The Care Quality Commission
  • Care Home
  • Care home

Archived: Laburnum Lodge

Overall: Good read more about inspection ratings

2 Victoria Street, Littleport, Ely, Cambridgeshire, CB6 1LX (01353) 860490

Provided and run by:
ARMSCARE Limited

Important: The provider of this service changed. See new profile
Important: The provider of this service changed. See old profile

All Inspections

19 April 2017

During a routine inspection

Laburnum Lodge is a residential care home for up to 22 people, some of whom may be living with dementia. This announced comprehensive inspection took place on 19 April 2017. At the time of the inspection there were 19 people in residence.

At our last inspection the service was rated as good. At this inspection we found the service remained good.

The service was safe because there were enough staff deployed who had been trained to make sure that people were protected from avoidable harm. Potential risks to people were managed well and medicines were given safely. Staff recruitment ensured that only staff suitable to work at this home were recruited.

The service was effective because staff received a thorough induction, followed by training and support that ensured they could do their job well. People were given enough food and drink and special dietary needs were met. People’s healthcare needs were met by the involvement of a range of healthcare professionals.

The service was caring because staff treated people with kindness and compassion, respected people’s privacy and dignity and encouraged people to be as independent as they could be. People living at the home and their relatives had warm, caring relationships with the staff. Visitors were welcomed.

The service was responsive because people were involved in planning the care they needed, which met their individual preferences. Some activities and entertainments were provided and staff were keen to improve in this area. People and their relatives knew who to speak to if they were not happy with the service and were confident their complaints would be addressed.

The service was well-led because there was a registered manager in post who provided good leadership and who was fully aware of further improvements they wanted to make. People, staff and visitors to the home were encouraged to put forward their views about the service being provided. The quality of the care was monitored by a range of audits that were carried out regularly.

Further information is in the detailed findings below.

28 May and 11 June 2015

During a routine inspection

Laburnum Lodge is registered to provide accommodation and personal care, without nursing, to up to 22 people. On the day of the inspection there were 14 people living at the home. The home is a converted and extended period property, located at the end of Main Street in Littleport. Accommodation is offered on two floors, with a stair-lift to access the first floor.

This inspection took place on 28 May and 11 June 2015 and was unannounced. The last inspection of this home was on 03 September 2014. At that time we found that the provider did not have an effective system in place to audit and monitor the quality of the service that people received. We also found that the provider did not have suitable arrangements in place to ensure that records required for the safe operation of the service were being maintained effectively. The provider wrote and told us they would be compliant with all the regulations by 05 November 2014. During this inspection we found that the necessary improvements had been made.

This service requires 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 2008 and associated Regulations about how the service is run. The provider had appointed a manager who told us she was in the process of submitting an application to the Commission to be registered.

People, their relatives and the health and social care professionals we spoke with were all very complimentary about all aspects of the service offered at Laburnum Lodge. They praised the staff and the manager. They particularly liked the atmosphere in the home and the ethos of treating each person as an individual.

The service was safe because there were enough staff on duty to meet people’s needs. Staff had been trained and were able to recognise and report abuse appropriately. All the required pre-employment checks had been carried out before staff started to work at the home. Any potential risks to people were managed so that the risks were minimised. People were given their medicines safely.

The CQC monitors the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS), which apply to care services. People’s capacity to make decisions for themselves had been assessed. This meant that the rights of people not able to make their own decisions about aspects of their care were protected.

People were given sufficient amounts of nutritious, appetizing food and drink and were supported to make choices about all aspects of their daily lives. Special diets were provided for people who needed them. People’s health was monitored and maintained by staff with the involvement of a range of healthcare professionals.

Relationships between people who lived at Laburnum Lodge and the staff were very good and staff showed they cared about the people they were looking after. Staff treated people well and respected their privacy and dignity. People were encouraged to remain as independent as possible.

People and their relatives were involved in the planning and reviewing of their care. Detailed information was available to staff so that each person received the care and support they needed in the way they preferred. A range of activities, outings and entertainments were offered to people and there were links with the local community.

The home was managed well. People, their relatives and the staff were encouraged to give their views about the home and put forward their ideas for improvements. People knew how to complain and felt comfortable with raising any issues with the management team. An effective system was in place to monitor and audit the quality of the service being provided.

02/04/2014 & 3/09/2014

During an inspection looking at part of the service

We carried out an unannounced  comprehensive inspection of this service on 2 April 2014. A breach of legal requirements was found. As a result we undertook a focused inspection on 3 September 2014 to follow up on whether action had been taken to deal with the breach.

You can read a summary of our findings from both inspections below.

Comprehensive inspection of 2 April 2014

Laburnum Lodge is a care home which provides accommodation and care for up to 22 older people, some of whom have a diagnosis of dementia. The home does not provide nursing care.

We saw that staff were able to deal with an incident in a way that kept the person safe and dignified. However this highlighted that there were not enough staff on duty in the areas within the home to ensure all other people were kept safe.

We heard staff talk with people in a pleasant and encouraging tone, and used the name the person wanted to be called. There were some terms of endearment, but it was evident that people in the home were very happy with that.

There were many visitors on the day of inspection, some of whom stayed for lunch. It was obvious that this was a normal occurrence and meant relative’s were encouraged to visit and stay for meals.

There was a new computer system where care plans and risk assessments were written and recorded for people living in the home. The system was word protected which meant people could be assured their information was kept safe.

Although there was evidence that staff had undertaken training such as moving and handling, fire safety, safeguarding and infection control, some competency and skills based training, such as medication, had not been completed. This meant staff responsibilities to deliver care to people safely and to an appropriate standard was not always met.

There were other training courses that had been undertaken by staff, such as dementia and whistleblowing, which meant their learning and development enabled them to provide effective care to people in the home.

The manager said there was no system in place to check the correct levels of staffing necessary. This meant that there were not always be sufficient numbers of suitably qualified and experienced staff on duty.

The service did not always follow current and relevant professional guidance about the management of medicines, and staff did not have sufficient training to enable them to manage people’s medicines safely.

There was an annual system in place to assess and monitor the quality of the service by seeking the views of people who live in the home or their relatives and other professional.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS), and to report on what we find. (The deprivation of liberty safeguards are a code of practice to supplement the main Mental Capacity Act 2005 Code of Practice.)

We looked at whether the service was applying the Deprivation of Liberty safeguards (DoLS) appropriately. These safeguards protect the rights of adults using service by ensuring that if there were restrictions on their freedom and liberty these would be assessed by professionals who are trained to check whether the restriction was needed. While no applications had been submitted, proper policies and procedures were in place but none had been necessary. Relevant staff have been trained to understand when an application should be made, and in how to submit one. We found the home was meeting the requirements of the Deprivation of Liberty Safeguards. People’s human rights were therefore properly recognised, respected and promoted.

Focused inspection of 3 September 2014

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to look at the overall quality of the service.

This inspection was unannounced, which meant that the provider did not know that we were coming. The purpose of this inspection was to check whether the provider had met the requirements of the compliance actions we had issued following our inspection on 2 April 2014. We had issued compliance actions because there had been breaches of four regulations.

The provider sent us an action plan and told us they would be compliant with all the regulations by 18 July 2014. We returned to the care home on 3 September 2014 to check that the provider had taken action to address the concerns we had raised previously.

Laburnum Lodge is registered to provide accommodation and care for up to 22 people. The care home provides a service for older people who have physical care needs and for people living with dementia. There were 12 people living there when we inspected on 3 September, one of whom was in hospital.

At the time of our inspection the person managing the care home had been in post for about four weeks and had not yet submitted an application to the Care Quality Commission to be registered as manager. This meant there was no registered manager in post.

We found that improvements had been made in the way people were cared for. People and their relatives were happy with the service they were receiving and we heard many positive comments about the service, the new manager and the staff team.

However, we found that the quality monitoring tool introduced by the provider was not sufficiently robust to give assurance that a good quality service was being provided. Some of the records required by the regulations were not being adequately maintained.

02/04/2014

During a routine inspection

Laburnum Lodge is a care home which provides accommodation and care for up to 22 older people, some of whom have a diagnosis of dementia. The home does not provide nursing care.

We saw that staff were able to deal with an incident in a way that kept the person safe and dignified. However this highlighted that there were not enough staff on duty in the areas within the home to ensure all other people were kept safe.

We heard staff talk with people in a pleasant and encouraging tone, and used the name the person wanted to be called. There were some terms of endearment, but it was evident that people in the home were very happy with that.

There were many visitors on the day of inspection, some of whom stayed for lunch. It was obvious that this was a normal occurrence and meant relative’s were encouraged to visit and stay for meals.

There was a new computer system where care plans and risk assessments were written and recorded for people living in the home. The system was word protected which meant people could be assured their information was kept safe.

Although there was evidence that staff had undertaken training such as moving and handling, fire safety, safeguarding and infection control, some competency and skills based training, such as medication, had not been completed. This meant staff responsibilities to deliver care to people safely and to an appropriate standard was not always met.

There were other training courses that had been undertaken by staff, such as dementia and whistleblowing, which meant their learning and development enabled them to provide effective care to people in the home.

The manager said there was no system in place to check the correct levels of staffing necessary. This meant that there were not always be sufficient numbers of suitably qualified and experienced staff on duty.

The service did not always follow current and relevant professional guidance about the management of medicines, and staff did not have sufficient training to enable them to manage people’s medicines safely.

There was an annual system in place to assess and monitor the quality of the service by seeking the views of people who live in the home or their relatives and other professional.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS), and to report on what we find. (The deprivation of liberty safeguards are a code of practice to supplement the main Mental Capacity Act 2005 Code of Practice.)

We looked at whether the service was applying the Deprivation of Liberty safeguards (DoLS) appropriately. These safeguards protect the rights of adults using service by ensuring that if there were restrictions on their freedom and liberty these would be assessed by professionals who are trained to check whether the restriction was needed. While no applications had been submitted, proper policies and procedures were in place but none had been necessary. Relevant staff have been trained to understand when an application should be made, and in how to submit one. We found the home was meeting the requirements of the Deprivation of Liberty Safeguards. People’s human rights were therefore properly recognised, respected and promoted.

2 April 2014

During an inspection

3 February 2014

During an inspection in response to concerns

A person who wished to remain anonymous contacted the Care Quality Commission and made some allegations about poor practice at Laburnum Lodge. We carried out an unannounced inspection on 3 February 2014 in response to the concerns raised. The acting manager had applied to be registered with CQC.

People were happy with the way staff treated them and said that staff spoke 'nicely' to them. We observed that staff treated people with respect and spoke to them in a polite and friendly manner. Staff were happy to be working at Laburnum Lodge. One member of staff told us, 'I love it here', another said, 'I love my job' and a third said, 'I've never been happier in a job: I wouldn't change it for the world.'

Staff had received training in how to protect vulnerable people and demonstrated they knew the procedures for reporting any concerns. Staff were recruited well, with all the required information being obtained before the member of staff started work. Staff received regular supervision and had undergone training in a range of topics so that they were competent to carry out their role. Staff told us the acting manager was very supportive and helpful.

However, medicines were not managed well enough to ensure people received their medicines safely and as they were prescribed.

22 August 2013

During a routine inspection

At our previous visit of 17 July 2013 we identified continued shortfalls in medication management, and cleanliness and hygiene, at the home. We issued a warning notice to the provider on 29 July 2012 as they were failing to comply with Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, Cleanliness and Infection control and Regulation 13, Management of Medicines.

As the purpose of this visit was to check that the provider was now compliant with these regulations, we did not request information directly from people using the service on this occasion.

Overall we found that the provider had taken sufficient action to address the shortfalls in relation to medication recording and administration, and cleanliness and infection control and was now compliant with these regulations.

The provider must ensure that these improvements are sustained in the long term.

17 July 2013

During a routine inspection

During our inspection on 1 May 2013, we found that the home had not been kept clean and hygienic enough to ensure that people who lived there, staff and visitors were protected against the risk of a health care related infection. The provider sent us an action plan, detailing how they would achieve and maintain acceptable standards of cleanliness and hygiene.

People we spoke with during our inspection on 17 July 2013 had mixed views about the cleanliness of their bedrooms. Two people told us, 'It's alright.' Another person said, 'Not always clean. They work very hard but it seems as though they're understaffed.'

We found that there had been some improvements to the cleanliness of the home. However, a number of concerns that we had raised following our previous inspection had not been addressed and, overall, the home was not clean and hygienic enough to ensure that people were protected from the risk of infection.

During our inspections in October 2012 and April 2013 we found that the management of medicines put people at risk. During our inspection on 17 July 2013 we found improved guidance for the administration of medicines prescribed to people on a "when required" basis. However, we found a number of areas of concern, which meant that people were still not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place for the obtaining, safe keeping, administration and recording of medicines.

1 May 2013

During a routine inspection

During our inspection we spoke with several people who lived at Laburnum Lodge, and with some of their relatives. Generally, people were happy with the service that was being provided. One person said, 'It's very good here. I would recommend it to anyone.' Another person told us, 'Staff are like friends and I'm quite happy here.'

Staff treated people with respect, encouraged them to retain as much independence as possible and supported them with personal care tasks when needed. People's preferences, likes and dislikes were recorded in their care plans, which had improved since our last visit. Care plans gave clear guidance for staff relating to the care and support people needed and there was evidence that people's health was monitored by other health professionals.

Staff received training in a range of topics so that they were equipped to carry out their role. They also received regular supervision and their working practices were monitored. Some aspects of the quality assurance system were in place, so that people had opportunities to put their views about the home to the managers.

However, the home was not kept clean and hygienic enough to ensure that people who lived there, visitors and staff would be protected from the risk of infection.

23 January 2013

During an inspection looking at part of the service

As a result of our inspection of Laburnum Lodge on 02 May 2012 we issued a compliance action with regard to the lack of effective assessment of people's care needs and the lack of individualised planning of people's care. We received an action plan from the provider, which stated that improvements would be made by 30 July 2012.

We carried out an inspection on 30 October 2012 and found that the provider was still failing to comply with the regulations and there continued to be a risk that people were not receiving appropriate and safe care. We issued a warning notice on 8 November 2012 in which we detailed areas where we had found that care planning was still failing to address people's assessed needs and there remained a risk that people's needs were not being met. We gave the provider until 11 January 2013 to become compliant with the regulations.

During this inspection on 23 January 2013 we looked at four people's care records and found a number of areas were there were inconsistencies in the planning and delivery of care. This meant that the provider had failed to comply with the warning notice.

30 October 2012

During an inspection looking at part of the service

We carried out this inspection to assess whether the compliance actions that had been issued at the last inspection had been met. We found that the staffing situation had improved. The manager now worked on a supernumerary basis so that she had time to complete management tasks as well as assisting with providing care to the people who lived at the home. Improved supervision and training had been provided to staff.

However, we found that improvements had not been made to the system for assessing people's needs and planning for their care. We looked at a sample of care records for people who lived at the home. We found examples of information that was either inconsistent, or that had omissions, in all three care records that we looked at.

During this inspection we also identified that there were concerns about the management of medicines as information regarding changes to a person's medicines was not accurate.

2 May 2012

During a routine inspection

During our visit on 02 May 2012 we spoke with several people who lived at the home. They were all very complimentary about the staff and the care that they received. One person told us that they had been anxious about moving to the home but that they were very happy there. They said that they had a key to their room and were able to look after their own medication.

One person told us that there had been a recent change in the morning routine which had meant that people were waiting some considerable time for breakfast. Several of the people living in the home had complained about the change and requested that they return to the more flexible routine for breakfast. They said that action was immediately taken to ensure that people were once again able to have breakfast at whatever time they chose to get up. People had been encouraged to complete a quality assurance questionnaire about this situation, as well as talking to the manager about it.

One person told us, 'Everyone is so kind and helpful'. Another said that, 'I am keeping my fingers crossed that I can stay here as everyone is lovely'. People told us that the staff spent time with them and always explained what they were going to do prior to assisting them. They said that they did not have to wait long for staff to come when they used the call bell. One person told us that the staff had really helped them to settle in well and that, 'Nothing is too much trouble.' Another told us that the staff always went to her room for a chat so that she did not feel isolated as she preferred to spend time in her room.

Several people had recently moved to the home at very short notice due to unforeseen circumstances at another care home. We spoke with some of the people involved and they all said that the staff had spent a lot of time with them getting to know their likes and dislikes and the care that they needed. They said that, although it had been a very stressful time the staff at the home had made the move as easy as they could. We spoke with two people who said that they were happy living at the home but would prefer another room as they wished to be on the ground floor. The manager told us that she was aware of this and that they would be offered a ground floor room as soon as one became available.