About the service

The Laurels is a care home that offers care and support to one person with mental health or neurological support requirements. There was one person using the service at the time of our visit.

At our last inspection on 13 June 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

People’s experience of using this service

• The person was happy living at The Laurels. They felt safe and liked the staff who supported them. Staff enjoyed their work and were proud of the service.

• Staff knew about safeguarding and how to protect people from abuse and avoidable harm.

• Risk was assessed and managed so that the person could continue doing the things they liked to do.

• Staff knew the person extremely well. They knew what made them happy and sad and about the things that may trigger risky behaviour and the best way to a manage this.

• Staff managed medicines in a safe way.

• There was a consistent staff group matched to the needs of the person. This meant the person received the support they required from staff they knew them very well.

• Staff were recruited in a safe way to make sure that only staff with the right skills and characteristics were employed.

• Regular maintenance and checks were carried out on the premises and equipment to make sure it was in safe working order.

• The service was clean and tidy and staff knew how to prevent and control infection.

• Staff had the right skills, experience and support to meet the needs of the person who used the service.

• The person was supported to maintain a healthy weight and had a balanced diet with a choice of meals that they had chosen.

• Staff knew how to recognise changes in the person’s health and wellbeing. Staff had noticed the smallest change in the persons behaviour and sought immediate medical attention which resulted in emergency medical attention being provided in a very timely way.

• The premises met the needs of the person and provided a safe, comfortable and homely environment.

• Staff followed the principles of the Mental Capacity Act 2005 and associated Deprivation of Liberty Standards. This meant that the person’s liberty was only deprived following authorisation and a best interest decision.

• The person felt cared about by staff. They had developed positive relationships and were treated with kindness and respect.

• Staff had time to spend with the person and supported them to do the things they liked.

• The person received support from advocates to make sure that care and support was being provided in their best interests.

• Staff protected people’s privacy and dignity and promoted their independence.

• The person was supported to maintain a relationship with their family members.

• The person received care and support which was personalised to suit their needs and preferences.

• They were able to pursue their hobbies and interests including holidays.

• The person was supported to raise concerns should they needs to.

• The person and staff felt supported by the registered managers.

• The staff team enjoyed working together and supported each other and the registered managers.

• The quality of the service was monitored and the person was asked for their feedback and this was acted upon.

• Staff worked in partnership with other professionals and organisations to make sure the person received joined up care and support.

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

Rating at last inspection

At the last inspection we rated this service Good (report published on 18 July 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme

The inspection took place on 13 June 2016. It was an announced visit, as we gave the provider notice the day before the inspection. The home provided accommodation one person with mental health or neurological support requirements and required nursing or personal care. There was one person living in the home when we inspected.

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. There was a registered manager in post.

The home was safe and staff understood their responsibilities to protect the person from harm or abuse and had received relevant safeguarding training. Staff were confident in reporting incidents and accidents should they occur. The person was safely supported to take their medicines.

There were effective processes in place to minimise and review risks to the individual. Assessments had taken place regarding the person’s individual risks and clear guidance was in place for staff to follow in order to reduce risk. Recruitment and shadowing processes were in place to ensure that staff employed in the home were deemed suitable for the role.

Staff had received training in areas specific to the person they were supporting and this helped to make sure that they received care that was individual to their needs. Staff gained the person’s consent to the care they were providing. The person was supported to access healthcare promptly wherever necessary. Their nutrition and hydration needs were encouraged and they were able to have drinks when they liked.

Staff were able to explain how they promoted choice for the person. The home complied with the requirements of the Mental Capacity Act 2005 (MCA).

Privacy and dignity were promoted and the person had strong, trusting relationships with staff who were kind and compassionate. The person was encouraged to be as independent as possible and make their own choices. Staff and the manager knew the person they cared for very well and understood how to meet their needs. The person planned their care with staff, and many activities were carried out in line with their preferences.

The manager visited the home regularly, and had been working closely with the person for over twenty years. The provider had many systems in place to monitor the quality of the overall service and these were used to develop and improve the service.

The person living in The Laurels told us that they were very proud of their home and showed us the progress they had made in their garden. They proudly showed us how they had planted various vegetables in the greenhouse and a mixture of flowers and vegetables in the garden itself.

When we asked, the person told us that they got on well with most of the staff and added, “Some better than others – but they’re all really good staff”. They also told us that their privacy and dignity were respected by staff and that staff treated them well.

The person we spoke with told us they felt safe living in The Laurels and we observed that they were comfortable discussing an area of concern with the member of staff on duty at the time of our visit.

The person who was living in The Laurels told us that they were very proud of having their own home and that the provider and staff had helped them a lot in becoming more independent.

This person also told us that they enjoyed lots of different activities and hobbies, which the staff supported them to do, such as gardening, growing vegetables, music, art exhibitions and fishing. Other things they said they enjoyed doing included pub trips and visiting their friends.

The person we spoke with told us that they knew what was in their support plan and that they agreed with the way their support was provided. The person also said that staff checked things with them on a regular basis and made changes when they needed to.

The person told us that they were able to choose the meals they wanted, with some guidance from staff to help make sure they were healthy choices.

The person we spoke with told us that their privacy and dignity were respected by staff and that staff treated them really well.

We spoke with the person who lived in the home. They told us that their needs were met and that they were consulted about the care and support that they were provided with. They were complimentary about the staff that cared for them and told us that they always treated them with respect and that their privacy was respected. They told us that there were enough staff on duty to assist them and that they felt safe living in the home. They also told us that the environment was comfortable and clean and that they were supported to do cooking, cleaning and to undertake daily activities.