Inspection on 31/05/05 for Warwick House

This inspection was carried out on 31st May 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 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 House 20/02/08

Warwick House 16/05/06

Warwick House 14/11/05

Warwick House 21/10/04

Warwick House 24/05/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

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

CARE HOME ADULTS 18-65 Warwick House 11-17 Warwick Gardens Worthing West Sussex BN11 1PF Lead Inspector Jo Hartley Announced 31 May 2005, 10:00 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 H60-H11 S14822 Warwick House V221467 310505 Stage 2.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Warwick House Address 11-17 Warwick Gardens, Worthing, West Sussex, BN11 1PF 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) 01903 235488 Mrs Jean Florence Harrity Miss Christine Cerina Winifred Lewis Care Home (CRH) 35 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia-over 65 years of age (MD(E)), (8) of places Mental disorder, excluding learning disability or dementia (MD), (27) Warwick House H60-H11 S14822 Warwick House V221467 310505 Stage 2.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 21 October 2004 Brief Description of the Service: Warwick House is a care home registered to accommodate up to thirty five service users with a mental disorder, eight of whom may be over the age of sixty-five. It is a row of four attached houses situated in the centre of the town of Worthing, West Sussex. The accommodation is located close to shops, the sea and local transport links. Service-users live on the ground and first floors. The private accommodation for service users is predominantly for single occupancy, although there are six shared rooms. The service is privately owned by Mrs Jean Harrity. The registered manager, responsible for the day to day running of the service, is Mrs Christine Lewis. Warwick House H60-H11 S14822 Warwick House V221467 310505 Stage 2.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection was carried out over a period of five and a half hours. Prior to the inspection the inspector read information held on the service file since the last inspection in October 2004, and read the previous two inspection reports. The pre-inspection questionnaire was not returned by the home prior to the inspection. On the day of the inspection the registered manager gave the inspector ten comment cards; four from relatives and six from service users. During the inspection the inspector spoke to five service users and four members of staff. Two members of staff were interviewed formally. The inspector undertook a tour of the premises and looked at nine care plans and four staff files. Various record books, policies and procedures were also examined. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Warwick House H60-H11 S14822 Warwick House V221467 310505 Stage 2.doc Version 1.20 Page 6 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 Standards Statutory Requirements Identified During the Inspection Warwick House H60-H11 S14822 Warwick House V221467 310505 Stage 2.doc Version 1.20 Page 7 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 standard(s) 2, 5 Service users have needs assessments prior to admission and these are used to develop individual care plans. On admission into the home service users receive a Service User Guide. There are no contracts signed by service users on file. EVIDENCE: Service users’ files were seen to include needs assessments completed by the referring authority. Prior to admission the manager also completed a needs assessment. It was evident that both of these had been used to develop the individual care plans that were inspected. No written contracts or statements of terms and conditions were seen on service users’ files. The manager should ensure that these are on file and signed by individual service users. The manager said that new service users are given a Service User Guide that includes the main terms and conditions of the home. Warwick House H60-H11 S14822 Warwick House V221467 310505 Stage 2.doc Version 1.20 Page 8 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 standard(s) 6, 9 Care plans are in place but a system of recording reviews and changes in needs should be implemented to ensure that all staff are aware of changes to care plans. Risk assessments for individual needs should be put into place to help protect service users from harm. EVIDENCE: Nine care plans were examined during the inspection. The plans were quite comprehensive and included general risk assessments. Risk assessments for needs specific to individual service users, such as misuse of alcohol, need to be put in place. Restrictions on choice and freedom were recorded. Evidence was seen of reviews of care plans and risk assessments on some service users’ files, but not all. A system should be put in place to record reviews and any changes generated from them. Warwick House H60-H11 S14822 Warwick House V221467 310505 Stage 2.doc Version 1.20 Page 9 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 standard(s) 12, 13, 16 Service users take part in appropriate activities with the aid of staff if needed, and are part of the local community. Service users rights are respected. EVIDENCE: Service users spoken to on the day of the inspection said they feel part of the local community. They use the local shops and facilities, with support from staff if required. One service user said that she has been attending college and has just taken two exams. Another service user said they help someone from the neighbourhood with their allotment. One service user said that he does some work for a local charity. Service users said that several residents attend the local church, and representatives from the church visit people in the home. Service users spoken to said they were aware of the recent elections and had the opportunity to vote if they wished. A member of staff was seen preparing things to do some arts and crafts activities with service users. Another member of staff spoken to said that the home organises bingo twice a week, and that residents are also encouraged to take part in cooking activities. Ten residents have recently returned from a holiday in Weymouth. Warwick House H60-H11 S14822 Warwick House V221467 310505 Stage 2.doc Version 1.20 Page 10 All bedrooms were seen to have locks, and service users were seen using their own keys to enter their rooms. Throughout the day of the inspection staff were seen interacting with service users. The inspector witnessed staff giving service users unopened mail that had arrived for them that day, and also witnessed a member of staff assisting a service user with financial concerns. Warwick House H60-H11 S14822 Warwick House V221467 310505 Stage 2.doc Version 1.20 Page 11 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 standard(s) 19, 20 Service users’ physical and emotional health needs are met by the home. Service users who self-administer their medication are protected by the home’s policies and procedures. EVIDENCE: Service users’ healthcare needs were seen to be set out in their care plans. A member of staff was seen arranging a medical appointment for a service user and recording the date of the appointment in the home’s diary. The home had a pharmacy inspection in March of this year. The certificate was seen during the inspection. The pharmacist made no recommendations. The medication book was seen to clearly document the receipt, administration and disposal of all medication. Individual agreements on the administration of medication were seen to be signed by all residents. One service user self-medicates. The service user’s file showed that the care manager has agreed this, and that a risk assessment had been undertaken. Warwick House H60-H11 S14822 Warwick House V221467 310505 Stage 2.doc Version 1.20 Page 12 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 standard(s) 23 Warwick House has procedures in place regarding protecting service users from abuse, neglect and self-harm. The manager must inform the CSCI of any adult protection issues. EVIDENCE: Policies and procedures were seen regarding protecting people from abuse. Staff training records showed that staff have received abuse awareness training. A copy of the West Sussex Multi-Agency Policy and Procedure for Protecting Vulnerable Adults was seen at the home. However a recent investigation into financial abuse of a service user by someone outside of the home had not been notified to the Commission for Social care Inspection. The manager needs to ensure that she notifies the Commission of any adult protection issues. Warwick House H60-H11 S14822 Warwick House V221467 310505 Stage 2.doc Version 1.20 Page 13 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 standard(s) 24, 26, 30 Warwick House is homely, clean and hygienic. There has been an improvement in the general décor of the home since the last inspection. Some redecoration and new furnishings are still needed. The gardens and grounds are very well maintained. EVIDENCE: On the day of the inspection the home was clean, tidy and free from offensive odours. Staff were seen cleaning communal areas. The garden was in very good order, with flower borders, patio, water feature, chairs and tables. Service users said they really liked the garden and enjoyed sitting in it. The home is currently undergoing some refurbishment. New carpets were seen in the lounge, hall and stairways. The laundry also had new flooring. Several communal areas have recently been redecorated to a good standard. Some work still needs to be done including the bathroom near the laundry which has paint flaking from the walls; carpeting in a service users bedroom was seen to be worn; and some furniture in service users rooms has become tatty and should be replaced. Warwick House H60-H11 S14822 Warwick House V221467 310505 Stage 2.doc Version 1.20 Page 14 Problems of damp in one bedroom, noted in the last inspection, have now been addressed. The room is now dry and has been redecorated. Bedrooms inspected had been personalised by service users. Residents said they liked their rooms. Some rooms still do not have the minimum furnishings listed in Standard 26.2, but two service users said that they did not want any more furniture in their rooms, and that they were happy with them the way they are. This should be noted in individual care plans. Bedrooms all have locks. Warwick House H60-H11 S14822 Warwick House V221467 310505 Stage 2.doc Version 1.20 Page 15 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35, 36 Staff at Warwick house are competent and qualified to support service users in the home. The homes recruitment policy does not meet the relevant Standards and Regulations. The manager also needs to ensure staff receive supervision at least six times per year. EVIDENCE: Staff at Warwick House were seen to be approachable to service users, be good listeners and able to communicate well. Training records seen indicate that there is a good skills mix within the home. Three members of staff will be starting their NVQ2 this June. Training undertaken by staff includes Health and Safety, Adult Abuse and Challenging Behaviour. At the time of the inspection the home had one staff vacancy. The manager said that she has introduced a new induction programme for staff and is also going to start using the TOPSS induction. On the day of the inspection the computer software package that is used to record staff induction and training was not working. The manager said she is hoping to buy a new software package that also includes care planning. Four staff files were examined during the inspection. Staff files seen were not all complete. Two did not have terms and conditions of employment; one had no proof of identification; and three had no CRB or POVA checks. Application Warwick House H60-H11 S14822 Warwick House V221467 310505 Stage 2.doc Version 1.20 Page 16 forms were present on all files but do not require employment history or qualifications to be completed by applicants. The manager needs to ensure that all staff files include the information required in the Standards. Application forms need to include employment history and qualifications of applicants. Staff records indicated, and staff spoken to confirmed, that staff do not currently receive supervision. The manager said that she started doing supervision but stopped during a period of high staff turnover. This needs to be re-started. Supervision should take place at least six times a year. Warwick House H60-H11 S14822 Warwick House V221467 310505 Stage 2.doc Version 1.20 Page 17 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The health, safety and welfare of service users are promoted and protected through staff training and regular safety inspections. Consideration should be given to installing water temperature governors on hand basins. EVIDENCE: The home had an Environmental Health inspection in November 2004. There was only one recommendation regarding the storage of vegetables, this has now been actioned. A Legionella Certificate dated December 2004 was seen. Water temperatures in hand basins were found to be very hot. The manager said that bath taps have governors on them but hand basins do not. Risk assessments regarding scalding were seen on individual service user files. Consideration should be given to governing water temperatures in hand basins. Fire equipment and electrical appliance, (PAT,) tests were both carried out in November 2004. The fire alarm system was inspected in May 2005. Warwick House H60-H11 S14822 Warwick House V221467 310505 Stage 2.doc Version 1.20 Page 18 Staff records seen during the inspection showed that staff has received training in Health and Safety Procedures including Food Hygiene, First Aid and Fire Safety. Warwick House H60-H11 S14822 Warwick House V221467 310505 Stage 2.doc Version 1.20 Page 19 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. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 2 x x x 3 Standard No 11 12 13 14 15 Warwick House x 3 3 x x Standard No 31 32 33 34 35 36 Score x 3 3 1 3 2 Version 1.20 Page 20 H60-H11 S14822 Warwick House V221467 310505 Stage 2.doc 16 17 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x Warwick House H60-H11 S14822 Warwick House V221467 310505 Stage 2.doc Version 1.20 Page 21 Yes 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 5 Regulation 5 Requirement Each service user has an individual writen contract or statement of terms and conditions with the home. The registered person must regularly review the service users plans and risk assessments and record the results of the reviews. The registered manager must notify CSCI of any event which adversely affects the well-being or safety of any service user. The registered person shall not employ a person to work at the care home unless she has obtained in respect of the person the documents specified in Schedule 2 of the regulations. Timescale for action 31/08/05 2. 6 15 31/08/05 3. 23 37 31/06/05 4. 34 19 26/11/04 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 34 Good Practice Recommendations The registered provider should request information about previous employment and qualifications on job application H60-H11 S14822 Warwick House V221467 310505 Stage 2.doc Version 1.20 Page 22 Warwick House 2. 3. 36 42 forms. Staff have regular, recorded supervision meetings at least six times a year. Consideration should be given to installing water temperature governors on hand basins. Warwick House H60-H11 S14822 Warwick House V221467 310505 Stage 2.doc Version 1.20 Page 23 Commission for Social Care Inspection 2nd Floor, Ridgeworth House, Liverpool Gardens Worthing West Sussex BN11 1RY 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 H60-H11 S14822 Warwick House V221467 310505 Stage 2.doc Version 1.20 Page 24 - 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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