The Laurels Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement.

This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The service was in breach of legal regulation in relation to safe care and treatment.

This service scored 59 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

For example, the registered manager held lessons learnt meetings with the staff team following incidents in the home, to encourage learning and development of the team, enabling a proactive and positive approach for the staff team to embed good practice.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People were supported in accessing appropriate healthcare professionals for their health needs. For example, people were receiving support from GPs, speech and language team (SALT), falls clinics, dietitians and occupational therapists.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People told us they were happy at The Laurels Care Home. A person told us, “I am very happy here, they take care of me.”

Relatives told us that their loved ones were safe. One relative told us, “I think absolutely the care is safe.”

Staff received safeguarding training and demonstrated a clear understanding of the procedures of reporting concerns. Deprivation of Liberty Safeguards (DoLS) authorisations were sought when required to lawfully deprive a person of their liberty for their own safety.

People had care plans and risk assessments describing support and care needed, however, some information on how risks were managed needed further review to ensure the right care and mitigation was provided consistently according to risk assessments.

For example, we found some people’s PEEP (Personal emergency evacuation plan) did not identify the use or availability of evacuation sheets, which potentially put people at risk, as staff may not know if they were in people’s rooms in the event of evacuation.

A staff member told us that all people with mobility issues had a fire evacuation sheet under their mattress in case of the need to evacuate quickly.

The registered manager acted promptly when we raised these concerns, and they advised us people’s PEEP had been amended.

The provider did not always detect and control potential risks in the care environment.

During our inspection, we found cupboards storing cleaning or hairdressing products unlocked or easily accessible and people’s toiletries were not always safely stored as risk assessed by the service. We observed a cleaning trolley unattended with accessible cleaning products for a prolonged period. This potentially put people at risk. We found no harm had come to people.

We raised the concerns with the registered manager, who acted promptly to address them during our inspection. The home had signage to support people to safely access areas around their home. However, we found inconsistencies, for example a communal shower room did not have any signage identifying its use and some signage was not always at a level for people using a wheelchair to see. The provider had identified these issues, and the registered manager had an ongoing action plan to address the door signage and works required to the home’s internal doors.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The provider had a robust recruitment system and an effective rota system to ensure staffing levels reflected the needs of people.

Staff told us that there were appropriate numbers of staff on duty to meet people’s needs.

A relative told us, “In my opinion there are plenty of staff and I go at different times of day and the staffing is fine.”

Staff had received appropriate training to carry out their roles in supporting people at The Laurels Care Home. We observed staff working as a team to support people’s needs.

The provider did not always assess or manage the risk of infection. For example, we observed staff returning the hoist and stand aid to the storage room after use, where they cleaned them ready for the next person to use. However, we did not see them complete the cleaning monitoring forms as part of the home’s procedure. The cleaning monitoring forms had gaps, so we were unable to confirm if they were cleaned after every use. We observed peoples used breakfast crockery and cutlery stacked on a sideboard in the lounge and it was not taken for cleaning for a prolonged period.

However, staff had been trained in infection control, and we observed staff using appropriate Personal Protective Equipment (PPE) when supporting people.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning as required medication.

There was detailed and person-centred care planned information available for staff to refer to when giving people their medicines. However, for some pain-relief medicines prescribed for occasional use at the discretion of staff (PRN medicines), there was a lack of detailed guidance for staff about the use of multiple pain-relief medicines to be given at the discretion of staff.

For people prescribed medicated skin patches, records did not confirm that the sites of application of the patches had been appropriately varied to prevent the risk of skin irritation from them or confirm that previous patches had been removed for safety.

Medicines were stored safely and securely. Records we checked showed that people received their medicines as prescribed and that prescribers reviewed people’s medicines. Staff carried regular checks of medicines and their records. When issues were identified they were recorded and investigated.

We observed that staff followed safe procedures when giving people their medicines. They had their competence regularly assessed around medicine management to ensure they managed people’s medicines safely.