Laurel Dene

Laurel Dene is a residential care home providing personal and nursing care to up to 99 people in one adapted building. The service provides support to older people, including those with dementia. At the time of our inspection there were 86 people using the service.

People’s experience of using this service and what we found

People living at the home felt safe and well cared for.

We heard mixed reviews about the quality of the food, however the home sought feedback from people and acted on this regularly.

There were enough staff to meet people’s needs and they were safely recruited. Medicines were administered when people needed them. Risk management plans were detailed in guiding staff as to how to support people.

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.

Prompt action was taken to support people with their healthcare needs. Staff received relevant training and supervision to ensure they were encouraged to develop in their roles.

People felt they were treated with dignity and respect by staff that cared for them. Staff respected people’s privacy and supported them to be as independent as they were able to be.

Care records were personalised and reflected individual preferences in people's day to day care. People were supported to express their end of life wishes where they wished to do so.

The registered manager was well thought of and approachable. Systems were in place to ensure quality was reviewed and improvements made where needed.

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 (published 16 January 2020).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Laurel Dene on our website at www.cqc.org.uk

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Laurel Dene is residential care home providing personal and nursing care. The home accommodates up to 99 people in one building, across three floors, each of which has separate facilities with lift access to the first floor. One of the floors specialises in providing care to people living with dementia. At the time of the inspection, there were 77 people using the service.

People’s experience of using this service and what we found

The provider had made improvements prior to our visit to mitigate risks in relation to admission of new people to the home and how they responded to behaviour that may present a challenge. The registered manager worked more closely with family members and other health and social care professionals to discuss any issues or concerns to people’s health and well-being. Staff had received additional training and support.

During our inspection we identified concerns about the premises. The registered manager shared with us an action plan put in place to repair the affected areas and refurbishment of the premises.

We were assured the service met good infection prevention and control guidelines in relation to the COVID-19 pandemic. People were protected from the risk of acquiring infections. Staff followed guidance to respond to COVID-19 and other infection outbreaks effectively. Staff had access to sufficient Personal Protective Equipment and used it appropriately. Visitors underwent COVID-19 checks to minimise the risk of spreading of infection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The last rating for the service was good, published on 15 January 2020.

Why we inspected

We undertook this targeted inspection to follow up on specific concerns about the service in relation to an admission of a person to the home and responding to behaviour that may be challenging.

The Care Quality Commission (CQC) have introduced targeted inspections to check specific concerns. A decision was made for us to inspect and examine those risks.

This Laurel Dene inspection report does not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question

Follow up

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.

Laurel Dene is a care home providing personal and nursing care for older people. The service can support up to 99 people. There were 97 people using the service during the inspection. The provider is Care UK Community Partnerships Limited and is situated in the Hampton area of London.

People’s experience of using this service and what we found

People said, and their relatives confirmed that Laurel Dene was a nice place to live and living there was a good experience. Staff told us it was a very good place to work. People using the service, relatives and staff all felt the home was a safe place to live and work in. Risks to people were fully assessed, enabling them to enjoy their lives and take acceptable risks, whilst living safely. The home reported, investigated and recorded accidents and incidents and safeguarding concerns. Staff were appropriately recruited and there were enough of them to meet people’s needs. Medicine was safely administered.

People’s diverse needs were met, they were treated with equality and did not encounter discrimination. Staff were well-trained and supervised and spoke to people in a clear way that people could understand. Staff encouraged people to discuss their health needs, and people had access to community-based health care professionals, as well as the staff team. People were protected, by staff from nutrition and hydration risks and they were encouraged to choose healthy and balanced diets that also met their likes, dislikes and preferences. The premises were adapted to meet people’s needs. Transition between services was based on people’s needs and best interests.

The home had a warm, friendly and welcoming atmosphere, provided by all staff irrespective of their roles who provided care and support in a way people enjoyed. The staff we met were caring, compassionate and provided positive interactions for people, throughout our visit. Staff observed people’s privacy, dignity and confidentiality and encouraged and supported them to be independent. If required people had access to advocates.

People were provided with person-centred care and their needs were assessed and reviewed with them. They did not experience social isolation, had choices, and pursued their interests and hobbies, as they wished. People were provided with information, to make decisions and end of life wishes were identified and recorded. Complaints were investigated and recorded.

The home promoted an open, positive and honest culture with transparent management and leadership. There was a clear organisational vision and values. Service quality was regularly reviewed, and areas of responsibility and accountability established. Records were kept up to date and audits carried out, when required. Good community links and working partnerships were established and registration requirements met.

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 the last inspection and update

The last rating for this service was good (published 28 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Laurel Dene is a nursing home providing care and support for up to 99 older people, who may have dementia. The service is located in the Hampton area of west London and owned and managed by CARE UK.

The home had a registered manager. 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 and associated Regulations about how the service is run.

In March 2015, the area of safe required improvement with a recommendation that the home reviewed its staffing numbers and the method used to calculate the staffing numbers required. The home had carried out this review at this inspection. The other areas of effective, caring, responsive and well-led were rated good and there was an overall rating of good.

People and their relatives told us that this was a nice place to live and staff provided good support and care that was delivered in a respectful way. People were given the opportunity to do what they wanted and joined in the activities provided if they wished.

The staff team made the home’s atmosphere warm, welcoming and inclusive. Visitors during the inspection told us that they were made welcome, but sometimes there were communication issues. They felt that the home provided a safe environment for people to live and work in, although sometimes it could be a little impersonal. This depended upon who the staff on duty were. The home was well maintained and clean. The décor was currently acceptable although it could be better focussed on the needs of people in the dementia areas.

There were up to date records kept and the care plans contained clearly recorded, fully completed, and regularly reviewed information. This enabled staff to perform their duties appropriately.

Most staff knew the people they worked with including their likes, dislikes, routines and preferences, although sometimes they were more focussed on getting tasks done, due to time constrictions. This varied depending upon people’s needs and the time of the day. The home had worked hard to reduce the use of agency staff, by recruiting permanent staff. During our visit depending on which unit, most people received the same attentive service and everyone was treated equally, although there was a task rather than person prioritisation, on some units. However, even when the prioritisation was task orientated, staff carried out their duties in a kind and caring way. Staff had appropriate skills, qualifications and were focussed on providing individualised care and support in a professional, friendly and compassionate way. Whilst professional they were generally accessible to people using the service and their relatives. However it was noted that communication between different floors was intermittent and we did see one unit try to contact another for 10 minutes without the internal phone being answered. This was not an isolated incident, although may arise from staff being busy.

Staff said they had access to good training, support and career advancement.

People were protected from nutrition and hydration associated risks with balanced diets that also met their likes and preferences. They said the choice of meals and quality of the food provided was very good. People were encouraged to discuss health needs with staff and had access to community based health care professionals, if they required them. People, we saw, were generally prompted to eat their lunch or drink in a timely manner.

The home’s management team were approachable, responsive, encouraged feedback from people and consistently monitored and assessed the quality of the service provided.

People told us: "it's good here", "you can do what you want" "we are treated well" and "there's lots of laughter". Comments about the food were positive and included "the food is good", "not bad" and "we get enough to eat here". Feedback about staff was positive with people saying "staff are kind", "staff give me the help I need", "staff are wonderful" and "staff are very good

Family members said "staff are good", "staff are approachable", "my relative has settled in well" and "we can see improvements in our relative's enthusiasm to communicate". Visitors were made welcome, offered drinks and kept informed of any changes.

Staff said "this is a very friendly place to work", "it's lovely here", "staff work well together" and "we give people the respect they need'. Staff told us they knew people and how to meet their needs and provided good care. Staff had the training and support they needed to do their job.

There was a relaxed and calm atmosphere at Laurel Dene. Staff took time to provide appropriate care and support to individuals. Some bedroom doors had pictures on to help people identify their room. Bedrooms had been personalised with people's photographs and belongings.

People told us they like living at Laurel Dene, one person said this was because "I do not have to worry about anything because the washing, cleaning and meals are all done for us and if you don't like the food on offer they will prepare something else". We saw that some people had bought small items of furniture, photographs and belongings when they moved in and some people said that this helped them settle and feel at home.

People made positive comments about the food, saying "we can choose what we eat", "lunch was good", "it's usually like this", "I like the food" and "we have enough to eat".

We received mixed comments about the level of activities provided, one person told us "my relative takes me out regularly and I can walk down to the local shops when I need to", "I generally spend time on my own, I am happy with my company doing my own thing", "there are things to do, although they are not always things I am interested in", "I enjoy painting and art and crafts", "I like talking with staff" and "I am happy when my family visit". One person said they did not join in with activities due to their visual impairment.

Comments about staff included "staff are very nice", "staff listen when I ask for things or want to talk", "staff are helpful", "I get on well with staff" and "they are lovely".