Inspection on 27/06/05 for Warwick Park Nursing Home

This inspection was carried out on 27th June 2005.

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 Park Nursing Home 12/09/06

Warwick Park Nursing Home 10/01/06

Warwick Park Nursing Home 06/10/04

Warwick Park Nursing Home 19/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Warwick Park Nursing Home 55 Warwick Park Tunbridge Wells Kent TN2 5EJ Lead Inspector Maria Tucker Unannounced 27 June 2005 11:00 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 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 Nursing Home H56-H06 S26212 Warwick Park V226825 270605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Warwick Park Nursing Home Address 55 Warwick Park Tunbridge Wells Kent TN2 5EJ 01892 541434 01892 549991 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Up-Beat Enterprises Limited Miss Karen Lesley Pratt Care Home with Nursing 25 Category(ies) of Old age registration, with number of places Warwick Park Nursing Home H56-H06 S26212 Warwick Park V226825 270605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Of the 25 beds 20 are registered for Nursing Care and 5 for Terminally ill. Date of last inspection 6 October 2004 Brief Description of the Service: Warwick Park Nursing and Residential Home is a large detached house set in its own grounds close to the centre of Tunbridge Wells. The Home has been adapted to provide accommodation for older people who require nursing and residential care. The accommodation consists of 15 single and 6 double rooms, however 2 of the double rooms are used as single rooms, which takes the occupancy to 23 service users. The home has three floors and access to the various floors is provided by a shaft lift. There are some rooms that are only accessible via a short flight of stairs equipped with a stair lift. There is a large, very well maintained garden to the rear of the building and limited parking to the front. The Home employs care staff that work a roster that gives 24-hour cover with a qualified member of staff on duty at all times. The Home also employs other staff for activities, catering, domestic and maintenance tasks. The aim of Warwick Park is to provide a home from home that caters as far as reasonably possible for the individual need and choice of each service user. Warwick Park Nursing Home H56-H06 S26212 Warwick Park V226825 270605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the first in the year running from April 1st 2005 to March 31st 2006. The inspection lasted from 9.55am until 2.10pm. Time was spent meeting the manager and responsible individual and going through various records and documentation. About one and a half hours was spent meeting service users collectively and individually. One relative was spoken with. Four staff on duty were spoken with. A partial tour of the premises and garden was undertaken. Service uses comments during the inspection included: “The carers are very good” “I could not fault anything” “The food is very good” “Everything is excellent” “The carers are very kind”. What the service does well: What has improved since the last inspection? The downstairs bathroom has had a wall knocked through to combine the toilet and bathroom making it larger and much more comfortable for service users. Warwick Park Nursing Home H56-H06 S26212 Warwick Park V226825 270605 Stage 4.doc Version 1.30 Page 6 The home has increased it staffing levels for the domestic and laundry support. The activities co-ordinator provides support to those service users who choose to remain in their rooms and due to the nice weather the garden is now used. New call bell points have been fitted so that the home no longer has ‘dead areas’. 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 Nursing Home H56-H06 S26212 Warwick Park V226825 270605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Warwick Park Nursing Home H56-H06 S26212 Warwick Park V226825 270605 Stage 4.doc Version 1.30 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 standard(s) 1, 2, 3, 4, 5, 6. Service users have comprehensive information about the home. They can feel confident that they will be admitted following a full assessment and that their needs would be fully met. EVIDENCE: A completed version of the Statement Of Purpose and Service Users guide was received by the CSCI prior to the inspection. This document is very comprehensive providing a useful insight into the home services and management. A relative spoken with confirmed that the placing authority had arranged the contract. A service user said this had been done with their relative. Comprehensive assessments are undertaken prior to service users moving in these form part of the overall care plan. A relative described how they chose the home after viewing some others and that since moving in their relative has been “happier and relaxed here” that “anything that ….needs they would be there doing it”. A service user who was in for a short period following discharge from hospital said, “I’ll be sorry to leave here”. Another service user spoken with said they had come in for a short stay and decided to stay permanently. The home does not provided intermediate care. Warwick Park Nursing Home H56-H06 S26212 Warwick Park V226825 270605 Stage 4.doc Version 1.30 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 standard(s) 7, 9, 10. Service users are individually cared and catered for in a flexible way that is responsive to their changing needs or choices. EVIDENCE: Service users care plans are individual and specific to their needs and health related condition. A record of an accident where a service user had fallen out of bed had been further prevented by the routine of the service user going to bed being made later. They are reviewed on a monthly basis. A copy of the service users care plan was looked at and discussed with a relative who commented that they were sent a written review from the funding authority and that their relative is “cared for properly to a high standard” that the “Doctor is called if anything is needed”. Staff were familiar with the care plan and the individual likes and choices of the service users describing how a service user has requested bubbles in their bath and that they had changed their daily routine with staff as the service user had a busy day planned. Another spoke of how a service user liked to have their pillow changed to have their decorative beaded one in place when receiving visitors. Qualified nursing staff administers the medication. The medication was seen to be stored appropriately and the mar sheets filled out accordingly. Lockable Warwick Park Nursing Home H56-H06 S26212 Warwick Park V226825 270605 Stage 4.doc Version 1.30 Page 10 facilities are provided in rooms should service users choose to self-administer their medication. Throughout the inspection all staff were seen and heard to treat the service users with dignity and respect. A service user was referred to with their preferred term of address and spoke highly of the staff to the inspector. A service user spoke of how their relative visits and is offered tea. A relative said they visit most days and assists with supporting their relative during lunch as they chose to do this. Warwick Park Nursing Home H56-H06 S26212 Warwick Park V226825 270605 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 14,15. Service users have a relaxed comfortable lifestyle and the pleasure of home cooked meals and snacks. EVIDENCE: There is a lot of art and craftwork around the home that the service users have been doing with the activity co-ordinator. Up the stairs there are geraniums on the windowsill that service users had planted. During the inspection some service uses were busy painting, others were in their rooms listening to the radio or watching television, another was quietly reading in the conservatory. A relative described how a strawberry cream tea activity had taken place in the garden and that although their relative was diabetic they still had the same as everyone else and the home balanced this with their diabetes. A service user spoken with who chose to stay in their room said “they offer to do activities but I prefer to be left alone in my room” another mentioned that the activity co-ordinator visits to sit and chat and let out their bird, stating that “they let her fly around”. There is a monthly C of E service which a relative said their “….. likes and sings hymns”. A service user spoke of how their relative manages their finances for them. Service users who were visited in their rooms had plenty of personal items and effects including furniture and paintings that were hung on the walls. A service user stated that the home had “let my …come to dinner on Sunday” that staff “all say do I want any extra cups of tea” and “if I don’t like Warwick Park Nursing Home H56-H06 S26212 Warwick Park V226825 270605 Stage 4.doc Version 1.30 Page 12 something they always find me something else”. The menu includes fresh fruit salads, fish, fresh vegetables and meat dishes. During lunch shandy or wine and fresh fruit juices are available. Ice cream floats are enjoyed in the hot weather. Without exception all of the service users commented how “nice” and “good” the food was. Warwick Park Nursing Home H56-H06 S26212 Warwick Park V226825 270605 Stage 4.doc Version 1.30 Page 13 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 standard(s) 16, 17, 18. Service users can feel safe in the home and secure in the knowledge that staff would take the appropriate measures to ensure this. EVIDENCE: A record of a minor complaint that had been made was viewed and discussed. It was found to have been managed and resolved very well. Throughout the inspection none of the service users spoken with had any complaints, one service user stated that they found when they first moved in the doors opposite could be noisy but this did not bother them. The home has an incident book, which had recorded that an adder had been spotted in the garden and advice had been sought. The home has had 1 adult protection alert that they raised, which was not connected to the home. It was managed very promptly and efficiently by the home evidencing good practice and a high standard of care. The manager has consulted the inspector with any areas of concerns for guidance and advice and regulation 37 notifications have been received as appropriate. Warwick Park Nursing Home H56-H06 S26212 Warwick Park V226825 270605 Stage 4.doc Version 1.30 Page 14 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 standard(s) 19, 20, 21, 22, 23, 24, 26. Service users live in an attractive comfortable environment; suited to individual taste; well maintained and exceptionally clean. EVIDENCE: Warwick Park has a very well maintained and attractive garden that the service users have full access to. It has gazebos, benches and chairs. A service user stated that they were going to go and sit in the garden after lunch. The home has a maintenance person who was at the home during the inspection undertaking some repairs. There have been some improvements made to the home including knocking down a wall combining a toilet and bathroom, redecorating it making it larger and more accessible. Extra call bells have been installed so there are no longer any dead areas. The carpets in parts of the corridors and stairs have been identified as needing replacing as part of the homes ongoing overall refurbishment programme. The manager stated that they were waiting for the quote to arrive. The service users private rooms seen were very comfortable, homely and had plenty of personal items and possessions. One service user said they had bought things in from home, including some furniture commenting that they Warwick Park Nursing Home H56-H06 S26212 Warwick Park V226825 270605 Stage 4.doc Version 1.30 Page 15 “had a little room and directly there was a vacancy they gave me this room”. Another said that their room was how they liked it. The middle and top bathroom need to be refurbished to meet the same standards as the rest of the home. The manager said they were in the process of discussing possibly turning into the top bathroom into a shower room so that extra choice is offered. Two of the chairs in the bathroom need to be replaced, as one has a fabric covering and the other is wooden. The storage of linen and equipment needs consideration so that they remain close at hand to use, yet are discrete. The home has some beds that are not adjustable beds. This has been discussed and was identified as something that the home would replace as part of the ongoing refurbishments. It has been agreed that if a service user chooses to have an ordinary bed as long as this does not compromise health and safety issues an adjustable bed would not be required. A service user commented that their bed was very comfortable, it had an air mattress and staff prop them up with pillows. Warwick Park Nursing Home H56-H06 S26212 Warwick Park V226825 270605 Stage 4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 30, Service users are cared for by a high level of competent, trained and experienced staff. EVIDENCE: The home has a high staffing level to support the service users needs these include house keeping; laundry; maintenance; kitchen assistants; activity coordinator; qualified nurses and care staff. The staffing levels have been increased to include 20 extra house keeping hours and an extra staff to work in the evenings on a ‘twilight shift’ and one in early to help the 2 waking night staff. Staff spoken with were very positive about the home and the management commenting that “we are a team”, and “brilliant team, a good matron who listens”. Service users were very complementary of the staff and of the care they received. A service user was heard talking to a staff that had returned from having the weekend off stating, “….I missed you” Another said the staff “come quickly when I press the call bell”. The interaction between staff and service users was one of mutual respect and genuine fondness. The level of training on offer was very high with specialist training to meet specific needs such as, ear irrigation as this was identified as something the district nurses no longer do. A staff-training matrix was seen and contained a list of individual training including mandatory training. A staff spoken with said, “I’ve done loads of study days”. Warwick Park Nursing Home H56-H06 S26212 Warwick Park V226825 270605 Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 36, 38. Service users benefit from a well managed home with a pleasant welcoming atmosphere and staff who are given clear direction and leadership. EVIDENCE: The home has a good atmosphere and an open and inclusive approach in its leadership and management. A relative commented that the “staff are lovely” and “staff understand and make allowances” evidencing the homes ethos and of putting the service user first. The manager is waiting a start date for the Registered Managers Award. She is a qualified nurse, with a degree in nursing and has kept up to date by further study. Staff commented that regular supervision including clinical supervision takes place. The manager and a staff have completed the clinical supervision course. All staff spoken with were very aware and safety conscious. The home has good systems in place for recording and monitoring health and safety issues, which are then acted upon for example a MDA alert notice that was applicable Warwick Park Nursing Home H56-H06 S26212 Warwick Park V226825 270605 Stage 4.doc Version 1.30 Page 18 to the home had been acted upon; various risk assessments had been conducted and regular maintenance and servicing of equipment takes place. Informal service user meetings have started the first discussed the choice of outings and activities. Warwick Park Nursing Home H56-H06 S26212 Warwick Park V226825 270605 Stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 4 4 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 4 COMPLAINTS AND PROTECTION 3 3 3 2 3 2 x 2 STAFFING Standard No Score 27 4 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 4 2 3 x x x 3 x 3 Warwick Park Nursing Home H56-H06 S26212 Warwick Park V226825 270605 Stage 4.doc Version 1.30 Page 20 No Are there any outstanding requirements from the last inspection? 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 OP 31 Regulation 9 (1) (2) (i) Requirement A person shall not manage a care home unless he has the qualifications necessary in that he has a qualification at the level of NVQ level 4 or equivalent. Timescale for action As dictated by course availability. 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 OP 22.7 Good Practice Recommendations It is recommended that the storage of linen and equipment be reviewed and consideration made so that they remain close at hand, yet discrete. It is recommended that the hoist is not stored in the dinning area. It is recommended that adjustable beds are provided for service users who request or require them. Or for health and safety reasons. It is recommended that the chairs in the bathroom is replaced. 2. 3. OP 24.3 OP 26.1 Warwick Park Nursing Home H56-H06 S26212 Warwick Park V226825 270605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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 Nursing Home H56-H06 S26212 Warwick Park V226825 270605 Stage 4.doc Version 1.30 Page 22 - 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. 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