15 October 2020
During an inspection looking at part of the service
The Laurels is a care home that was providing nursing and personal care to 17 older people at the time of our inspection. The service can support up to a maximum of 68 people.
The premises is divided into three separate units, each of which has their own adapted facilities (the 2nd floor unit remains closed indefinitely for refurbishment).
Approximately half the people using the service were living with dementia.
People’s experience of using this service and what we found
The provider still needed to make substantial improvements to ensure the service was suitably governed. Staff had not received up to date infection control training in light of the COVID-19 pandemic, nor did they always wear Personal Protective Equipment (PPE) correctly.
Management did not ensure that people received care in line with their assessed care needs, nor did staff always receive appropriate training to support them to care for people's specific needs. Best practice was not adhered to when seeking consent from people.
Quality assurance systems were not always completed to ensure care delivery was appropriately delivered and reviewed.
Monitoring of incidents and accidents still required improvement to ensure they were appropriately recorded and investigated. People’s risk assessments had improved to ensure they were clearer in defining people’s specific needs. Staff were safely recruited, and there were suitable safeguarding processes in place to support staff to express any concerns.
Staff, people and relatives felt that management support had improved. The service worked effectively with partnership agencies to ensure that people’s care needs were met.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this 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 Requires Improvement (published 18 September 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.
Why we inspected
We undertook this focused inspection to check they had followed the action plan they sent us and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions; Is the service Safe, Effective and Well-led?, which contain those requirements.
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 coronavirus and other infection outbreaks effectively.
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.
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 Care Centre Limited 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 monitor the service.
We have identified breaches in relation to good governance at this inspection.
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 request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.