Inspection on 16/08/06 for Warwick Park House

This inspection was carried out on 16th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Warwick Park House 12/01/09

Warwick Park House 09/01/08

Warwick Park House 05/07/07

Warwick Park House 09/05/06

Warwick Park House 09/08/05

Warwick Park House 26/04/05

Warwick Park House 23/02/05

Warwick Park House 15/09/04

Warwick Park House 04/03/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Warwick Park House 17 Butt Park Road Honicknowle Plymouth Devon PL5 3NW Lead Inspector Andrea East and Rachel Proctor Unannounced Inspection 10:40 16th August and 12 September 2006 th X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Warwick Park House DS0000003616.V312679.R02.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Warwick Park House DS0000003616.V312679.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Warwick Park House Address 17 Butt Park Road Honicknowle Plymouth Devon PL5 3NW 01752 772433 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Warwick Park Limited Mrs Roberta Carole Davina Quarterman Care Home 50 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (10), of places Physical disability over 65 years of age (50) Warwick Park House DS0000003616.V312679.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. To include 4 Service Users under 60 years old for Service User categories The Home is registered as a Care Home with Nursing for a maximum of 50 Service Users in the categories of PD(E)50, OP 10, TI 4 The home can provide care to 4 persons suffering with Dementia DE(E) named elsewhere. 09/05/06 Date of last inspection Brief Description of the Service: Warwick Park Nursing home is privately owned and is registered to provide care for a maximum number of 50 people of either gender with physical frailty, disability or illness. The home is located in the Honicknowle area of Plymouth and is close to shops and near to a bus route. The home was opened in 1993. It is arranged on 2 floors with the communal lounges and dining room on the ground floor. There is level access to all parts of the home via a passenger lift and ramps. Level access is provided to a large secluded garden with a variety of seating areas. There are 32 single bedrooms and 9 double rooms, most benefit from en suite WCs. The manager is a 1st Level Registered Nurse who leads a team of nurses, care staff and domestic/catering staff. A registered nurse is on duty at all times. The range of monthly fees for the home were £273- £508, this information was provided on 04/08/06. Additional charges are made for chiropody, hairdressing, outings, newspapers and reflexology. Warwick Park House DS0000003616.V312679.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over two days, in August and September of this year, by two inspectors. The inspectors examined a range of documents including staff and service users files, policies, procedures and the homes service users guide. Service users were spoken too in the homes lounge and in private rooms and members of staff were also spoken with. The homes manager was present throughout the inspection and the homes providers/owners were also present in the afternoon to receive feedback from the inspectors. Feedback about the home was also received by post in quality questionnaires provided by the Commission and in discussion with visitors to the home. What the service does well: What has improved since the last inspection? The Commission had received a complex complaint regarding the care of a service user, which also included referral to the safeguarding adults team. This resulted in the homes manager and directors addressing a number of areas that had placed service users at risk and were in breach of Regulations and Standards. While the home was addressing these issues the home was restricted in admitting service users through Plymouth Social Services. Many of the areas highlighted through this time have now been addressed or partly addressed. The Commission has received detailed action plans and regular updates on how the home is continuing to progress. Since the last inspection there have been many areas of improvement including the purchase and introduction of a new computer system, the development of new policies and procedures for example in medication administration and admission and discharge procedures in the home, the purchase of new furniture, carpeting and specialist equipment such as hoists, the extension and purchase of new equipment in the kitchen and the introduction of more detailed records for service users. In addition there has been the introduction of risk assessments for the premises, the beginnings of a Warwick Park House DS0000003616.V312679.R02.S.doc Version 5.2 Page 6 quality assurance system monitoring practice and windows have been restricted. The Staff had also been introduced to a new system of supervision and induction and new routines in the home. These improvements had made the home a safer, cleaner and more attractive place for service users and staff to work and live in, had improved the care of service users to include more choice and a more relaxed atmosphere and had raised the standard of care being provided so that service users needs and preferences were being more consistently met. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Warwick Park House DS0000003616.V312679.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Warwick Park House DS0000003616.V312679.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6 The quality of the outcomes for service users in this outcome area is adequate. Prospective service users have the information they need to make an informed choice about where to live and service users move into the home after having their needs assessed. The home does not provide intermediate care. EVIDENCE: Inspectors looked at seven service users individualised files, which held a range of information. The home had invested in a new process of recording initial assessments of service users needs, which they had completed for new and existing service users who have lived a the home for some time. These documents showed, where they had been completed, that service users had been assessed outside of the home and the full range of service users needs. The initial and ongoing assessments also informed the service users plan of care, providing a range of information to staff including more detailed information on service users needs, preferences and choices. Some initial assessments had lots of information, while others had not been fully completed. Information was captured on other documents such as charts and Warwick Park House DS0000003616.V312679.R02.S.doc Version 5.2 Page 9 this was not always transferred to initial or ongoing service users care plans. There was limited evidence of service users or their relatives/advocates seeing and being part of the homes initial assessment or initial care plan. Staff spoken too were much clearer about the full needs of the service users and how service users needs could be met. The manager stated that she has introduced a new admission procedure, which included sending a letter informing service users about the homes Service Users Guide and statement of purpose, which was sent to service users prior to them being admitted to the home. The inspectors also saw a draft copy of this letter. Warwick Park House DS0000003616.V312679.R02.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 The quality of the outcomes for service users in this outcome area is adequate The service users health, personal and social care needs are set out in an individual plan of care. The service users feel they are treated with respect and their privacy is upheld. The homes policies and procedures for dealing with medicines protect the service users from harm. EVIDENCE: Inspectors looked at service users records on both visits to the home. On the first visit documents were poorly completed and gave very little information about the needs of the service users or how needs were being met, despite the purchasing of a new computerised system for assessment and care planning. On the second day inspectors visited, Service users individualised files had been updated and included care plans, risk assessments, manual handling assessments, weight charts and pressure area care charts. The care plans examined were more fully completed. However there were areas that still needed to be included that had been missed, for example how to care for a service user identified at risk from potential pressure wounds and bowel care. Warwick Park House DS0000003616.V312679.R02.S.doc Version 5.2 Page 11 Care documents were generally improved in that they were now more consistently signed and dated. Reviews of documents had been completed in more detail capturing changes in service users care needs. Daily reports highlighted care being given and had significantly improved in that more specific information had been recorded, which was directly related to individual service users and their needs and preferences. However, this was not always consistently completed and although much improved, needs to continue to be an area that the staff team work on so that all information is consistently recorded. When speaking to staff they confirmed that the new recording process helped to keep them informed and they demonstrated a much more detailed knowledge of service users needs and preferences. Twenty- eight Staff surveys were returned to the Commission. Seven surveys said that staff, were unaware of what to do if a service user became unwell and eight surveys said that they were not always informed of service users changing needs. Thirteen Relative Surveys were returned to the Commission and thirteen said that they were satisfied with the overall care provided by the home. Feedback on these survey forms were generally positive in their praise for the home, saying things like “ I believe that my relative has always been well cared for” “I am completely satisfied that all my relatives needs are met”. Service Users said that staff treated them with kindness and respect, taking into account their privacy. The manager confirmed that changes had been made to the staff routine in the home including how staff dispense medicines so that medication was administered to service users at appropriate times and more safely. The home has a medication trolley on each floor and staff said that medication is dispensed from the trolley to the service user. Medication records were well completed, showing that staff had singed to say when medication had been dispensed. Other medication records also well completed were a drugs disposal record and a controlled drugs record. The homes policy and procedures on medication was in the homes staff policy manual. Warwick Park House DS0000003616.V312679.R02.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15, The quality of the outcomes for service users in this outcome area is adequate. Some Service users find the lifestyle in the home matches their preferences, and they are helped to exercise choice and control over their lives. Service users social, cultural, religious and recreational interests appear to be satisfied. Service users maintain contact with family, friends and representatives in the home and local community. Service users receive a wholesome balanced diet in pleasant surroundings at a time convenient to service users. EVIDENCE: The homes pre inspection questionnaire, which is submitted to the Commission before an inspector visits lists a range of activities inside and outside of the home for example Bingo, movement to music, outings monthly to areas such as Badgers Holt, the Barbican, Trago Mills and Buckfast Abbey and annual summer and Christmas fetes. Staff also said that service users were supported in carrying on interests and hobbies and on the second day of the inspection a Music –to - movement session was taking place in the homes lounge. Care plan and assessment information did include more information (than the inspection of May 2006) on service users personal preferences and choices and gave a brief social history or refer to past interests such as hobbies or if they attended church, however this was not extended to information on how Warwick Park House DS0000003616.V312679.R02.S.doc Version 5.2 Page 13 individual service users social needs are met by the home. Records did not make clear what activities the service users had participated in or how activities were structured around individual needs, for example memory games for service users with poor memory recall. One feedback card from a relative said that “entertainment seemed to be lacking”. Service users did not comment on the entertainment available. The manager said that daily routines in the home, for example getting up in the morning and when going to bed had been changed to a more flexible routine to accommodate service users choices. Staff also confirmed that routines in the home had changed and that they were getting familiar with new practices and procedures. The manager has also submitted to the Commission prior to the inspection action plans which detail how the home intend to continue to maintain flexible routines and service user choice. Throughout the inspection service users were observed receiving visits from family and friends and relatives spoken too said that they felt welcomed into the home at any time. Service users also said that they regularly received visits from family and friends and sometimes this was recorded in the daily ongoing records, although this was not consistently completed for all service users. The inspectors spent some time in the homes kitchen (also see environment) in discussion with the homes cook, the manger and tone of the directors of the company and examined a range of new documents that gave more information about the choices of foods available to service users. The food stored in the kitchen and the menu plans indicated that a range of foods were available for service users. The cook confirmed that if service users did not want the meal on the menu plan an alternative could be offered such as soups, omelettes, cold meats etc. The cook also referred to written lists that showed service users special diets and some preferences. Most of the service users spoken too said that the food was fine. The manager said that members of staff now inform service users individually every day about the choice of foods available. New recording systems showed that a snack meal is now offered to service users in the evening. Staff and the cook confirmed that service users can choose were they eat, and service users were observed taking meals in the homes’ dining rooms, lounges or in their private rooms. At the previous inspection it was identified that that service users food was prepared and left uncovered for long periods. Food became cool and needed to be reheated or was soft and tasteless and indicated that the choices open to service users were limited. The manager and staff confirmed that this practice has now stopped and new routines have been introduced to ensure service users have a choice of meals at a time that suits them. Warwick Park House DS0000003616.V312679.R02.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The quality of the outcomes for service users in this outcome area is poor. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users are not protected from abuse EVIDENCE: The Commission had received a complex complaint regarding the care of a service user, which also included referral to the safeguarding adults team. This resulted in the homes manager and directors addressing a number of areas that had placed service users at risk and were in breach of Regulations and Standards. While the home was addressing these issues the home was restricted in admitting service users through Plymouth Social Services. Many of the areas highlighted through this time have now been addressed or partly addressed and the Commission has received detailed action plans and regular updates on how the home is continuing to progress. The service users guide stored in individual service users rooms included a complaints procedure and service users and their relatives confirmed that they felt able to raise concerns with the staff on duty or the homes manager. Members of staff and relatives said that they would be able to bring any concerns to the attention of the manager who would deal affectively with any problems, worries or issues. Four Comment cards from relatives and visitors Warwick Park House DS0000003616.V312679.R02.S.doc Version 5.2 Page 15 to the home said that concerns had been raised with the manager and those concerns had been “addressed satisfactorily”. Service users were not protected from abuse as not all staff employed at the home had been subject to thorough recruitment checks such as criminal record checks and employment/personal references. This remains an outstanding issue, since the last inspection, as gaps highlighted at the previous inspection had been addressed but new staff appointed since the May inspection had not undergone thorough recruitment checks. (See Staffing) A large number of service users nursed in bed had bed rails and bumpers fitted to their beds, this information was part of some service users assessment and care plans, but did not extend to all service users with bed rails in place. One service user had a bed rail but no bumper and the reasons for this were unclear to staff. The manager and staff said that they were much more aware of forms of restraint and the use of bed rails and bumpers. Warwick Park House DS0000003616.V312679.R02.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 The quality of the outcomes for service users in this outcome area is adequate Service users live in a well- maintained environment. Service users have access to specialist equipment and the home is pleasant clean and hygienic EVIDENCE: The inspectors observed that the homes kitchen had undergone a major transformation since the last inspection, the Kitchen was no longer dirty, cleaning schedules were in place, new fridges and freezers were in place, building work had taken place to extend the kitchen and a range of new documents monitoring health and safety, cleanliness and services users preferences had been introduced. Foods were labelled and stored in clean areas clearly dated and covered. The appearance of Service users rooms had also improved in that rooms were clean and had been personalised with service users photographs and furnishings. Carpeting had been cleaned or replaced. The homes lounge had also been fitted with new carpeting, new furnishings and fittings. Throughout the home new signs identifying rooms had been fitted. Warwick Park House DS0000003616.V312679.R02.S.doc Version 5.2 Page 17 In bathrooms, toilets and service users rooms there were aprons, gloves and cleaning agents for staff to use. The manager confirmed that all staff had been informed that service users own personal items such as soap must be used so that service users do not share soap. The home had a range of specialist equipment including special mattresses and hoist equipment, and the manager confirmed that specialist mattresses alarms were now routinely checked. Staff confirmed that they were aware of the action to take when a mattress sounds. A folder of receipts detailing the homes purchases were also available for inspection and included checks to machinery and building work and the purchase of new commodes. On the first day of this inspection inspectors observed that windows in the upper floors of the home were not restricted. The home did not have risk assessments for the premises covering health and safety issues such as the restricting of windows, water temperatures and guarding of radiators. At the second day of the inspection risk assessments were available and windows had been restricted. Overall the inspectors noted a marked improvement in the standard of accommodation now available to service users. Warwick Park House DS0000003616.V312679.R02.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The quality of the outcomes for service users in this outcome area is poor. Service users needs are not fully met by the skill mix of staff as staff are not consistently supervised or trained. Service users are not protected by the homes recruitment policy and practices. The home has enough staff to meet service users needs. EVIDENCE: On the first day of the inspection staff records showing staff supervision and appraisal were not available for inspection. Staff questionnaires returned to the Commission consistently said that they did not receive supervision from the manager or a senior member of staff. With comments such as “I don’t have supervision of any kind” “I have never been supervised since the day I started”. On the second day of the inspection staff supervision records including a summary of the emerging staff concerns and issues were available for inspection. The manager confirmed that this new process would be continued. The inspectors examined staff files, which had a range of documents in, including application forms and contracts of employment. There were significant shortfalls in recruitment records for example no police checks for new staff and no references for new staff. This had been previously highlighted for two existing staff and for those staff this had been resolved. Warwick Park House DS0000003616.V312679.R02.S.doc Version 5.2 Page 19 Induction for new staff had been newly introduced with staff files including information on induction for new staff. A newly formulated ongoing training record for all staff showed significant areas of training that some staff have not received, for example some staff have not received updated training on manual handling, infection control, abuse, health and safety, first aid, wound care, or how to care for someone with a peg feed. Documents showing planned staff training were displayed on the notice board and some training for staff had taken place between the two days of the inspection. Staff rosters over the months of November to September show fluctuating numbers of staff, in May staffing levels fell and were then increased, with low numbers of staff employed in the evening and weekend increasing over a period of weeks. The manager confirmed that new staff had been employed to increase staffing numbers including the employment of more qualified nurses such as Registered General Nurses. Staff questionnaires and relative comment cards consistently highlighted concerns about the number of staff employed at the home and how low staff numbers affected the care of the service users. Warwick Park House DS0000003616.V312679.R02.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 The quality of the outcomes for service users in this outcome area is adequate. Service users live in a home, which is run and managed by a person who is fit to be in charge. The manager and provider have worked to discharge their responsibilities fully and the home is now run in the best interests of the service users. The service users finances are safeguarded. EVIDENCE: The registered manager is an experienced nurse manager who confirmed she has a National Vocational Qualification at level 4 in management. The manager was unable to produce evidence that she had recent relevant knowledge and training in key areas such as risk assessment, dealing with abuse issues/adult protection, care of the client with dementia and supervision of staff. Staff questionnaires gave a mixed view of the manager’s skills and knowledge for example some staff said that they felt well supported by the manager while others criticised the manger for poor team working, a lack of Warwick Park House DS0000003616.V312679.R02.S.doc Version 5.2 Page 21 confidentiality and more involvement on the floor of the home rather than in the office. Relatives and visitors feedback cards said that the manager “addressed concerns” and some indicted that they had been able to resolve difficulties with the manager. There have been significant areas of improvement in some areas, as detailed throughout the report, the manager and provider had addressed or partly address previous failures under the regulations and standards under the Care Standards Act 2000. Safeguarding service users at risk and protecting their health, welfare and safety, for example recording keeping, maintenance and hygiene practices. Recruitment practices and the lack of staff training continue to have shortfalls that potentially put service users at risk, which the manager and providers said would be addressed. The manager confirmed that the procedure of managing Service users finances had been updated so that where some receipts were joint receipts for example chiropody and hairdressing these had been itemised and personalised for the individual service user. Items of value, which had been stored for safety were recorded in a formal easily readable way. A folder containing quality audit checks in key areas such as cleaning and a summary of staff supervision issues had been newly formulated. The manager said that this was the start of a quality assurance system that would include staff, service users and their advocates thoughts about the quality of the services provided in the home. Warwick Park House DS0000003616.V312679.R02.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 1 3 x x x x x x 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x 3 x x 3 Warwick Park House DS0000003616.V312679.R02.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP27 Regulation 18 Requirement The registered person must ensure that all staff receive training and regular updates in the protection of vulnerable adults, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. Previous timescales of 01/09/05 and 10/08/06 not met Timescale for action 02/02/07 2. OP27 18(1a) 02/02/07 The registered person must ensure that at all times there are suitable qualified, competent and experienced staff in the care home as appropriate to meet all of the health and social care needs of all persons living in the home. Staff must receive training in key areas such as moving and handling, dementia care, first aid. Previous timescale of 01/09/05 and 10/08/06 not met The registered person must not 30/10/06 employ a person to work at the care home unless the person is fit to work at the care home; and he has obtained in respect of that person the information and DS0000003616.V312679.R02.S.doc Version 5.2 Page 24 3. OP29 19 Warwick Park House documents specified in paragraphs 1 to 7 of schedule 2 and is satisfied on reasonable grounds as to the authenticity of the references referred to in paragraph 5 of schedule 2 in respect of that person. Previous timescale of 01/09/05 and 10/08/06 not met 4 OP31 9 The manager must update her 02/02/07 knowledge and skills in key areas such as staff supervision, health and safety, risk assessment to ensure that she has the experience, qualifications and skills to manage the care home RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. OP7 2 OP12 3 OP27 4 OP33 Review staffing numbers to ensure that staff are always employed in sufficient number to meet service users needs. Continue to extend the homes quality assurance system. Refer to Standard Good Practice Recommendations Continue to improve upon the recording in service users care plans, assessments and ongoing records to ensure that records are consistently well completed. Record the activities that service users participate in. Warwick Park House DS0000003616.V312679.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Warwick Park House DS0000003616.V312679.R02.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!