CQC report explained · a residential care home
What the CQC found at Laural House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, June 2023
Requires Improvement; inspectors found kind, person-centred care, but identified gaps in risk checks, staffing, medicines reviews and management oversight.
The inspection took place on 20 and 25 April 2023. One inspector spoke with the two people living at the home, two relatives and four staff. They also checked medicines records, care plans, infection control and management records.
People were treated kindly and with respect. Staff understood people's communication needs and supported their choices, independence and community activities. Relatives and visiting professionals gave positive feedback about the care and management.
Inspectors found some safety risks had not been properly assessed or managed. Staffing hours were not always delivered, medicines competency checks were not reviewed annually, and some audits did not identify known problems. The manager acted quickly on the issues found during the inspection.
The overall rating was Requires Improvement. Safe and Well-led were both rated Requires Improvement. The previous overall rating was Good, published on 16 May 2018.
Kind and respectful care
Inspectors found that staff provided compassionate care, protected privacy and dignity, and responded to people's individual needs.
“People received kind and compassionate care. Staff protected and respected people's privacy and dignity.” from the report
Choice and independence
Staff supported people to make decisions, use the least restrictive approach and develop meaningful everyday lives.
“Staff focused on people's strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life.” from the report
Communication support
Staff understood how people communicated, including through body language and sign language, and helped them interact comfortably.
“People who had individual ways of communicating, using body language and sign language could interact comfortably with staff” from the report
Responsive management
The manager was open during the inspection and acted quickly when inspectors raised concerns.
“The registered manager acted efficiently on queries and feedback throughout the inspection.” from the report
Risk controls
seriousSome care plans did not include important historical information. Community activity risks had not always been assessed, and hot radiators and water were found. The manager arranged action during the inspection, and no harm was found.
“Risks to people were not always properly assessed to protect them from avoidable harm.” from the report
Staffing hours
needs fixingDuring April, people's commissioned one-to-one and two-to-one staffing hours were not consistently delivered. Staff said lone working reduced opportunities to access the community.
“During the month of April, people's hours were not consistently being delivered.” from the report
Medicines competency
needs fixingStaff were trained and initially assessed, but their knowledge and competence were not reviewed annually as recommended by national guidance.
“However, staff did not have an annual review of their knowledge, skills and competence in line with national guidance.” from the report
Management checks
needs fixingAudits did not identify some safety problems and were not always accurate. The manager had also not sent CQC a required notification about the outcome of a liberty restriction application.
“The processes had not identified the areas of improvement identified within the safe section of this report.” from the report
- 01How are you making sure each person's commissioned one-to-one and two-to-one staffing hours are delivered?
- 02What new checks are in place to make sure risks from activities, falls, hot water and radiators are recorded and managed?
- 03How often are staff medicines skills and competence now assessed?
- 04How do your audits check that care records and environmental risk assessments are accurate?
- 05Have all required CQC notifications and the outstanding legionella actions now been completed?
This inspection assessed Safe and Well-led; no ratings were given for Effective, Caring or Responsive in this report. This explanation was written from the published report of 14 June 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, May 2018
Rated Good; inspectors found personalised, kind support, with hygiene, medicines and policy issues being addressed.
This was a comprehensive, announced inspection on 16 April 2018. One inspector observed care, met both residents, and spoke with family members, staff and social care professionals. The inspector also checked care records, staff records, medicines, safety records and quality monitoring.
The home continued to be rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that personalised support had helped people become more relaxed, learn skills and take part in activities. Staff understood people's communication and treated them with respect and kindness.
There were some issues to address. Items stored in an outhouse created a hygiene risk, and instructions for some as-needed medicines did not explain when they should be given. The provider took action or updated arrangements, and inspectors found no evidence of serious risks or concerns.
Improved quality of life
Inspectors found that personalised support had reduced distress and helped people become more relaxed, learn skills and enjoy activities in the community.
“Previous emotional distress, demonstrated through physical and verbal aggression, had been reduced to the point where people were relaxed and happy” from the report
Kind and respectful care
Staff showed patience, empathy and respect. They supported privacy and helped people become more independent where possible.
“(The staff) are very kind and patient with a very positive, accepting attitude.” from the report
Safe medicines and staffing
Medicines were kept securely, records were detailed and staff were trained. Staffing arrangements provided one-to-one support at home and two-to-one support for community activities.
“People received their medicines as prescribed and in a safe way.” from the report
Detailed support planning
Staff kept detailed daily records about mood, behaviour, activities and progress. These records helped the service review and update support plans.
“The detailed, daily records provided a good additional picture of the person.” from the report
Hygiene risk in outhouse
needs fixingThe outhouse contained items including straw and chicken food in an unsealed container alongside cleaning and laundry equipment. Some items were removed and the provider said they would consider moving the tumble drier.
“The provider did not fully protect people from the risk of unhygienic conditions, but action taken immediately made the situation safe.” from the report
As-needed medicine instructions
needs fixingProtocols for some as-needed medicines did not say in what circumstances the medicine should be given. Staff updated the arrangements to make them safer.
“This did not include under what circumstance to administer the medicine but staff updated the arrangements to make them safer.” from the report
Some policies were out of date
minorSome reviewed policies did not refer to recent legislation. The provider said the policies would be reviewed more thoroughly.
“However, some, although reviewed, did not include recent legislation.” from the report
- 01Have all the items creating a hygiene risk in the outhouse been removed, and has the tumble drier been moved?
- 02Do all as-needed medicine protocols now clearly explain when each medicine should be given?
- 03Have the policies been updated to include recent legislation, including the Equality Act?
- 04How will staffing levels be matched to my relative's needs at home, at night and during community activities?
- 05How are changes in my relative's mood, behaviour, health and goals recorded and used to update their support plan?
This was a comprehensive inspection covering all five key questions, with feedback limited because residents could provide only limited verbal feedback. This explanation was written from the published report of 16 May 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Laural House
3 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- June 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2018Goodstayed GoodSafe: GoodWell-led: Good
- March 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- January 2014
Registered with the Care Quality Commission on 17 January 2014.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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76 live-in carers within about two hours of Somerset
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,370 a week. 62 can care for a couple. 12 years' experience on average.
“She looked after my mum, who can be incredibly challenging, so well and so gently, and we always felt confident that my mum was getting the best care available.”
“She was not phased by anything, she was adaptable, kind & gave us complete confidence to go away & not worry about a thing!”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.