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Inspection Summary


Overall summary & rating

Outstanding

Updated 1 September 2017

The Laurels is a specialist rehabilitation service. It provides care and support for up to 12 people who have an acquired brain injury and complex neurological conditions. The service supports people to access a range of rehabilitation programmes. These are designed individually with the aim to support people to return to life in the community. There were 12 people living at the service time of this inspection.

The service can also provide care for people in their own homes in the city of Lincoln and its surrounding villages. At the time of our inspection there were no people receiving care in this way. However, the registered persons had ensured systems were in place so that this type of service could be provided if needed at any time.

The service was run by a company that is the registered provider. There was a registered manager in post. 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. In this report when we speak about both the company and the registered manager we sometimes refer to them as being, ‘The registered persons’.

At the last inspection we carried out on 23 June 2015 the service was rated ‘Good.’

This inspection was carried out on 12 July 2017 and was announced. During this inspection we found the service was ‘Outstanding.’

There was a registered manager in place who ran the service. 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. In this report when we speak about both the company and the registered manager we sometimes refer to them as being, ‘The registered persons’.

The registered manager was known personally to everyone at the service and people were kept at the heart of the services provided. People were actively involved in the preparation and on-going review of their personal care plan. Staff understood what was important to each person and worked closely with each other and external health and social care professionals to promote people’s well-being.

The creative and individualised approach to support displayed by the registered manager and staff provided clear therapeutic benefits for people. People received individualised support which was responsive to their diverse and changing needs and preferences.

The registered persons provided staff with strong, values-led leadership. Staff worked together well and were proud to work for the service. They felt listened to and well supported through supervision and training to work effectively.

The registered persons had assessed potential risks to people. When any accidents or incidents had occurred they had put preventive measures in place to reduce the risk of them occurring again. Staff knew how to recognise and report any concerns they had for people’s safety in order to ensure people were kept safe from harm.

Staff were recruited using safe systems to do this and there were enough staff in place to provide the care each person needed and in the way they had chosen to receive it.

People were involved in making decisions about their care and how they wanted to be supported. The registered manager had processes in place which ensured, when needed, they acted in accordance with the Mental Capacity Act 2005 (MCA). This measure is intended to ensure that people are supported to make decisions for themselves. When this is not possible the Act requires that decisions are taken in people’s best interests.

The Care Quality Commission is required by law to monitor how registered persons

Inspection areas

Safe

Good

Updated 1 September 2017

The service was safe.

People were protected from the risk of avoidable harm and kept safe by staff who knew how to identify and manage such situations.

Staff were recruited safely and background checks had been completed before new staff were employed.

Staff resources were well managed, and staff were deployed in ways which ensured they met people’s needs in a consistent and timely way.

Clear systems were in place to ensure people’s medicines were managed in a safe way.

Effective

Outstanding

Updated 1 September 2017

The service was very effective.

Staff had the knowledge and skills required to meet people’s individual needs and promote their health and wellbeing.

The registered person’s ensured staff received all the training, including any specialised training they required and actively supported the on-going development of staff skills.

Staff worked very well with local social and healthcare services and supported people to access any specialist support they needed.

People were supported to make their own decisions and staff had an understanding of how to support people who lacked the capacity to make some decisions for themselves.

People were supported to maintain their health and well-being and have enough to eat and drink to stay well.

Caring

Outstanding

Updated 1 September 2017

The service was very caring.

Care and support was provided in a warm and friendly way that took account of each person’s personal needs and preferences.

Staff knew people as individuals and supported them to have as much choice and control over their lives as possible.

The registered persons organised additional support for the people who used the service to promote their health, well-being and happiness.

People were treated with dignity and respect, confidentiality was maintained at all times and people's diverse needs were met.

People and their circle of support had received the care and support each had chosen and needed at the end of their lives.

Responsive

Good

Updated 1 September 2017

The service was responsive.

People received personalised care that was responsive to their changing needs. People were actively involved in the preparation and review of their personal care plan.

Staff encouraged people to maintain and develop all of their chosen personal relationships and to have an active presence in their local community. People were also supported to to maintain any personal interests they had.

People knew how to raise concerns or complaints and were very confident that the registered persons would respond promptly and effectively.

Well-led

Outstanding

Updated 1 September 2017

The service was very well-led.

The registered manager was known personally to everyone who used the service and provided staff with strong, values-led leadership.

A culture based on collaboration and team work had been established and maintained by the registered manager. Staff benefitted from acting on good practice guidance, were well supported and proud to work for the service.

The registered persons sought people’s opinions on the quality of the service and were committed to the continuous improvement of the services they provided.

The registered persons achieved this through the range of auditing and monitoring systems they had in place to ensure the care provided reflected people’s needs and preferences.