Laurel Grove

Updated 25 January 2024

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection team consisted of 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Laurel Grove is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Laurel Grove is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

The inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We visited the service location on 13 December 2023. We spoke with 3 people who used the service and 2 relatives about their experience of the care provided. We spoke with 6 members of staff including the registered manager and deputy manager.

Updated 25 January 2024

About the service

Laurel Grove is a residential care home providing accommodation for persons who require nursing or personal care for to up to 3 people. The service provides support to younger adults with a learning disability or autistic spectrum disorder. At the time of our inspection there were 3 people using the service.

People’s experience of the service and what we found:

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: There were shortfalls in safely managing people’s medicines; medicine protocols were not in place for the administration of when required medicines. The provider did not always assess risks to ensure people were safe. Staff did not always take action to mitigate any identified risks. Staff were recruited safely and had appropriate training on how to safeguard people using the service.

People’s care plans did not evidence involvement of the person. People’s likes, dislikes and preferences were highlighted in their care plans. This provided guidance for staff to follow to ensure people’s needs and choices were met.

Each person had a communication plan which included information about how people preferred to communicate. Plans contained information in an accessible format.

Right Care: The care people received was person-centred and promoted people's dignity and privacy. People were encouraged to communicate freely and access the community for activities when they wanted to. Staff supported people to maintain important contacts.

People had individual positive behaviour support plans (PBSP) to guide staff when people became distressed or anxious.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service do not support this practice. For example, people's capacity was not always assessed and there was limited evidence of best interest decisions being made.

Right Culture: Staff understood and spoke positively about the importance of person-centred care and helping people to live as independently as they wished.

People were encouraged to share their views of the service.

People were cared for by staff who felt well supported by the managers.

The provider had internal processes in place to drive improvement at the service. A recent internal audit was completed which highlighted key areas for improvement. The registered manager and deputy manager were awaiting the final report.

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 the service under the previous provider was Good, (published 24 October 2018).

Why we inspected

We undertook a focused inspection to review the key questions of safe and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

During the inspection we found there was a concern with mental capacity assessments (MCA) so we widened the scope of the inspection to include effective.

Enforcement

We have identified breaches in relation to medicines, MCA and governance of the service at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow Up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

You can read the report from our last comprehensive inspection by selecting the ‘All inspection reports and timeline’ link for Laurel Grove on our website at www.cqc.org.uk.