Archived: Laurel Grove

The service was last inspected on 24 June 2015 when we found there was a breach in the legal requirements and regulations associated with the Health and Social Care Act 2008, relating to obtaining people’s consent to care. We asked the provider to take action to make improvements, and this action has been completed.

This inspection took place on 10 August 2016 and was unannounced.

There was a registered manager at 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.

The service was following the guidance in people’s risk assessments and care plans and the risk of unsafe care was reduced. People’s records were up to date and indicated that care was being provided as detailed in people’s assessments. The records had been updated to reflect changes in people’s care needs. Medicines were managed safely.

People were safeguarded from abuse because the provider had relevant guidance in place and staff were knowledgeable about the reporting procedure.

Consent to care and support had been sought and staff acted in accordance with people’s wishes.

People told us they enjoyed their food and we saw meals were mostly nutritious. People’s health needs were met. Referrals to external health professionals were made in a timely manner.

People and their relatives told us the care staff were caring and kind and that their privacy and dignity was maintained when personal care was provided. Relatives were involved in the planning of people’s care and support. There was a range of activities and events available to enable people to take part in hobbies and interests of their choice.

Complaints were well managed. Communication systems were effective. The provider had systems to monitor the quality of the service and obtained feedback about the quality of the service from people, their relatives and staff.

Is the service safe?

People told us that they felt safe living at Laurel Grove. Their personal files included a range of risk assessments and these included procedures to safely manage risks.

People's signatures were recorded on forms giving their consent to having medication administered to them.

We found the service to be meeting the requirements of the Deprivation of Liberty Safeguards. People's human rights were therefore properly recognised, respected and promoted.

Is the service effective?

People told us that staff encouraged them to be as independent as possible. One person told us, 'I look after my money. I go out for walks on my own.'

Staff encouraged, and supported, people to take risks that increased their independence. These risks had been thoroughly assessed and recorded.

People were fully involved in planning their lives. We saw recorded evidence of this in their care plans through individual signatures. Staff also confirmed this and one staff member spoke about the way they had involved people in planning a holiday. Care plans guided staff to meet people's needs in a consistent and informed way.

Staff had been provided with most of the training needed to meet people's needs. One person, who uses the service, told us, 'I am happy.'

Staff also had positive views on the service. One member of staff told us, 'We all work well together. There's a good atmosphere.'

Is the service caring?

People's privacy and dignity were respected. One person told us, 'Staff always knock on my bedroom and bathroom door.'

We observed, and heard, staff interacting with people in a way that showed they were genuinely interested in them.

People told us that staff respected their likes and dislikes and thought that their needs were being met. One person said, 'Staff help me do the things I like.'

Is the service responsive?

People's personal records showed that staff were encouraged to take an approach to people which was centred on their individual needs. People's personal preferences, and likes and dislikes, were recorded and support was provided that met people's wishes.

There were meetings for the people who use the service. These were held monthly and the minutes of these reflected people's close involvement in making decisions about their life. One person told us, 'Staff listen to me.'

Is the service well-led?

Staff described a set of sound values upon which the service was based. These included supporting people in their own home, fulfilling people's needs and ensuring dignity, choice and equality.

The service had a quality assurance system which identified, assessed and managed risks to people's health, safety and welfare. However, the service was not comprehensively monitoring the quality of service that people received. People had not been asked recently for their views about their support and the views of people's relatives, staff or external professionals were not sought. This reduced the effectiveness of the service's quality monitoring system.

There was no development or business plan in place. This meant that the manager had no monitoring record of action plans and priorities set to improve the quality of service provision.

We have asked the provider to tell us what they will do to meet the requirements of the law in relation to quality assurance.

We found that care plans were in place and these included detailed, personalised information describing people's choices and wishes and how best they could be supported. We found that people were involved appropriately in their care planning.

We found that the provider had effective recruitment and selection procedures in place.

We found that staff were not always supported to deliver care and treatment safely and to an appropriate standard as they were not offered regular supervision and appraisal. Some staff had not completed mandatory training at the time of our visit.

We found that there were systems in place to handle complaints and people told us they would feel confident about raising concerns. There was information available to people about how to make a complaint and it was in a format accessible to them.