home had improved its systems for control and management of medicines. The home was clean, with systems to prevent risk of spread of infection. All of the staff we spoke with knew about the importance of safeguarding people who were vulnerable, including people who had dementia and could show aggressive behaviours.

The provider had systems for auditing the quality of the service it provided. This included a range of areas such as the catering service and safe methods for staff employment. Some areas relating to audit were being further developed by the provider, for example making sure people's needs were fully identified and all actions taken to meet people's individual needs.

25 April 2012

During an inspection in response to concerns

We commenced this inspection at 5:30am and finished it at 12:15pm. We started the inspection early in the morning because of information which had been given to us about people's care at night.

We spoke with 18 out of the 72 people who lived at the home. People gave us different responses about the support they received. Some were positive. One person told us 'It's a very good home', another they had 'nothing to grumble about' and the home had a 'nice atmosphere, everyone friendly ' no problems'. Some people commented on the staff. One person said about the care worker who had care for them that night 'I like that one ' she's kind and gentle'.

However other people were not so favourable in their comments. A diabetic person said to us the staff never told them about how their blood sugar levels were, saying 'I would like to know ' I hope they're going alright'. Another person told us about ringing their bell 'you never get an answer'. Another person asked us 'don't divulge my name or I'll be in the doghouse'. A person said when they were given new tablets, they were just given them and 'told to take them and that was it'.

24 January 2012

During an inspection in response to concerns

Most of people told us they were happy with the way they received their medicines, and there were no problems with this. One person told us they had some concerns that sometimes doses of medicines were given later than they should be, or were sometimes missed altogether.

8 September 2011

During an inspection in response to concerns

People said they liked the night staff. One person told us that the care worker on their unit that night had been 'very good' and wanted us to note that this care worker had been very helpful to them all the night. People said that staff supported them in the way they wanted. One person told us they really appreciated being able to have a bath at 6:00am when they asked. Another person said they liked being helped to get up at 6:30am every morning, as this was what they liked. People who had dementia were relaxed and nicely turned out in clothes they looked comfortable in.

Some staff seemed to be under the impression that a set number of people had to be assisted to get up and dressed before the day shift came on duty. This could restrict people's choice. Some people, including night staff, felt there were not enough staff on duty, particularly at night when people were unwell or needed high levels of support. This meant that at times people who have dementia or are frail may be left without support from staff, as staff need to care for people in other parts of the building. Staff may not always be able to take a break from their duties during a twelve hour night shift.

8 June 2011

During an inspection looking at part of the service

People told us that they liked living in the home. One person said 'I'm very lucky to be here', another 'it's a lovely place and they are so kind to you'. A relative told us 'I think its absolutely wonderful, staff are very polite and helpful'.

As the home cares for people with dementia, some people were not able to tell us what they thought about the home, so we observed staff interaction with people. We observed a care worker reassure a person who was confused about the time of day, making sure they could see the clock and explaining what had just happened and what would be happening next. Staff took prompt action to ensure people's safety. We observed two people in a sitting room on a dementia unit who started to argue with each other. A care worker promptly intervened to divert the person who had started the argument into doing something else.

Staff showed a detailed knowledge of different people's individual needs. One person told us that they had a chest condition. A care worker told us about this person's condition in detail and how they were supporting them. We heard a person calling out 'please help me' from their room. We told a care worker about this and they attended to the person at once. They were very gentle and kind to the person. The care worker told us that the person had very limited eyesight and short term memory loss, so they called out often, as they forgot where they were. The care worker said that it was important to reassure the person each time they called out.

6 January 2011

During a routine inspection

Some of the people we spoke to were positive about the care they received. One person told us 'I feel safe here', another said 'staff are helpful, I always find they are good'. People told us they liked the building 'the way it's laid out ' very good' and another person said 'I like visitors and I have as many as I like'.

We observed that there was limited evidence that people and their advocates were involved when developing care plans. A person said 'the staff do have a care plan, it's in the office I think, I don't look at it'.

Although one person told us 'I think they know how to meet my needs', we observed that staff were not meeting the needs of some frail people. People who were not able to change their positions independently were not always having this done for them. Other areas were also not being addressed, such as the changing of some medical appliances, ensuring that people were comfortable and prompt reporting of accidents.

A person commented about the meals 'when its good its very good but can be bad'. We observed there was generally a relaxed and unhurried atmosphere at mealtimes. There was a lack of choice and information available about some meals. Frail people were not fully supported in having food and drinks.

We observed that some confidential records were in public areas. Records were not up-to-date or completed at the time care was given. Several issues, particularly record-keeping, had been brought up at previous inspections. The home's internal quality audit systems had not identified some deficits in services provided to people.

22 November 2010

During an inspection in response to concerns

We spoke to some people who had medicines given to them by the nurses who were happy with the way this was done. We spoke to someone who looks after some of their own medicines who was pleased to be able to do this, as it helped their condition and maintained their independence.

We observed a nurse administering medication who took their time with people. Medicines were given in a safe and caring manner.