The Laurels

Updated 5 May 2023

The Laurels is the base for one of the North London Hospices community teams that are registered with the Care Quality Commission. This service offers community services to people living in the London Borough of Haringey who have life-limiting or life-threatening illnesses. The community team works alongside and supports primary healthcare professionals to manage people's symptoms particularly around pain management. It provides educational support and advice, a bereavement service and support to a network of partners acting in a multidisciplinary team such as district nurses, GP’s, nursing homes and medicine of the elderly community services. They also provide practical financial support, bereavement/counselling and support for people through their illness and death.

The Laurels is a multi-provider integrated service from which the local NHS trust is the lead provider and the North London Hospice the main clinical provider who holds the CQC registration. The team consists of a specialist palliative care team which includes clinical nurse specialists (CNS), assistant practitioners, a social worker, administrative support, and a consultant team and team leader.

At the time of the inspection the service had 180 people on their caseload.

The service first registered this location with CQC in April 2021. The Laurels has a registered manager in post and is registered with the CQC to provide the following regulated activities:

• Treatment of disease, disorder or injury
• Diagnostic and screening procedures
• Transport services, triage and medical advice provided remotely

The service does not treat children.

The location has been inspected before at a different location (George Marsh Centre) in 2016. It was rated Good.

Updated 5 May 2023

We carried out an inspection of The Laurels using our comprehensive methodology on 1 March 2023. We rated it as good because it was safe, effective, caring and responsive. The service was rated requires improvement for well-led:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. The service reviewed safety incidents well and learned lessons from them.
• Staff provided a high level of care and treatment. Managers monitored the effectiveness of the service and made sure staff were competent. There was a strong, visible, patient centred culture. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available to support timely patient care.
• Staff consistently treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers. Patient emotional and social needs were seen as being as important as their physical needs.
• The service planned care to meet the needs of local people, and took account of patients’ individual needs, and made it easy for people to give feedback. Patient individual needs and preferences were central to the delivery of tailored services. People accessed the service when they needed it and did not have to wait long for treatment. The service responded well to complaints and received many compliments.
• Leaders ran services with a clear vision and strategy. They supported staff to develop their skills. Staff felt respected, supported and valued. There were consistently high levels of engagement with staff, stakeholders and people who used the services. Staff were committed to improving services continually.

However:

• The service did not have a comprehensive local audit or assurance programme that allowed leaders to support the delivery of their service at a local level.
• We were not assured that all incidents were effectively reported by the service. There was reliance on partners of care to report incidents.
• The service did not hold records or have agendas for cross organisational team meetings.
• The service did not hold a centralised risk record that accurately reflected the services’ risks.

Updated 5 May 2023

Our rating of the service stayed the same. We rated it as good.

We rated this service as good because it was safe, effective, caring and responsive. We rated well-led as requires improvement.

See the summary above for details.