• Care Home
  • Care home

Archived: Laburnum House Limited

Overall: Inadequate read more about inspection ratings

1 Wells Street, Bury, Lancashire, BL9 0TU (0161) 797 9013

Provided and run by:
Laburnum House Limited

All Inspections

3 and 4 December 2014

During a routine inspection

This unannounced inspection took place over two days on 3 and 4 December 2014. There were 11 people using the service at the time of this inspection.

Laburnum House provides personal care and accommodation for up to 13 people who are recovering from a mental illness. The home is a detached property with a small garden area and is situated in a residential area close to Bury town centre.

The home had a manager registered with the Care Quality Commission (CQC) who was not present on the day of the inspection. A registered manager is a person who has registered with 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 and associated regulations about how the service is run.

At our previous inspection on 24 September 2014 the provider was not meeting the requirements of the law. This was in relation to the safety and suitability of the building, supporting workers and assessing and monitoring the quality of the service provided. Following the inspection we required the provider to send us an action plan to tell us what improvements they were going to make. The provider failed to send us an action plan.

During this inspection we looked to see what improvements had been made and if the Warning Notice, served on the 28 October 2014 following the September 2014 inspection, had been met. We also looked at other areas of the service to check the provider was meeting the regulations.

The Warning Notice was served because the provider had failed to have regard to the professional and expert advice given to them in respect of fire safety within the home. During this inspection we found the Warning Notice had been complied with.

We found that although the staff understood what care and support people required there were not enough staff available at all times to ensure people’s needs were met.

People were not protected against the risk of unsafe or inappropriate care because care records were not updated, did not reflect people’s needs and failed to show how identified risks were to be managed.

We found that people were not always cared for in a dignified way. Some people looked unkempt and were wearing creased ill-fitting clothing.

There was no encouragement or support for people to undertake activities either inside or outside of the home. No activities were provided to help promote people’s well- being.

Inspection of the training plan showed that staff did not receive the necessary training to enable them to have the skills to do their job properly and care for people safely and effectively.

We found the management of medicines was unsafe and did not protect people who used the service. The provider had failed to keep medicines secure. This meant people were able to access the unsecured medicines and this placed their health and safety at risk of harm.

We found that food stocks were minimal and people were not provided with a choice of suitable and nutritious food to ensure their health and well-being were protected. People we spoke with told us they felt they had enough to eat but they would sometimes like something different.

We asked to see the recruitment files of staff who had been employed by the provider since our last inspection of 24 September 2014. We were told that one new staff member had been employed but that the recruitment file could not be found. Records of recruitment must be available to show that people employed by the provider are of good character, fit to do their job and are suitable to work with vulnerable people.

We looked around all areas of the home and found several areas of the home were in a poor state of repair. Carpets were stained, furniture was damaged, wallpaper was ripped, there were problems with some aspects of the plumbing and the home was cold. This affected the well-being of the people who used the service.

The staff we spoke with were not able to demonstrate their understanding of the requirements of the Deprivation of Liberty Safeguards (DoLS). They were also not aware of the procedure to follow in the event of a person being deprived of their liberty. This could result in people being deprived of their liberty in an unlawful way.

There were no systems in place to assess and monitor the quality of the service provided to ensure people received safe and effective care.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 which corresponds to the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what enforcement action we have taken at the back of the full version of this report.

During this inspection we found that people were supported by kind and patient staff. The people we spoke with told us they liked the staff. They told us the staff were understanding and they felt safe with them.

The staff we spoke with were able to demonstrate their understanding of the whistle blowing procedures and they knew what to do if an allegation of abuse was made to them or if they suspected that abuse had occurred.

18, 24 September 2014

During an inspection looking at part of the service

During the last inspection of 7 May 2014 we found the provider had not met the requirements of the law in relation to complying with the following; care and welfare of people, cleanliness and infection control, the safety and suitability of the premises, staffing and supporting workers. We made compliance actions that required the provider to tell us what they were going to do to make the necessary improvements.

Following the inspection the provider sent us an action plan telling us what steps they were going to take to ensure compliance. The purpose of this inspection was to check if the provider had made the necessary improvements.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

' Is the service safe?

' Is the service caring?

' Is the service effective?

' Is the service responsive to people's needs?

' Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, with the staff supporting them, and from looking at records.

Is the service safe?

There had been an improvement in people's care records. Overall they contained enough information to guide staff on how people were to be safely cared for and supported.

Staff spoken with showed they had a very good understanding of the needs of the people they were supporting.

The home was a lot cleaner. There was a cleaning schedule in place that outlined the daily duties for staff involved in cleaning the environment, equipment and furniture. Systems were in place to prevent the spread of infection and help prevent contamination from one area of the home to another.

On this inspection we found that some improvements had been made to the environment. Some areas of the home had been redecorated and refurbished. We were told that the refurbishment of the home was 'a work in progress'.

There was no evidence to show the electrical installation within the home was safe. Electrical wiring can be a source of ignition and can give rise to electric shocks. Failing to have a safe electrical installation within the home places the health and safety of everybody at risk of harm.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to ensuring that the electrical installation within the home is safe.

Greater Manchester Fire and Rescue Service (GMFRS) visited the home following our inspection of 7 May 2014. One of the requirements made by GMFRS was that all staff must have training in fire prevention and evacuation procedures. Following the fire risk assessment of 24 June 2014, undertaken by an external contractor with previous experience within the fire service, management were required to ensure that all staff, especially those working alone at night were fully trained and capable of handling a fire emergency. Inspection of the training plan showed that five of the eleven staff had not received initial or updated fire training. Inspection of the staff roster showed that one of the staff without fire training worked alone at night. Failing to have staff trained in fire prevention and evacuation procedures places the health and safety of people at risk of harm.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to ensuring that all staff are trained in fire prevention and evacuation procedures.

Is the service caring?

We saw there was plenty of friendly chatter between the staff and the people who used the service. The people we talked with spoke positively of the staff's kindness and attitude. Comments made included; 'I feel wanted and I feel cared for. I have my independence and I am happy with that' and 'I'm okay and happy enough'.

Is the service effective?

Although records showed that the majority of staff had undertaken the essential training necessary to enable them to deliver safe, effective care and support, several staff needed initial or updated training. This was in relation to infection control, moving and handling, the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS) and fire evacuation procedures.

People we spoke with told us they were happy with the support they were given and that their needs were met.

Is the service responsive to people's needs?

Inspection of care records showed that people were referred to the appropriate healthcare professional when an issue of concern had been identified. One person had been referred to a dietician due to unexplained weight loss and another person told us about their visit to the local hospital to have some medical investigations.

Is the service well led?

The service has a manager who is registered with the Care Quality Commission. The manager however has been on leave from the home since January 2014. In the registered manager's absence the home has been managed by a deputy appointed by the provider.

We found the provider had failed to manage the risks relating to the health, welfare and safety of people who used the service and to others who worked or visited the home. The provider had also failed to have regard to the professional and expert advice given to them in respect of both the electrical and fire safety within the home.

15 July 2014

During an inspection looking at part of the service

We carried out this inspection to check whether Laburnum House Limited had taken action to comply with the Warning Notice served on them in May 2014.

During a previous inspection of the home in January 2014 we found that personal care records and records in relation to some aspects of the management of the home were not accurate and not up to date. After the inspection we made a compliance action requiring the provider to have systems in place that ensured people's care records and records in relation to the management of the home were accurate. Following the inspection the provider sent us an action plan telling us what steps they were going to take to make the necessary improvements.

During the inspection of the home in May 2014 we found there had been very little improvement. People were not protected against the risk of unsafe or inappropriate care and treatment because personal care records and records in relation to some aspects of the management of the home were not accurate and not up to date.

We served a Warning Notice following the May 2014 inspection to ensure that improvements were made quickly in order to protect people.

During this inspection we found the Warning Notice had been complied with. Overall the care records contained enough information to show how people were to be supported and cared for. Staff documented in the care plans if people were at risk of harm from any hazards. Staff then wrote down what action they would need to take to reduce or eliminate any identified risk. Information in the care records showed the staff at the home involved other health and social care professionals in the care and support of the people who used the service.

7 May 2014

During a routine inspection

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

' Is the service safe?

' Is the service caring?

' Is the service effective?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service and the staff supporting them, and from looking at records.

The detailed evidence supporting our summary can be read in our full report.

Is the service safe?

The care records did not contain enough information to show how people were to be safely supported and cared for.

The systems in place to control the spread of infection were not adequate. There were no clear procedures in place for the safe handling, storage and disposal of incontinence waste. Hand washing facilities were not adequate.

Some areas of the home were dirty and not well maintained. Mattresses and bed bases were badly stained and bed linen was in a poor condition. Carpets and flooring in some bedrooms were dirty and worn.

Following the inspection we were informed by Rochdale Local Authority that Environmental Health Officers from Rochdale and Bury had inspected the home. We were told they had identified issues in relation to infection control issues and that requirements had been made. We were told that a further visit would be undertaken by them to check compliance with the requirements.

We identified concerns in relation to gas, electrical and fire safety. Following the inspection we contacted Greater Manchester Fire and Rescue Service to inform them of our concerns.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to ensuring that people are kept safe.

Is the service caring?

The care staff had a good understanding of people's needs and they had a relaxed and friendly rapport with the people using the service.

Is the service effective?

For the people who had a mental illness, there were not enough staff to promote their wellbeing and aid their recovery. There was no encouragement and support to provide appropriate activities or community involvement.

There was no evidence to show that staff had received or updated their training to ensure that safe and effective care could be provided.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to ensuring there are sufficient skilled staff provided to meet people's needs.

Is the service responsive?

People were not always referred to the appropriate healthcare professional when an issue of concern had been identified. Despite one person losing a large amount of weight in a short period of time no action had been taken to address the issue.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to ensuring people's health and welfare are protected.

Is the service well led?

Management failed to ensure systems were in place to help protect people against the risks of inappropriate or unsafe care.

Records in respect of the management of the home were either not available or were not accurate.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to ensuring records are accurate and systems are in place to help protect people from harm.

If you want to see the evidence supporting our summary please read our full report.

15 January 2014

During a routine inspection

During our inspection we spoke with two people using the service. We asked them to tell us how they felt they were being cared for. Comments made included; 'It's worthwhile living here. I look after myself but I wouldn't want to move' and 'The staff are lovely and we get well looked after, although I do sort myself out.'

The systems in place to protect people who lacked the capacity to make decisions about their own care and support were not adequate. Staff were not able to demonstrate fully their understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

The planning and delivery of care did not ensure that the individual needs of the people using the service were met.

Arrangements were not in place to ensure that people using the service were cared for by staff that were safely recruited and properly trained.

We found that sufficient numbers of care staff were not available at all times to ensure that the individual needs of the people using the service were met.

Systems were in place for monitoring the quality of the service provided within the home. They were not robust enough however, to identify the issues of concern we identified in relation to care records.

People were not protected against the risk of unsafe or inappropriate care and treatment because personal care records and records in relation to some aspects of the management of the home were not always accurate and up to date.

26 November 2012

During an inspection looking at part of the service

We did not speak to people using the service during this visit. We checked to see if staff had received the necessary training to enable them to safely care and support people. We found there had been a big improvement in staff training.

21 June 2012

During a routine inspection

During our visit we spoke with four people using the service. They were complimentary about the care and support given to them. Some of the comments were:

'I love it here and I would not want to go anywhere else'.

'They are very good to me and let me help around the place'.

'It is like being at home; I feel safe'.

'They know all about me and know what I need'.

'The manager is fantastic, in fact they all are'.

'They never miss giving me my tablets'.