CQC report explained · a residential care home
What the CQC found at The Laurels
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found incomplete or outdated risk assessments, overdue environmental safety checks, gaps in recruitment checks and some medicine guidance. There were enough staff, safeguarding procedures were understood and infection control was robust.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its previous rating was carried forward when calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its previous rating was carried forward when calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its previous rating was carried forward when calculating the overall rating.
- Well-led?
- Requires improvement
- Quality assurance systems were not effective, there was no registered manager, formal feedback was not being collected and statutory notifications had not been submitted as required.
What inspectors found, January 2023
Requires Improvement; inspectors found gaps in safety checks, risk management and management oversight, although people received prescribed medicines and there were enough staff.
This was an unannounced focused inspection on 28 December 2022. One inspector spoke with people and staff, observed care, and checked care, medicine, recruitment and management records.
The home was not always safe. Risk assessments and safety checks were incomplete or out of date. Recruitment checks, occasional medicine guidance and the analysis of accidents also needed improvement. Some checks were arranged after inspectors raised the issues.
The home was not well-led. There was no registered manager, quality systems had not found the problems, and required notifications had not been sent to CQC. The overall rating fell from Good to Requires Improvement. CQC will ask for an action plan and monitor progress.
Enough staff
Inspectors found enough staff on duty. People said staff were available when needed, and the home had a calm atmosphere.
“There were enough staff on duty. People told us there was enough staff around the home to support them when required.” from the report
Medicines recorded accurately
People received their medicines as prescribed. Medicine administration records were completed accurately and storage temperature checks were maintained.
“Medicine administration records (MAR) were in place for each person and these were completed accurately.” from the report
Safeguarding and infection control
Staff knew how to report safeguarding concerns. Inspectors were assured that infection prevention and control arrangements were effective.
“We were assured that the provider was using PPE effectively and safely.” from the report
Staff understood people's risks
Staff could explain how they supported people safely with mobility and movement.
“Staff knew people's risks well. They told us how they would support people safely in different ways, for example, with their mobility and movement.” from the report
Overdue safety checks
seriousGas and electrical safety had not been established, annual electrical equipment checks had not been completed and there was no fire risk assessment. The provider arranged appointments for the checks after inspectors raised this.
“Gas safety, electrical safety has not been established within the home.” from the report
Incomplete risk management
seriousSome people did not have all the necessary risk assessments, and reviews were not always completed monthly. Accident and incident analysis was also not carried out as planned.
“Risk assessments were not always up to date. The providers policy of monthly review had not always been followed.” from the report
Weak management oversight
seriousAudits and monitoring did not identify the problems found during the inspection. The report says this breached Regulation 17.
“The provider had failed to ensure governance systems were operating effectively to ensure risks were managed, recruitment processes were safe, and the service improved.” from the report
Required notifications missed
seriousThe provider had not sent statutory notifications to CQC since March 2022. The provider submitted them retrospectively after inspectors raised the issue.
“The provider had not submitted statutory notifications since March 2022.” from the report
Recruitment checks
needs fixingTwo staff files did not contain the two references required by the provider's policy. The provider said the files would be completed.
“Recruitment processes were not always followed. Staff did not always have the necessary checks in place before they started work” from the report
Limited formal feedback
minorThe home was not formally asking people, relatives or external professionals for feedback to help improve care. Meetings did not always take place.
“The provider did not seek formal feedback from people, their relatives and external professionals and use it to drive improvements within the home.” from the report
- 01Have the gas, electrical equipment and fire risk checks now been completed, and can you show us the results?
- 02How are you making sure every person's risk assessment is complete and reviewed on time?
- 03What recruitment checks are completed before new staff start work, including references and DBS checks?
- 04How are occasional medicines now described in personalised guidance for staff?
- 05Who is currently responsible for management, and when will a registered manager application be made?
This was a focused inspection of Safe and Well-led only; the other ratings were carried forward from the previous inspection. This explanation was written from the published report of 18 January 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, March 2022
The Laurels is rated Good; inspectors found safe care and improved management systems, after a previous Requires Improvement rating.
This was an unannounced, focused inspection on 3 March 2022. One inspector spoke with people living in the home, relatives, staff and a health professional. They also reviewed care, medicines, recruitment and management records.
The home was rated Good for Safe and Well-led. Inspectors found enough staff, safe medicines systems, risk assessments, safeguarding arrangements and infection control measures. People and relatives said the home felt safe and communication had been consistent during the COVID-19 pandemic.
Management systems had improved since the previous inspection. Audits and checks were being used to identify and complete improvements. The overall rating changed from Requires Improvement to Good, and the previous breach of Regulation 17 had been resolved.
Improved management checks
The home had introduced audits and other checks to monitor care, identify improvements and make sure actions were completed.
“There were improvements to the home's governance procedures. Audits were in place to monitor the standard of care provided.” from the report
Enough staff
Inspectors found enough staff on duty, and people and relatives said staff were available when needed.
“There were enough staff on duty. People and their relatives told us there was enough staff around the home to support them when needed.” from the report
Safe medicines systems
Medicines were ordered, stored and administered safely. Electronic checks provided an extra safeguard against errors.
“The home used an electronic system to manage medicines safely.” from the report
Open communication
People, relatives and staff gave positive feedback about communication and the management of the home.
“People and their relatives commented on The Laurels feeling, "Like home.” from the report
Inspectors raised no specific concerns in this report.
- 01How are the care records being transferred to the paper-based system, and how will you prevent any information being missed?
- 02What checks are now completed on medicines, accidents, incidents and daily notes, and how do you follow up any actions?
- 03How do you review staffing rotas against the changing needs of each person living in the home?
- 04How will you keep relatives informed about visiting arrangements if COVID-19 guidance changes?
- 05What were the findings from the last full inspection for Caring, Effective and Responsive care?
This was a focused inspection of Safe and Well-led only; the other ratings were carried over from the last comprehensive inspection. This explanation was written from the published report of 22 March 2022 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 The Laurels
6 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- January 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2022Goodup from Requires improvementSafe: GoodWell-led: Good
- August 2021Requires improvementSafe: Requires improvementWell-led: Requires improvement
- February 2021Inspected but not ratedSafe: Inspected but not rated
- November 2018Goodup from Requires improvementSafe: GoodWell-led: Good
- January 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- July 2011
Registered with the Care Quality Commission on 18 July 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.
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