We carried out a review of the data available to us about The Laurel 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 The Laurel, you can give feedback on this service.
We found the following examples of good practice:
Safe arrangements were in place for professionals visiting the service. This included a confirmed negative lateral flow device test result, proof of vaccination against COVID-19, temperature checks, hand sanitisation and wearing personal protective equipment (PPE).
The service was clean and fresh, staff carried out a regular cleaning schedule. Regular infection control audits took place and actions had been followed up when required. An additional cleaning schedule had been introduced to ensure robust measures to reduce infection risks, including additional tasks such as cleaning of any regular touchpoint surfaces.
The provider had robust systems to ensure safe admissions, including only allowing new admissions after a confirmed negative result of the Covid-19 test. The provider had also assessed the environment, with consideration given where to allocate people should they need to isolate.
Staff had received training on infection prevention and control guidance. This included updates on the use of PPE and how to put it on, take it off and dispose safely. Staff's competency around infection control and PPE was checked regularly to prevent staff complacency. There were several designated areas for donning and doffing PPE. There was signage all around the service on donning and doffing PPE and handwashing.
The provider ensured there was a sufficient stock of personal protective equipment (PPE) and the vetted supplier ensured it complied with the quality standards.
The provider participated in the Covid-19 regular testing programme for both people and staff.
There was a comprehensive contingency plan of what to do in case of an outbreak. The management team completed risk assessments to assess and mitigate risks in relation to COVID-19. Managers were supported by a regional quality and assurance manager who regularly supported quality and assurance audits on the service.
The care service has been developed and designed in line with the values that underpin the ‘Registering the Right Support’ and other best practice guidance. These values include choice, promotion of independence and inclusion. The service believed that people with learning disabilities and autism using the service can live as ordinary a life as any citizen.
There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
At our previous inspection in June 2016 we had rated the service Good. At this inspection we found the service remained Good, however, the provider had improved to Outstanding in the Responsive domain.
We received some extremely positive feedback about the service. People and their relatives told us the quality of the care and support provided by The Laurel surpassed all their expectations.
People received safe care from staff who had been appropriately trained to protect people and identify signs of abuse. Staff understood their responsibilities to report any concerns and followed the provider's policies in relation to safeguarding and whistleblowing. Robust recruitment procedures helped to ensure only suitable staff were employed at the service.
Risks were assessed, managed and reviewed to help ensure people's safety. There were enough staff to keep people safe. Medicines were administered as prescribed.
People’s rights were recognised, respected and promoted. Staff had a good understanding of the Mental Capacity Act 2005 and we saw people’s consent was sought routinely. Staff were knowledgeable about the rights of people to make their own choices. This was reflected in the way the care plans were written and the way in which staff supported and encouraged people to make decisions when delivering care and support.
People and relatives were delighted with the kindness and thoughtfulness of staff. People we talked to consistently referred to the registered managers and staff as kind and caring people. They told us they valued their relationships with the staff who supported them and the support provided often exceeded what they had requested. Empowering people to communicate and express their needs was an area of strength within the service, as staff had a deep understanding of people's preferred communication methods.
The service was extremely responsive to people’s needs and wishes even if the support people needed proved to exceed their contracted hours. People told us that staff went over and above the call of duty and people said this made a profound difference to their lives.
The service provided excellent care and support to people enabling them to live fulfilled and meaningful lives. People and their relatives spoke overwhelmingly positively of the support, guidance and healthcare interventions people had received. Activities and people's daily routines were personalised and tailored to people's particular choices and interests. People were supported to develop their skills and pursue their hobbies and interests. People benefited from consistent support, good teamwork of staff, good planning and delivery of person-centred care.
People felt consulted and listened to about how their care would be delivered. The care plans were personalised and centred on people's preferences, views and experiences as well as their care and support needs. People's histories, family relationships and religious and cultural needs were taken into account while preparing their care plans. People's care and support was planned in such a way as to facilitate working towards their aims and ambitions. The provider recognised people's achievements and encouraged them to always make headway by setting new goals whenever their care was reviewed.
People were able to express their opinions and were encouraged and supported to have their voice heard. People were fully involved in planning and reviewing their care and support needs.
There was a complaints procedure in place and people felt confident to raise any concerns either with the staff or the registered manager if they needed to.
There was a complaints procedure in place and people felt confident to raise any concerns either with the staff or the registered manager if they needed to.
The registered manager led their team by example, showing strong, inclusive and innovative leadership that focused on enhancing the service and creating positive outcomes for people.
There were systems in place to monitor the quality of the service and staff reflected on their practice to identify and implement changes when required.
This inspection took place on 6 April 2016 and was announced. At the previous inspection carried out on 28 February 2014, the registered provider had been assessed to be compliant with the regulations.
The home had two registered managers in place who were responsible for the five locations owned and run by the provider. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
The testing of fire equipment had not always been carried out in accordance with the provider’s policy. There were gaps in weekly fire alarms and three monthly emergency light checks. However, the registered manager took immediate action to put these checks in place.
People and their relatives told us they felt safe using the service. Staff demonstrated they understood the importance of keeping people safe. They were aware of their responsibilities for reporting any concerns regarding potential abuse. Risks to people's health and welfare had been assessed and support plans gave staff clear instructions on how to minimise the identified risks. As a result, staff knew how to ensure people’s safety.
Accidents and incidents were appropriately recorded and analysed for any trends. People were protected against the risks associated with unsafe use and management of medicines.
There were sufficient numbers of staff on duty to meet the needs of people who use the service. The provider had an effective recruitment and selection procedure in place and carried out relevant checks in the course of the recruitment process. Staff were suitably trained and relevant training sessions were planned for any due or overdue training. Staff received regular supervisions and appraisals.
The management and care staff were trained in and understood the principles of the Mental Capacity Act 2005 [MCA] and promoted a least restrictive approach in dealing with each person provided with care.
Staff had access to induction and on-going training, supervision and appraisal. This ensured staff had the skills and knowledge to support people using the service safely and effectively.
People's health needs were monitored and people were referred to external healthcare professionals if such a need was identified.
People who use the service and their family members were complimentary about the standard of care at The Laurel. Staff treated people with dignity and respect and helped to maintain people's independence by encouraging them to care for themselves where possible.
Care records showed that people's needs were assessed before they moved into the service and care plans were written in a person-centred way.
Activities were arranged with people who use the service and were planned to meet their preferences and interests. People were supported to meet their social care needs.
The service regularly used community services and facilities and had links with other local organisations.
Staff felt supported by the manager and were confident to raise any concerns if they needed to do it. People who use the service, family members and staff were regularly consulted about the quality of the service.
The service had a complaints procedure in place, which was available in an 'easy-to-read' version to help people understand how to raise any concerns they might have.
The registered manager promoted an open culture and involved all people in running the service. There was good communication between staff members who were encouraged to share their ideas to make improvements to the service.
Staff members said they liked working in the home and the teamwork was enjoyable due to other members’ attitudes. Staff meetings took place each month and staff were confident to discuss ideas and raise issues with the managers at any time.
People were supported to be fully involved in the planning and reviewing of their care and support. People's independence was promoted and supported.
The home had safe procedures in place to administer medication and the staff were appropriately trained to carry out this responsibility.
The home ensured that there were sufficient staffing provided on duty to meet people's needs.
There were safe procedures in place for the recruitment of staff. Appropriate checks were completed before people were appointed. People who lived in the home were involved in the recruitment process for new staff.
People told us they received the required support to undertake activities in the community and were encouraged and supported to maintain their independence. People told us they were involved in the planning and reviewing of their care and support and enjoyed having a key-worker to work with. We were told that The Laurel was a safe place to live.
We found that people's care and support needs were well met and that detailed and up to date care plans were in place.
We found that the home correctly stored and administered medication and that appropriate training was provided for staff before they undertook this responsibility.
The home had the required recruitment procedures and pre-employment checks in place for staff.
One person told us they were 'safe and happy'. Others were keen to show us their rooms and talk about their hobbies and possessions. Two of the people were excited about their forthcoming holiday and were keen to talk about their experience when they returned from a short trip into town.