The Laurels

Updated 4 November 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 Health and Social Care Act 2008.

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

This inspection was carried out by one inspector.

Service and service type

The Laurels is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Laurels is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 25 August 2022 and ended on 7 September 2022. We visited the service on 25 August 2022.

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 (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke to one person who used the service about their experience of the care provided and used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with seven members of staff including the registered manager and carers. We reviewed a range of records. This included support planning documentation for three people and multiple medicines records. We looked at three staff files in relation to recruitment. We also reviewed a variety of records relating to the management of the service, including risk assessments, quality assurance records, training data and policies and procedures.

Updated 4 November 2022

About the service

The Laurels is a residential care home providing a regulated activity to up to seven people. The service provides personal care support to adults with learning disabilities and/or autism. At the time of our inspection there were seven people using the service.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: People were supported to make choices using their preferred communication methods and were listened to by staff. People were able to choose what they did when and if they didn’t want to do something or changed their minds they were listened to.

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.

Right Care: The registered manager and staff team were passionate about promoting person centred care and we saw this demonstrated throughout the inspection. We observed people being supported by staff who knew them well using a person-centred approach. Staff were relaxed, confident and engaged with people consistently. People’s privacy and dignity was fully supported, and the provider’s policies and processes supported this.

Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.

People were kept safe from avoidable harm and we observed people being supported by staff who knew them well. There were appropriate policies and systems in place to protect people from abuse. Staff knew how to recognise abuse and protect people. Managers maintained people’s safety and investigated incidents. Lessons learned were shared with the whole team and the wider organisation.

There was a culture of positive risk taking within the service led by the registered manager. Staff demonstrated their knowledge and understanding of people’s needs and we observed staff spent time confirming with people their choices and that they had fully understood what the person had chosen.

People confirmed there were enough staff to support them and that they were staff who they knew and were comfortable being supported by. We observed safe staffing levels during the inspection and staff had time to spend with people and people were supported with activities of their choice. People confirmed to us they didn’t feel rushed by staff. Staff had the information and time they needed to provide safe and effective care.

At the last inspection we had identified concerns in relation to outstanding maintenance works and medicines. At this inspection we found there was an effective process in place for maintenance management and that the provider had robust medicines management, administration and storage processes in place.

Since the last inspection there had been changes to the environment. People seemed happy with the changes and the changes had been made with the involvement and consideration of the people living at the service.

The provider worked with a variety of health and social care workers. The registered manager had developed close working relationships which supported positive outcomes for people.

People, and those important to them, worked with managers and staff to develop and improve the service. The provider sought feedback from people and those important to them and used the feedback to develop the service. People and staff confirmed they felt listened to and were able to make suggestions. Staff told us they felt supported, valued and appreciated.

There were a number of systems and processes in place for monitoring the quality of care and used to plan improvements. Where issues were identified remedial action was taken. Staff had access to policies and procedures which encouraged an open and transparent approach.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 6 October 2021) and there was a breach in regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 22, 24 and 25 June 2021. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.