CQC report explained · a residential care home
What the CQC found at The Laurels Residential Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, April 2020
Rated Requires Improvement; inspectors found kind and effective care, but safety checks and management systems did not always protect people from risk.
This was a planned, unannounced inspection on 18 and 20 February 2020. Inspectors spoke with 17 people, five family members and 10 staff. They also checked care, medicines, recruitment and management records.
The overall rating was Requires Improvement. Safe and well-led were Requires Improvement. Effective, caring and responsive were Good. Inspectors found unlocked cupboards containing cleaning products, matches, lighters and prescribed thickener. They also found personal belongings stored in communal kitchen cupboards and some care plan information was out of date.
People said they were happy with the care and felt safe. Inspectors found staff were caring, people's health and nutrition needs were supported, and complaints and care reviews were managed. The home had improved its work around consent and mental capacity since the previous inspection.
The home was still rated Requires Improvement after two consecutive inspections. The provider was asked to make changes, and CQC said it would monitor progress and return under its re-inspection programme.
Kind and respectful staff
People said staff were caring, respectful and available to listen. Inspectors observed positive relationships between people and staff.
“Positive relationships had been formed between people and the staff that supported them with lots of laughter taking place.” from the report
Good support with health and nutrition
People had access to healthcare professionals when needed, and meals were prepared around their dietary needs and wishes.
“People were protected from poor nutrition and dehydration.” from the report
Medicines managed safely
Medicines were stored in locked facilities, staff had training and regular checks were carried out.
“Regular checks took place to ensure that people's medicines were managed safely.” from the report
Improved consent processes
The home had improved its systems for mental capacity assessments and Deprivation of Liberty Safeguards since the previous inspection.
“A monitoring system had been implemented to ensure that DoLS and mental capacity assessments in place were reviewed on a regular basis.” from the report
Hazardous items were not secured
seriousCleaning products, matches, lighters and prescribed thickener were found in unlocked cupboards. The manager removed the items immediately, but inspectors said this created an increased risk that people could be harmed.
“We found a large number of cleaning products, prescribed fluid thickener, lighters and matches stored in unlocked cupboards around the building.” from the report
Management checks missed safety problems
seriousRoutine checks did not identify unsafe storage, misplaced personal belongings or outdated care records. This was linked to the breach of Regulation 17.
“Systems were either not in place or robust enough to demonstrate safety was effectively managed. This placed people at risk of harm.” from the report
Personal belongings were stored inappropriately
needs fixingGlasses, jewellery and photographs were found in kitchen cupboards on two units. The items were moved immediately after inspectors raised the issue.
“People's personal property was not always respected.” from the report
Some care records were out of date
needs fixingAt least one care plan did not reflect recent weight information, even though the person's weight was being monitored weekly. The management team arranged a full review.
“Not all the information in people's care plans was up to date.” from the report
Staffing levels caused some concern
needs fixingSome people and relatives said staffing could feel low at times, especially at weekends. The provider was recruiting to vacancies during the inspection.
“Sometimes at weekends it seems like there's not enough staff but if I use my buzzer they come straight away” from the report
- 01How are cleaning products, matches, lighters and prescribed thickener now locked away, and who checks this?
- 02What changes have been made to the management checks since the inspection?
- 03How do you protect residents' glasses, jewellery, photographs and other personal belongings?
- 04How often are care plans checked against people's current needs, weights and health information?
- 05What is the current staffing level, especially at weekends, and how are vacancies covered?
This was an unannounced inspection covering all five CQC questions, with the effective rating improving from the previous inspection while safe and well-led remained Requires Improvement. This explanation was written from the published report of 22 April 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.
What inspectors found, February 2019
The Laurels Residential Care Home was rated Requires Improvement; care was kind and generally safe, but consent records and oversight needed improvement.
This was an unannounced, planned comprehensive inspection on 22 January 2019. Inspectors spoke with people living in the home, relatives and staff. They reviewed care files, recruitment records, medicine records and quality checks, and observed care.
People said they felt safe and were treated with kindness and respect. Staff understood people's needs, care plans were detailed, medicines were managed safely and activities were available. People also received support from health and social care professionals when needed.
The main concern was that consent was not always properly checked or recorded. It was also unclear whether all necessary applications had been made when people were being deprived of their liberty. Recruitment records and quality checks were not always complete or effective.
The home was rated Good for Safe, Caring and Responsive. It was rated Requires Improvement for Effective and Well-led, giving an overall rating of Requires Improvement. This was the first inspection under the registered provider.
People felt safe
People and relatives told inspectors they felt safe in the home. Risks were assessed and steps were taken to reduce them.
“People told us they felt safe living at The Laurels.” from the report
Kind and respectful care
People and relatives described staff positively. Inspectors saw staff speaking respectfully and protecting people's dignity and privacy.
“We observed staff supporting people in warm, familiar and caring ways, speaking respectfully to people and ensuring their needs were met.” from the report
Personalised support
Care plans recorded people's needs, preferences and routines. Staff knew the people they supported well.
“Care plans were detailed regarding the support people required and had been reviewed regularly to ensure they were accurate.” from the report
Health and medicines support
People received their medicines safely and were supported to access doctors and other health professionals when needed.
“Medicines were managed safely and people told us they received their medicines when they needed them.” from the report
Activities and choice
The home offered group and individual activities, including support to use the local community. People had choices about meals, routines and activities.
“Individual activities were also provided to people who preferred not to, or were unable to join in with group activities.” from the report
Consent and legal safeguards
seriousConsent was not always sought or recorded correctly. Records did not always show the specific decision being considered, the best-interest process or involvement of people legally authorised to decide for someone else.
“Consent was not always sought and recorded in line with the principles of the MCA.” from the report
Liberty restriction applications
seriousThe report could not confirm that applications had been made for everyone who needed one when their liberty was being restricted.
“It was not clear if applications to deprive people of their liberty had been made for all people who required one.” from the report
Quality checks missed problems
needs fixingAudits were in place but did not identify the consent and recruitment issues found by inspectors. Actions to make improvements were not always clearly recorded.
“However, they did not highlight the issues we raised during the inspection, such as those relating to consent and safe recruitment practices.” from the report
Recruitment records
needs fixingSome staff files had gaps in employment histories and did not contain photographic identification.
“Not all safe recruitment practices were evident as there were gaps in staff members employment history and not all files contained photographic identification of staff.” from the report
Mixed views about food
minorPeople had different views about the meals. Everyone said they had enough to eat and drink, and staff knew about dietary needs and preferences.
“People's feedback regarding meals was mixed.” from the report
- 01How do you now assess and record whether a resident has capacity to make each specific decision?
- 02How do you record best-interest decisions and involve anyone with legal authority to make decisions for a resident?
- 03How do you check that all required applications to lawfully restrict a resident's liberty have been made?
- 04What changes have you made to staff recruitment checks and records since this inspection?
- 05How do your current audits make sure problems are identified and improvement actions are clearly recorded?
This was an unannounced comprehensive inspection covering all five key questions and both the care provided and the premises. This explanation was written from the published report of 20 February 2019 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 Residential Care Home
2 rated inspections over a year: the service has held its Requires improvement rating throughout.
- April 2020Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at The Laurels Residential Care Home →
- February 2019Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at The Laurels Residential Care Home →
- March 2018
Registered with the Care Quality Commission on 14 March 2018.
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