Inspection on 23/03/06 for Warwick House

This inspection was carried out on 23rd March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Warwick House 05/03/07

Warwick House 18/05/05

Warwick House 11/11/04

Warwick House 18/05/04

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

CARE HOME ADULTS 18-65 Warwick House 12 Grosvenor Road Paignton Devon TQ4 5AY Lead Inspector Susan Samways Unannounced Inspection 23rd March 2006 10:00 Warwick House DS0000055762.V269661.R01.S.doc Version 5.1 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 House DS0000055762.V269661.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 Adults 18-65. 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 House DS0000055762.V269661.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Warwick House Address 12 Grosvenor Road Paignton Devon TQ4 5AY 01803 663421 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@moduscare.com Modus Care Limited Stephen Robert Lawson Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Warwick House DS0000055762.V269661.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 7 Service Users within the Learning Disability category may reside at the home. Date of last inspection Brief Description of the Service: Warwick House is a large detached house in Paignton which has easy access to shops, public transport and other community facilities. The home provides services for up to seven adults with a learning disability, in particular autistic spectrum disorder. All the bedrooms are en-suite and the communal rooms are spacious and well decorated. The home also benefits from a large rear garden. Warwick House is owned by a company which has other care homes and hospitals specialising in the care of people with autistic spectrum disorders. Warwick House DS0000055762.V269661.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection which lasted for six hours. At the time of the inspection there were four service users resident in Warwick House. Since the last inspection there has been a change of manager. The new manager was available for the whole period of the inspection and the Responsible Individual made an unplanned visit. The service users declined the opportunity to speak to the inspector but one called into the office and said hello. Documents including service users’ care plans and staff records were examined and discussions took place with the manager and the Responsible Individual. What the service does well: What has improved since the last inspection? What they could do better: Development of the quality monitoring system needs to continue to ensure that all aspects of the running of the home are included. Warwick House DS0000055762.V269661.R01.S.doc Version 5.1 Page 6 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 House DS0000055762.V269661.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Warwick House DS0000055762.V269661.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: As no new service users had been admitted since the last inspection no standards in this section were assessed on this occasion. Warwick House DS0000055762.V269661.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,9 Service users can be confident that their care plans clearly identify their needs and how they will be met. EVIDENCE: The files for two service users were examined. These are lengthy and contain detailed information about the service user including the individual programme plan, personal profile, risk assessments, health and medication records and reviews. Service users’ needs were clearly identified and how they would be met. Service users’ signatures on various documents showed their involvement in their plans and reviews. In addition there are summary files which contain key information about each service user. These are used by new members of staff when first getting to know the service users. When they are more established they gradually read the full files. Service users are encouraged to be as independent as possible and the degree of assistance required by each service user to achieve this is included in the individual programme plans and risk assessments. Risk assessments are detailed and clearly show what action should be taken to support the service user and reduce the risk. Risk assessments are completed by the manager Warwick House DS0000055762.V269661.R01.S.doc Version 5.1 Page 10 and the key worker for all activities undertaken by service users. Other staff are also involved if required. These are reviewed at least every six months, sooner if there is a change in the service user’s circumstances or behaviour and this was reflected in the records seen. Warwick House DS0000055762.V269661.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,17 Service users are provided with good support to enable them to access social and educational opportunities. Service users’ contact with friends and relatives is positively encouraged. EVIDENCE: Service users’ records show that they are all encouraged to participate in a wide range of activities both in the home and in the local community. Each service user has an activities sheet showing their programme for the week. This includes educational courses such as literacy and numeracy, physical activities like horse riding, bowling and swimming and domestic and leisure activities within the home. They also have membership of local organisations such as the zoo and the Torbay Coast and Country Trust. Service users have the use of a computer which has a broadband connection and two of them use e-mail to contact family members. The staff have access to lease cars which can be used to take service users to appointments and to attend college or social events. The staff have to have had a driving licence for at least 12 months and are required to pass the company’s driving test before they are permitted to drive the lease cars. Warwick House DS0000055762.V269661.R01.S.doc Version 5.1 Page 12 Service users are expected to assist in the running of the home. With assistance they keep their own rooms clean and are encouraged to help with other household tasks such as cleaning and washing up. One service user, who is working towards more independent living, helps with food preparation and cooking and also does some ironing under supervision. Service users’ dietary requirements and preferences are recorded and their menus developed with them on an individual basis and reviewed every two months. The home has a good relationship with the dietetic service at the hospital and changes of menu are discussed with a dietician to ensure that a good nutritional balance is maintained. One service user has been enabled to lose weight by being encouraged to stick to her diet with explanations being given of the consequences of different food choices. Service users make their own drinks under supervision and work alongside staff baking cakes and making sandwiches or toast. Warwick House DS0000055762.V269661.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Service users receive personal care and support in the way they prefer and which promotes privacy, dignity and independence. Medication is managed in a way which safeguards service users and promotes well-being. EVIDENCE: The home operates a key worker system which ensures that each service user’s individual needs are met. Support required with personal care is recorded in the service users’ care plans including how that support should be provided. For example all service users have assistance with washing their hair and washing their backs when bathing but one service user likes to have a member of staff in the bathroom with them the whole time when bathing as that makes them feel safe. Another service user needs to be given a specific time to be ready in order to achieve that task. Prompts regarding aspects of personal care are given as required and recorded in the daily records. Service users’ records provide evidence that they are involved in managing their own health care and that health care professionals are accessed as required. Support is provided by staff as identified by the care plan or as requested by the service user. Warwick House DS0000055762.V269661.R01.S.doc Version 5.1 Page 14 The home operates a good system for the administration of medication. All staff receive training in the safe administration of medication and are required to observe an experienced member of staff at least three times before they are supervised administering medication themselves. Two staff work together when dealing with medication. Support regarding medication, especially PRN medication, is available out of hours from staff at the company’s hospitals. Service users’ consent to medication is recorded in their care plans. Medication records examined were seen to be in order and the medication stored securely. Warwick House DS0000055762.V269661.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: No standards in this section were assessed on this occasion. Warwick House DS0000055762.V269661.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: No standards in this section were assessed on this occasion. Warwick House DS0000055762.V269661.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,35 The home employs sufficient staff who have the skills, training and understanding to meet the needs of service users. EVIDENCE: Since the last inspection there has been a change of manager but apart from the retirement of one part-time member of staff there have been no changes in the staff team. The home benefits from being part of a company which has several homes and which employs a team of bank staff to cover for staff sickness, holidays and other absences. Bank staff undergo the same training programme as the permanent staff. Training records showed that staff attend both internal and external courses which equip them to meet the needs of service users, especially those with challenging behaviour. The training chart in the office shows the training each member of staff has done, that which is planned and when refresher training is due. Warwick House DS0000055762.V269661.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39 Service users can be confident that the home is well run and that their views will be taken into consideration in the plans for the home. EVIDENCE: Since the last inspection there has been a change of manager who has applied for registration with the Commission for Social Care Inspection. The manager clearly knows the service users well and demonstrated a good understanding of their needs and their behaviour. She was also seen to have a good relationship with the staff who were observed to approach her with ease and confidence. She is currently undertaking NVQ level 4 in management and the Registered Managers Award. She also has the NVQ assessor award. The home was found to be well run with the manager able to answer questions about the service with confidence. The service users were confident in their approach to both the manager and the staff and a difficult situation was seen to be dealt with promptly and appropriately. Warwick House DS0000055762.V269661.R01.S.doc Version 5.1 Page 19 Service users are able to air their views directly to a member of staff if they wish or complete the questionnaire in the service users’ guide. The manager stated that any views expressed, especially if the service user was worried about something, would be discussed with them. Other aspects of quality assurance are being developed. Warwick House DS0000055762.V269661.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 x 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 x ENVIRONMENT Standard No Score 24 x 25 x 26 x 27 x 28 x 29 x 30 x STAFFING Standard No Score 31 x 32 x 33 3 34 x 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 x x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 2 x x x x Warwick House DS0000055762.V269661.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action 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 YA39 Good Practice Recommendations The registered provider should ensure that further development work is undertaken to provide an effective quality monitoring system for all aspects of the running of the home reflecting aims and outcomes for service users. Warwick House DS0000055762.V269661.R01.S.doc Version 5.1 Page 22 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 House DS0000055762.V269661.R01.S.doc Version 5.1 Page 23 - 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. 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