Archived: Laurel House

Laurel House is a residential care home providing personal care and accommodation to up to five people with a learning disability and/or autism. At the time of the inspection there were five people living at the service. The home is on a residential street in a community setting and designed to promote people's inclusion and independence.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service:

People and their relatives told us the staff were kind and caring to them, and the registered manager and staff understood, and could meet their needs.

There was a person-centred culture at the service. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People enjoyed personalised activities in the local community.

Care records were up to date and risk assessments provided staff with enough information to manage identified risks. Staff understood people’s needs and preferences and were able to work safely with the range of risks presented. Staff recruitment was safe and there were enough staff to meet people’s needs and provide flexible, responsive care.

People were supported to access external health professionals to help promote good health and wellbeing. We received positive feedback from health professionals who worked in partnership with the service.

People were safeguarded against the risks of abuse and harm by the systems and by the staff.

Relatives and professionals spoke highly of the registered manager, and staff told us they were supported effectively in their role through supervision and training.

Quality audits took place to ensure medicines were safely managed and the service provided was of a good standard.

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 the service was good (published 2 August 2017).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Laurel House is a care home for adults who have a learning disability. The maximum number of people the home can accommodate is five. On the day of the inspection there were five men residing at the home. They all have lived at Laurel House for a number of years and we had met them all at the last inspection.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us the staff were kind and they felt safe at the home. Staff understood their responsibilities to keep people safe from potential abuse.

Risks had been recorded in people’s care plans and ways to reduce these risks had been explored with the person and were being followed appropriately.

We saw that people using the service were relaxed with staff and everyone told us they knew each other very well.

There were systems in place to ensure medicines were handled and stored securely and administered to people safely and appropriately. Relatives told us that the registered manager had worked in collaboration with people’s doctors and psychiatrists to ensure people were not prescribed unnecessary medicines.

Staff were positive about working at the home and told us they appreciated the support and encouragement they received from the registered manager.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff understood the principles of the Mental Capacity Act (MCA 2005) and knew that they must offer as much choice to people as possible in making day to day decisions about their care.

People told us they enjoyed the food cooked by staff and that they were offered choices of what they wanted to eat.

People had regular access to healthcare professionals such as doctors, dentists, chiropodists and opticians.

Staff treated people as unique individuals who had different likes, dislikes, needs and preferences.

Everyone had an individual plan of care which they had input into and which was reviewed on a regular basis with their involvement.

People using the service and their relatives told us that the management and staff listened to them and acted on their suggestions and wishes.

Both people using the service and their relatives told us they were happy to raise any concerns they had with the registered manager.

People were included in monitoring the quality of the service and we saw that their suggestions for improvements and preferences about how they wanted to live their lives were respected and acted on.

One person who used the service told us "staff are nice, they take me out." One person's relative said in respect to the person living at the home " X is happy" and "We have a good relationship with the staff."

We observed that the provider had systems in place for the safe management and storage of medication.

The provider had adequately trained staff so they were able to support people appropriately. We saw copies of the service's rotas and these showed that there were adequate numbers of staff on shift at any one time.

The provider had a complaints policy in place and a pictorial version for people who used the service. Staff we spoke with were able to tell us the complaints procedure and records showed that where a complaint had been made, this had been dealt with appropriately.

We reviewed the service's records including, staff personal files, medication records, people's care plans, risk assessments and office files and the company's policies and procedures.

We saw that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan and to ensure people's safety and welfare. A relative said "the support is good, I only have to mention extra help is needed and it is dealt with." Staff and relatives told us that people's behaviour had improved since they had been living at the home. People's care reflected relevant research and Department of Health guidance.

People who use the service were protected against the risk of unlawful or excessive control or restraint because the provider had made suitable arrangements. Staff told us that de-escalation and breakaway techniques were used and not restraint.

Appropriate checks were undertaken before staff began work and effective recruitment, selection, employment and education processes were in place.

People who use the service and their representatives were asked for their views about their care and treatment by the service and we saw that these were acted on. Records showed that monthly audits had been made by the manager.