The Laurels

Updated 18 January 2023

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

The 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 not a registered manager in post.

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 service improvement and safeguarding teams. The provider completed a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with three people who used the service about their experience of the care provided. We spoke with four members of staff including the provider and care workers. We made observations throughout the day of interactions between people and staff.

We reviewed a range of records. This included six people's care records and medication records. We looked at three 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.

Updated 18 January 2023

About the service

The Laurels is a residential care home registered to provide care and support to up to 20 people. The building had been adapted and care was provided over two floors with stairs and a stair lift as access. There were 13 people living at the home at the time of inspection.

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

Improvements were needed to the governance within the service. Systems were either not established or effective in identifying the shortfalls found within this inspection. Statutory notifications had not been submitted to CQC as required to ensure we are informed of events that happen with services.

Safety checks were not always carried out as planned to ensure people were living in a safe environment. We raised this immediately with the provider who sought to rectify the shortfall by arranging external professionals and trades people to carry out the checks. Risk assessments were not always in place to ensure people were safe from avoidable harm. Reviews did not take place as planned. We have made a recommendation about risk management within the service.

Accidents and incidents were recorded, and the necessary actions taken. However, analysis was not robust to ensure lessons were learned to prevent reoccurrence of incidents. This meant people could be at increased risk. The Laurels did not actively seek formal feedback from people, their relatives, staff and professionals in order to drive continuous improvements.

We have made a recommendation about recruitment processes; they had not always been followed which meant staff did not always have the necessary checks to ensure they were safe to work with people who required care and support.

People received their medicines as prescribed. However, some improvements were needed to guidance for staff where medicines were taken occasionally and storage arrangements.

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.

Safeguarding procedures were in place and staff knew them well and were confident the provider would take any concerns seriously. Infection control procedures were robust and in line with the latest government guidance for best practice.

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 3 March 2022).

Why we inspected

We received concerns in relation to the management of the home. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. 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 good to requires improvement based on the findings of this inspection.

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, The Laurels on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to the management oversight in the home and failure to notify CQC of events as required by law at this inspection. We have made a recommendation about the providers recruitment process and risk management within the home.

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

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.