Archived: Laurieston Care Home for the Elderly

Updated 23 April 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Laurieston Care Home for the Elderly is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager in post who was in the process of registering with the Care Quality Commission. Once registered, they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with two people who used the service and eight relatives about their experience of the care provided. We spoke with 12 members of staff including the provider, manager, deputy manager, activities co-ordinator, domestic staff, care staff and two ex-employees. We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We liaised with, and obtained information from, the local authority, commissioning, safeguarding, the fire service and the infection control team.

Updated 23 April 2022

About the service

Laurieston Care Home for the Elderly is a residential care home providing accommodation and personal care to 12 people aged 65 and over at the time of the inspection. The service can support up to 16 people in one adapted building.

People’s experience of using this service and what we found

People were not protected from abuse or avoidable harm. Risks to people were not always safely identified, assessed and managed. Care records were not always comprehensive or up to date and therefore did not accurately reflect people's needs. The provider failed to ensure there were enough suitably competent and skilled staff on duty to meet people’s needs. Staff were not always recruited safely. Medicines were not safely managed, although regular stock checks were carried out and these records were accurate. Staff did not follow infection prevention and control procedures and had not completed up to date training in this area. PPE was not always worn correctly. The service was accessing COVID-19 testing in line with government guidance.

The service was not well-led. People did not always receive person-centred care and there was not a positive culture within the home. The provider failed to make improvements when things went wrong and the quality of the service had deteriorated since the previous inspection. Staff roles and responsibilities were not clear, and quality assurance measures were ineffective. The provider did not always comply with regulatory requirements. The service did not always engage appropriately with people, staff and professionals. We received mixed feedback from relatives about communication and atmosphere within the home. One relative told us, “I don’t feel confident or comfortable speaking to anyone” whereas another relative told us, “It is friendly and homely.” Referrals to healthcare professionals were not made in a timely manner, or at all, although the deputy manager had sought outside professional assistance before our inspection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 22 December 2018).

Why we inspected

We received concerns in relation to the way people using the service were being treated by the provider. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has changed from good to inadequate. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Laurieston Care Home for the Elderly on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to providing person-centred care, safeguarding service users from abuse and improper treatment, providing safe care and treatment, good governance, recruitment and staffing.

We have identified a breach in relation to the service's regulatory requirement to notify CQC of important incidents. This will be dealt with outside the inspection process.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.