The Laurels Residential Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 63 (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 did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them. Not all people’s needs had been fully assessed, and some care plans required further clarity to ensure staff had clear guidance to meet those needs. Feedback from relatives about involvement in care planning was mixed, with some reporting limited involvement.

The manager had recognised this and taken action to improve engagement, including increasing face-to-face involvement with people and their relatives to support a more inclusive approach to care planning.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. The provider made timely and appropriate referrals to relevant healthcare professionals. Clinical assessment tools, including the Malnutrition Universal Screening Tool (MUST) and the Waterlow scale, were used effectively to identify risks and inform care, with preventative measures implemented.

Care plans did not always clearly reflect people’s specific dietary requirements. However, staff knew people well and demonstrated a good understanding of people’s needs in practice. Following our feedback, care plans were updated to improve clarity and guidance.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Daily meetings were held to ensure staff were informed about day-to-day developments within the service. Systems were in place to communicate key information directly to staff via their devices, supporting timely and effective information sharing.

Updates and guidance from external professionals were incorporated into care plans, including outcomes from GP visits and hospital admissions. This information was shared promptly with staff to ensure continuity of care and up-to-date support for people.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. The service identified risks to people’s health and wellbeing and took action to prevent deterioration. Records were appropriately maintained to show when staff had made referrals to external agencies. People were supported to maintain a balanced diet, with nutritious meals provided. Menus were varied, and relatives told us portion sizes were sufficient. Some improvements were being considered, including increasing choice for people with diabetes following feedback from a resident. Relatives told us appropriate medical attention was sought when people’s health needs changed, ensuring timely support.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. Some people experienced behaviours of concern which were repetitive in nature. There was a lack of effective monitoring, learning and analysis of this behaviour to identify people’s potential triggers, early warning signs and strategies successful in reducing their occurrence and impact. This meant opportunities to adapt and continuously improve people’s psychological care and outcomes were missed.

However, people had access to regular clinical input, including visits from district nurses and routine GP reviews, supporting ongoing health monitoring. Relatives gave several examples whereby their family member's health had deteriorated, staff reacted quickly and contacted other health professionals in a timely manner.
 

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. The provider did not always ensure people were informed about their rights in relation to consent. People’s capacity to make their own decisions had been considered; however, mental capacity assessments (MCAs) were not always completed where a person lacked capacity. Some mental capacity assessments required further details regarding how capacity had been assessed in line with the principles of the Mental Capacity Act 2005 (MCA). Best interest decisions had been completed, however, these were not always carried out with involvement from the people who knew the person best. The manager commenced a review of all MCAs to ensure there were no further short falls.

Staff consistently sought consent from people before delivering care or support, and we observed this practice in action several times during this assessment. A staff member told us, "We always ask the resident." One staff member described how they supported a person to make choices in line with their capacity and communication needs. For example, when gaining consent to apply a cream, they used visual prompts and observed the person's reactions to help identify their preferences.