Inspection on 21/03/06 for Warwick Nursing Home

This inspection was carried out on 21st March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 Nursing Home 14/12/06

Warwick Nursing Home 08/12/05

Warwick Nursing Home 10/03/05

Warwick Nursing Home 10/09/04

Warwick Nursing Home 24/02/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Warwick Nursing Home 10 Warwick Crescent Harrogate North Yorkshire HG2 8JA Lead Inspector Denise Rouse Unannounced Inspection 21st March 2006 10:30 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 Nursing Home DS0000027949.V283766.R01.S.doc Version 5.1 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 Nursing Home DS0000027949.V283766.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Warwick Nursing Home Address 10 Warwick Crescent Harrogate North Yorkshire HG2 8JA 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) 01423 560807 01423 500885 Mrs Celina Jowett Mrs Celina Jowett Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Warwick Nursing Home DS0000027949.V283766.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age Range 60 upwards Date of last inspection 8th December 2005 Brief Description of the Service: Warwick care home is owned and managed by Mrs Celina Jowett and provides nursing care for up to 17 residents. Previously an Edwardian private dwelling, circa 1908, it has been converted and extended for its present use. It is built with a mix of stone facing and white washed pebbledash and is on two floors including ground with a four person vertical lift providing level access to the first floor. It is located in a quiet residential area close to open parkland and within reasonable walking distance of Harrogate town centre. The ethos of the home is to provide a family run establishment in a homely environment. Warwick Nursing Home DS0000027949.V283766.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over two hour five minutes, following a half days preparation. A tour of the building was undertaken which included communal areas, bedrooms, kitchen, treatment room and office. The nurse in charge was available to commence the inspection. The proprietor manager also assisted with this process. Service users and one visitor was spoken with. The homes physiotherapist, keep fit “chair aerobics” facilitator, care staff and visiting National Vocational Qualification Assessor were also spoken with. What the service does well: What has improved since the last inspection? What they could do better: Warwick Nursing Home DS0000027949.V283766.R01.S.doc Version 5.1 Page 6 Storage facilities for medications must be reviewed. Sluicing facilities must be re-assessed. 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 Nursing Home DS0000027949.V283766.R01.S.doc Version 5.1 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 Nursing Home DS0000027949.V283766.R01.S.doc Version 5.1 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): Not assessed on this visit. EVIDENCE: Warwick Nursing Home DS0000027949.V283766.R01.S.doc Version 5.1 Page 9 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): Standards 8 9 Service users health care needs are met, however storage facilities relating to medications must be reviewed. EVIDENCE: Standard 8 was inspected in relation to the shortfall highlighted during the last inspection. The proprietor stated that a suction machine was going to be purchased for the home. Medication received within the home was recorded correctly. Staff were seen to be administering medications in a safe and professional manner. The Boots Medication Dosage System was in operation and works well within the home. The proprietor confirmed that a supplier was contracted to dispose of medications utilizing the correct disposal systems. Service users at present do not self medicate although the home could provide this facility if service users were assessed to be capable and wished to do so. Storage of medication occurred within two areas of the home. One area used for storage contained a staff toilet. It was noted that available storage space, which could be utilized within the home for medications, was extremely limited Warwick Nursing Home DS0000027949.V283766.R01.S.doc Version 5.1 Page 10 due to the design and layout of the building. The proprietor must ensure that both storage areas comply with current law and legislation in regards to the Medicines Act 1968, the Royal Pharmaceutical Society and Misuse of Drugs Act 1971. Warwick Nursing Home DS0000027949.V283766.R01.S.doc Version 5.1 Page 11 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): Standards 13 14 Service users have control over their lives; receiving visitors at any time and could follow their chosen community activities if they wished. EVIDENCE: Service users could receive visitors at any time. Information regarding visiting was available within the service user guide and was made available to all new service users, their family and friends at the time of admission to the home. Service users were seen to exercise choice and control over their lives, and were assisted appropriately by the care staff. Service user had detailed care plans in place regarding their spiritual needs, Emotional and psychological wellbeing and Family Involvement. Service users could state whom they wished to see or not to see. Service users had continued to keep contacts with the local community as they wished. Warwick Nursing Home DS0000027949.V283766.R01.S.doc Version 5.1 Page 12 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): Not assessed on this visit. EVIDENCE: Warwick Nursing Home DS0000027949.V283766.R01.S.doc Version 5.1 Page 13 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): Standard 26 Service users live within a home that was clean, however commode-sluicing facilities must be reviewed. EVIDENCE: The domestic staff were seen cleaning the home at the time of the inspection. There was no malodour present within any area of the home. There was no sluice disinfector machine provided within the home. Sluicing of commode pans was undertaken by utilizing a cleaning sanitizing product each time a commode pan was emptied. The staff also bleach all the commode pans twice a week. The bleach was stored within the sluice in a lockable cupboard. At the time of the inspection the cupboard was unlocked, the proprietor stated that this was not usually left unlocked and rectified this immediately. Warwick Nursing Home DS0000027949.V283766.R01.S.doc Version 5.1 Page 14 Although space was limited within the sluice room, the proprietor must review the sluicing facilities provided, to ensure service users are not placed at possible risk. Warwick Nursing Home DS0000027949.V283766.R01.S.doc Version 5.1 Page 15 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): Standard 28 Service users were in safe hands at all times. EVIDENCE: Service users were looked after by staff who were encouraged to undertake the National Vocational Qualification in Care at level 2 or 3. At present 3 care staff hold this qualification, with a further 2 undertaking it. One carer was seen with the NVQ assessor within the home, and was progressing well with the qualification. Once the two care staff have completed the course the home would have nearly achieved a 50 ratio of staff that hold this qualification. The proprietor actively encourages new and existing care staff to attain this qualification. Warwick Nursing Home DS0000027949.V283766.R01.S.doc Version 5.1 Page 16 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): Standard 33 38 The home is managed in such a way that the health and safety of service users and staff is considered. EVIDENCE: The proprietor has commenced the implementation of a Quality Assurance system, and will continue to develop this by means of questionnaires issued to service users, relatives and visitors. Also minutes of resident and relatives meetings will be taken and displayed within the home. Outcomes of one to one discussions with service users may also be recorded to evidence the quality assurance taking place within the home on a day-to-day basis. Standard 38 was not fully inspected, however the area of shortfall relating to the last inspection was examined. Staff now read and sign a document to say that they have understood the homes policies and procedures. The proprietor stated that this has been helpful to ensure that all staff have a full understanding of the homes policies and procedures. Warwick Nursing Home DS0000027949.V283766.R01.S.doc Version 5.1 Page 17 Warwick Nursing Home DS0000027949.V283766.R01.S.doc Version 5.1 Page 18 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 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 1 9 1 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X 1 STAFFING Standard No Score 27 X 28 2 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X X X X 3 Warwick Nursing Home DS0000027949.V283766.R01.S.doc Version 5.1 Page 19 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 OP8 Regulation 16 (1)(2) (c) 13 (2) Requirement Timescale for action 31/03/06 2. OP9 3. OP26 13(3) 16(2) A medical suction machine must be purchased. (Previous time –scale of 01/01/06 not met) The registered provider must 14/04/06 ensure that all medications are stored correctly in regards to The Medications Act 1968, The Royal Pharmaceutical Society guidelines, and the Misuse of Drugs Act 1971. Suitable sluicing facility and a 01/05/06 sluicing disinfector must be provided. The proprietor must provide a written account of how the commode pans are sluiced and disinfected at present. (Previous time-scale of 01/04/05 and 01/03/06 not met) Warwick Nursing Home DS0000027949.V283766.R01.S.doc Version 5.1 Page 20 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 Refer to Standard OP28 Good Practice Recommendations The provider should continue to encourage care staff to undertake the National Qualification In Care. A 50 ratio of staff should be attained. A formal system of quality assurance should continue to be implemented within the home. 2 OP33 Warwick Nursing Home DS0000027949.V283766.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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. 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