CQC report explained · a nursing home
What the CQC found at Laurel Bank
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found people were protected from abuse and avoidable harm. They found sufficient staffing, safe medicine systems, suitable recruitment checks and measures to manage risks such as choking, malnutrition and infection.
- Effective?
- Good
- This question was not rated in this inspection.
- Caring?
- Good
- This question was not rated in this inspection, although people and professionals described staff as caring.
- Responsive?
- Good
- This question was not rated in this inspection.
- Well-led?
- Good
- Inspectors found clear staff responsibilities, regular audits, feedback systems and effective work with outside agencies. The management team had introduced a process to monitor nutritional risks more closely.
What inspectors found, January 2024
Rated Good; inspectors found people were safe and the home was well led, after earlier concerns about nutrition and staff training were addressed.
This was an unannounced inspection on 20 December 2023. One inspector spoke with six people, a relative, a visiting professional, seven staff and two members of the management team. They also checked the building, care and medicine records, recruitment files and management systems.
The inspection was prompted partly by concerns about nutritional risks and staff training. The provider had taken effective action. Inspectors found no evidence that people were at risk of harm from these concerns.
The home was rated Good overall. Safe and Well-led were both rated Good. The report says this meant people's outcomes were consistently good and their feedback confirmed this. The previous rating was also Good, published on 7 March 2020.
People felt safe
People told inspectors they felt safe and could get help promptly. Inspectors found staff were available and familiar with people's needs.
“Yes, there's always a staff member around, so when I press the call bell I never have to wait long.” from the report
Managing health risks
The home reviewed risks linked to choking and malnutrition. Staff received choking and swallowing difficulty training, and the home worked with outside agencies to improve records and risk assessments.
“This included risks linked to nutritional intake, such as choking and malnutrition.” from the report
Safe medicines support
Inspectors found medicines were administered safely, with regular staff competency checks and audits. Staff followed people's care plans, risk assessments and preferences, including when people chose to manage their own medicines.
“Staff followed the person's medication care plan, risk assessment and preferences, such as when they chose to self-administer.” from the report
Clear management
Managers had clear communication systems and used audits, meetings and surveys to monitor care and gather views. The home also worked closely with outside professionals.
“The registered manager had created clear lines of communication for staff to understand their responsibilities in retaining people's safety and wellbeing.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you now monitor each person's risk of choking or malnutrition, and how often are their risk assessments reviewed?
- 02What ongoing training and competency checks do staff receive for choking, swallowing difficulties and nutritional support?
- 03How do you decide whether someone can safely self-administer medicines, and how is this reviewed?
- 04How do staffing levels and the use of familiar staff match the needs of people living here?
- 05What changes were made after the earlier concerns about nutritional risk management and staff training?
This was an unannounced focused inspection of Safe and Well-led; the report did not give new ratings for Effective, Caring or Responsive. This explanation was written from the published report of 12 January 2024 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, March 2020
Rated Good; inspectors found kind, personalised care, but medicines and some records were not always managed consistently.
Inspectors visited on 7 and 13 February 2020. The first visit was unannounced and the second was announced. They spoke with people living there, relatives and staff, and checked care, medicine and management records.
People said they felt safe and were treated kindly. Inspectors found enough staff, clean surroundings, person-centred care, a good choice of food and activities, and support with healthcare and end of life care.
Some medicine records and other care and management records were incomplete, inaccurate or not up to date. Inspectors also found that some checks did not identify or follow up risks effectively. The overall rating and all five question ratings were Good.
Kind and respectful staff
People described staff as kind and caring. Inspectors observed respectful support and staff knew people's preferences.
“People were treated with respect, compassion and kindness, they were given emotional support when needed.” from the report
People felt safe
People and relatives told inspectors they felt safe. Staff responded quickly to calls and there were enough staff to meet people's needs.
“The registered provider made sure there were enough staff to meet people's needs in a timely way and in line with their care plan.” from the report
Activities and relationships
The home offered a wide range of activities and supported people to keep in touch with family, friends and community groups.
“There was a programme of people centred activities to help promote people's intellectual and emotional wellbeing.” from the report
Positive leadership
Inspectors found an open and supportive culture. Managers and staff shared a focus on people's wellbeing and improvement.
“There was a positive culture at the service which focussed on providing people with high standards of care.” from the report
Medicine recording
needs fixingMedicine processes had improved but were not always followed consistently. For example, administration times were not always recorded for time-sensitive medicines, which could expose people to risk.
“We found examples where people had not been given their medication in line with guidance.” from the report
Incomplete records
needs fixingSome care and management records were incomplete, inaccurate or out of date. Inspectors said there was no impact on people, but this could compromise the quality and safety of care.
“We found some records relating to care and the management of the service were either incomplete, inaccurate and/or not kept up to date.” from the report
Mental capacity records
needs fixingSome records supporting decisions under the Mental Capacity Act were incomplete or contained conflicting information. The provider was asked to make sure the process was followed consistently.
“The documentation in place to support the principles of the MCA was not always fully completed.” from the report
Management checks
needs fixingSome audits did not identify or escalate important risks. Actions were not always clearly identified or monitored to make sure problems were dealt with.
“Audits completed by senior staff did not always identify and escalate relevant risks and issues.” from the report
- 01How do you now check that time-sensitive medicines are given at the right time and that the administration times are recorded?
- 02How do you make sure care records are complete, accurate and kept up to date?
- 03How are mental capacity assessments and best-interest decisions checked for consistency?
- 04What changes have been made to audits so that risks are identified, escalated and followed through?
- 05How have the improvements from the previous inspection been kept in place through recent management and senior staff changes?
This was a planned inspection covering all five key questions; the previous rating was Requires Improvement and the service had improved to Good. This explanation was written from the published report of 7 March 2020 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 Laurel Bank
5 rated inspections over 8 years: the service has held its Good rating throughout.
- January 2024Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2020Goodup from Requires improvementSafe: GoodWell-led: Good
- March 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 15 February 2011.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
85 live-in carers within about an hour of Lancashire
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 £980 to £1,260 a week. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
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.