Inspection on 05/07/07 for Warwick Park House

This inspection was carried out on 5th July 2007.

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

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

Other inspections for this house

Warwick Park House 12/01/09

Warwick Park House 09/01/08

Warwick Park House 16/08/06

Warwick Park House 09/05/06

Warwick Park House 09/08/05

Warwick Park House 26/04/05

Warwick Park House 23/02/05

Warwick Park House 15/09/04

Warwick Park House 04/03/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Warwick Park House 17 Butt Park Road Honicknowle Plymouth Devon PL5 3NW Lead Inspector `Andrea East: Second Inspector Mandy Norton Key Unannounced Inspection 5th July 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Warwick Park House Address 17 Butt Park Road Honicknowle Plymouth Devon PL5 3NW 01752 772433 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Warwick Park Limited Position Vacant Care Home 50 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (10), of places Physical disability over 65 years of age (50) Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. To include 4 Service Users under 60 years old for Service User categories The Home is registered as a Care Home with Nursing for a maximum of 50 Service Users in the categories of PD(E)50, OP 10, TI 4 The home can provide care to 4 persons suffering with Dementia DE(E) named elsewhere. 05/04/07 Date of last inspection Brief Description of the Service: Warwick Park Nursing home is registered to provide care, for a maximum number of fifty older people with physical frailty, disability or illnesses, who may need nursing care. The home is located in the Honicknowle area of Plymouth and is close to shops and near to a bus route. It is arranged on two floors with the communal lounges and dining room on the ground floor. There is level access to all parts of the home via a passenger lift and ramps. Level access is provided to a large secluded garden with a variety of seating areas. There are thirty-two single bedrooms and nine double rooms, most benefit from en suite toilet facilities. The range of weekly fees for living at the home was £380- £475. This information was provided on 05/07/07 at the site visit to the home. Additional charges are made for chiropody, hairdressing, outings and newspapers and reflexology. The homes service users guide and the last inspection report can be found in the entrance hall of the home and in the homes office. Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was carried out over a day, by two inspectors. We examined a range of documents including staff and peoples individual files, policies, procedures and the homes service users guide. People were spoken too in the homes lounge and in private rooms and members of staff were also spoken with. The homes manager and owner were present throughout the inspection. Feedback about the home was also received by post in survey questionnaires provided by the Commission and in discussion with visitors to the home. This report also contains information obtained at previous random inspection visits to the home. Random inspections were part of working closely with the home’s owners, previous manager, a private consultant and the new manager to improve services to the people living in the home and to protect people from abuse and harm. This had resulted in the homes manager and owners addressing a number of areas that had placed people at risk and were in breach of Regulations and Standards. While the home was addressing these issues the home was restricted in admitting people through Plymouth Social Services. Many of the areas highlighted throughout this time have now been addressed or partly addressed. Detailed action plans and regular updates on how the home is continuing to progress had been submitted to the Commission prior to our visit to the home. What the service does well: The owner had responded well to serious concerns about the standard of care in the home. Part of this response was to employ for a short time a consultant, to consider the best way to improve the service and the employment of a new manager. This was important, as it had helped to raise the standard of care in the home. Surveys said that the people using the service and their relatives were able to raise issues and concerns with the manager, owner or staff and felt that they would be addressed and resolved. This indicates that action is taken to ensure peoples concerns are listened to and that peoples’ needs and preferences are considered. The service had good recruitment practices that had been consistently completed for all new staff employed in the home. For example police checks and references for new staff had been consistently completed. This is Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 6 important to protect people from abuse from staff who may not be suitable to work with vulnerable people. What has improved since the last inspection? What they could do better: Assessments completed prior to people coming to live at the home could be extended so that it is clear that the people using the service or their relatives/advocates are part of this process. This would ensure that people’ s needs are made clear, so that they can be cared for right from the start of the service to them, in the way they wished to be cared for Care plans, assessments and daily reports could be extended to show how the people using the service or their advocates are actively involved in decisions about their care. This would show how people were supported to make choices about how they were cared for. The current system of medication could be changed and shortened so that it was not as time consuming and taking two nurses to complete. This meant that some people had their medication at different times and there did not appear to have been any discussion with the person receiving the medication that this was acceptable to them. Activities and entertainments that people have participated in need to be extended and recorded. This would make it clear what activities people have enjoyed in a group or individually. The manager should continue as planned to ensure peoples assessments and care plans are extended. The use of bed rails should be recorded and assessed. So that bed rails and bumpers are fitted correctly and match individuals needs and wishes, as they may be used as a form of restraint. Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 7 Staff must undergo the planned training, and continue with induction and supervision. The lack of training, induction or supervision affects the abilities of staff to provide good care to people with complex needs. The manager must also register with the Commission. This will ensure that the manager has gone through a process of selection that deems him fit to provide good leadership, based on sound knowledge and skills. This would protect the people using the service from harm and ensuring they receive the best care possible. As planned the manager must continue to extend the quality assurance system too include staff, the people using the service and their advocates. This will ensure that the quality of care is monitored and services to the people living at the home are continually improved. 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. The summary of this inspection report can be made available in other formats on request. Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The people using the service were confidant that their care needs had been assessed and that their needs could be met, right from the start of their stay in the home. The services provided did not include intermediate care. EVIDENCE: We looked at four people’s individualised files, which held a range of information. At previous unannounced random inspections the provider had invested in a new process of recording initial assessments of peoples needs. Staff had been completing assessment documents for people new to the service and for those people who had lived at the home for some time. These documents showed, that people had been assessed outside of the home and the range of people needs had been considered. The initial assessments also informed the individual plans of care, providing a range of information to staff including more detailed information on peoples Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 10 needs preferences and choices. Information was captured on other documents such as charts and this had not always been transferred to initial care plans. There was limited evidence of the people using the service or their relatives/advocates seeing and being part of the homes initial assessment or initial care plan. The manager stated that he had continued to extend the admission procedure and intended to include the person using the service and their advocates in this process. The members of Staff spoken too were clear about the needs of the people using the service and how peoples needs could be best met. Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People using the service had their health, personal and social care needs met and this was set out in an individualised plan of care. Individuals were not involved in decisions about their lives, and did not play an active role in planning the care and support they received. People were treated with dignity and respect and their privacy was upheld EVIDENCE: We looked at records, related to the care of the people living in the home, on several visits to the home. Documents had in the past been poorly completed and gave very little information about the needs of the people using the service or how those needs were being met. Despite the purchasing of a new computerised system for assessment and care planning improvements in recording had been slow and inconsistent. At this visit to the home individualised files had been updated and included care plans, risk assessments, manual handling assessments, weight charts and pressure area care charts. The care plans examined were more fully Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 12 completed and were much more focused on what was important to the person receiving the care. Care documents were generally improved in that they were now more consistently signed and dated. Reviews of documents had been completed in more detail capturing changes in peoples care needs. Daily reports highlighted care being given and had continued to improve in that more specific information had been recorded. However, this was not always consistently completed. The manager said he was aware that the staff team continue to work on fully completing all documents so that all information is consistently recorded. Care plans, assessments and daily reports did not show how the people using the service or their advocates were actively involved in decisions about their care. It was not clear if or how people were supported to make choices about how they were cared for. For example it was not clear if people had chosen to eat in the lounge or had been placed there by staff. We observed staff spending time discussing the needs of the people using the service, as morning staff shared information to staff coming on duty. The members of staff were able to describe peoples individualised needs in a much more relaxed and detailed way, than previously observed in the home. One survey completed by a health professional said that on their visits to the home they had observed that individual’s health care needs were always met. Nine surveys from relatives and carers said that the care needs of the people using the service were usually or always met. The people using the service said that staff treated them with kindness and respect, taking into account their privacy. The manager said that further changes in how members of staff dispensed medicines had been started so that medication was administered more safely. He said that this had included changing pharmacist and obtaining through the pharmacist additional equipment such as a new medication fridge and medicines trolley. The home had a medication trolley on each floor and staff said that medication was dispensed from the trolley to the person using the service. We observed members of staff administrating medication and this appeared to take a long time (over an hour). This meant two nurses were not available to fully concentrate on doing other things for this time. It also meant that some people had their medication at different times and there did not appear to have been any discussion with the person receiving the medication that this was acceptable to them. Medication records were well completed, showing that staff had signed to say when medication had been dispensed. Other medication records also well Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 13 completed were a drugs disposal record and a controlled drugs record. The homes policy and procedures on medication was in the homes staff policy manual. Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People’ s lifestyle in the home met their expectations and satisfied their needs. People who used the services were able to make choices about their life style, and were supported to develop their life skills. Social, educational, cultural and recreational activities met individual’s expectations. People enjoyed an appealing, varied diet, at a time that suited them, with support from staff. EVIDENCE: The homes manager said that the activities available to people living at the home centred on different regular visiting entertainers. In the past a range of activities were available inside and outside of the home for example Bingo, movement to music, outings and a craft evening. Some of those activities had not been available for some time and the homes Annual Quality Assurance Assessment lists this as an area, which the home wished to extend and improve upon. Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 15 Care plan and assessment information had been extended to include more information on people’s personal preferences and choices. Care plans also gave a brief social history or refer to past interests such as hobbies or if they attended church. These records had not been extended to information on how individual social needs are met by the home. Records did not make clear what activities people had participated in or how activities were structured around individual needs: for example memory games for people with poor memory recall. The manager said that daily routines in the home, for example getting up in the morning and when going to bed had been changed to a more flexible relaxed routine to accommodate peoples choices. Staff also confirmed that routines in the home had changed and that they were getting familiar with new practices and procedures. The previous manager has also submitted to the Commission prior to the inspection action plans which detailed how the home intended to continue to maintain flexible routines and peoples choice. The new manager said that he had continued to support a more flexible relaxed approach based on individual’s choices and preferences. Throughout the inspection people were observed receiving visits from family and friends. Relatives spoken too said that they felt welcomed into the home at any time. The people using the service said that they regularly received visits from family and friends. Sometimes a record was made in the daily ongoing records of those people who had received visitors in the home. This was not consistently completed for all those people living at the home and their visitors. We spent some time in the homes kitchen in discussion with the homes cook, and examined a range of documents that gave information about the choices of foods available to the people living at the home. The food stored in the kitchen and the menu plans indicated that a range of foods were available for people. The cook confirmed that if people did not want the meal on the menu plan an alternative could be offered such as soups, omelettes, cold meats etc. The cook also referred to written lists that showed peoples special diets and some preferences. Most of the people spoken too said that the food was fine. Members of Staff and the cook confirmed that people can choose were they eat, and people were observed taking meals in the homes’ dining rooms, lounges or in their private rooms. The dining room was not a welcoming area in that decoration and furnishings had become worn and “tired looking”. The manager said that he had noticed that not many people chose to eat in the dining room and to improve this area he had ordered tablecloths and table decorations to brighten the room. Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People who used the service were able to express their concerns, and complaints and suggestions from those using the service, relatives or other visitors to the home were treated seriously. People were protected from abuse, and had their rights protected. EVIDENCE: We have been working closely with the home’s owners, previous manager, a private consultant and the new manager to improve services to the people living in the home and to protect people from abuse and harm. This had resulted in the homes manager and owners addressing a number of areas that had placed people at risk and were in breach of Regulations and Standards. While the home was addressing these issues the home was restricted in admitting people through Plymouth Social Services. Many of the areas highlighted throughout this time have now been addressed or partly addressed. Detailed action plans and regular updates on how the home is continuing to progress had been submitted to the Commission prior to our visit to the home. The manager had recently dealt with a serious incident of theft. The manager had been altered by one of the people living at the home and taken appropriate action to raise those concerns with the authorities. Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 17 The service users guide stored in individual’s rooms, included a complaints procedure and the people living at the home and their relatives confirmed that they felt able to raise concerns with the staff on duty or the homes manager. Members of staff and relatives said that they would be able to bring any concerns to the attention of the manager who would deal affectively with any problems, worries or issues. Nine surveys from relatives and visitors to the home said that they knew how to make a complaint and that the care service usually or always responded appropriately if concerns had been raised. People were protected from abuse as all staff employed at the home had been subject to thorough recruitment checks, such as criminal record checks and employment/personal reference checks. The owner said that all staff had now received training on abuse and adult protection/safeguarding issues. Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People lived in an adequately maintained house, which offered a range of facilities and was comfortable, clean and safe. EVIDENCE: We noted that the progress made in the improvements in the standard of accommodation had been maintained. Some people’s rooms required new floor covering/carpet, as it appeared worn and faded. The owner confirmed that this was planned for the future, as part of the ongoing maintenance of the home. We noted that the home, including peoples private rooms were clean and had been personalised with photographs and small furnishings. In bathrooms, toilets and peoples rooms there were aprons, gloves and cleaning agents for staff to use, to prevent the spread of infection. Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 19 The arrangements for the domestic staff remained unchanged since the last inspection; that is, a team of four worked to cover the home seven days a week to ensure it was kept clean and fresh. The domestic staff working hours covered from 7am to 3pm daily. Rooms were vacuumed, dusted and sinks and en-suits cleaned and a disinfectant mop used over the floor areas. Carpets were professional cleaned on a regular basis. The light coloured carpets in individuals rooms showed signs of wear and some slight staining. At the previous visit to the home risk assessments for the premises including health and safety issues such as the restricting of window openings, measuring water temperatures and guarding radiators, had been developed. The owner confirmed that these documents remained in place and had been updated. In this and previous visits to the home we noted that a large number of people nursed in bed had bed rails and bumpers fitted to their beds. The reasons for this was detailed in some peoples assessments and care plans but did not extend to all those people with beds fitted with rails. The use of bed rails should be recorded and assessed, to match individuals needs and wishes, as they may be used as a form of restraint. The manager said that all bed rails had now been fitted correctly and that records would be fully completed. Overall we noted a continued improvement in the standard of accommodation now available. Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The people using the service, were supported by Staff, who were trained, skilled and competent. Staff had been subject to rigours recruitment checks EVIDENCE: Staff surveys consistently said that staff had received an introduction into the home and that they had enough support from the manager to begin work with people. Staff surveys also consistently said that staff received formal and informal supervision with the manager or a senior member of staff. Staff supervision and introduction into the home have been processes that had been started, had stopped and have now been re-started. The manager said that he was aware that staff induction and supervision needed to continue in a more consistent way. To achieve this a new system of delegating supervision and induction to senior staff had been started. Staff training had improved since the last inspection visit. The manager said that most staff had now completed training in moving and handling and that further training was planned for the future. Planned training included, infection Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 21 control, medication administration, health and safety, first aid, wound care, and how to care for someone with a peg feed. We examined staff files, which had a range of documents in, including application forms and contracts of employment. There were significant improvements in recruitment records for example police checks and references for new staff had been consistently completed. The manager and administrator had developed clear processes, to enable them to check that all documents were in place, before starting a new member of staff at the home. Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People lived in a adequately managed home, with the management, administration and staff team, working together to provide a safe environment that respected and protected peoples’ rights. EVIDENCE: The owner said that the current manager of the home had a range of experience, knowledge and skills that would equip him to manage the home effectively. The manager had not been registered with the Commission and so had not undergone the Commissions process for recruitment checks. Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 23 The owner produced a file for the manager that included employment records and included background information supplied by the manager, which had been checked. Surveys from staff were positive about the new managers skills and abilities. There had been continued improvement in several areas in the home, as detailed throughout this report. The manager and provider had addressed or partly address previous failures under the regulations and standards under the Care Standards Act 2000. For example recording keeping, maintenance and hygiene practices, recruitment practices and staff training had continued to improve. The owner confirmed that the procedures for managing peoples finances had been maintained so that receipts had been kept, itemised and personalised for the individual. Records were examined that showed how peoples finances were monitored and audited. Records also showed that those people who did not wish to manage their own money or have the home support them had financial support outside of the home, for example through solicitors and relatives. Some quality assurance checks had been completed. A folder containing quality audit checks in key areas such as cleaning had been formulated at the previous visit to the home. The manager said that this was the start of a quality assurance system that would include staff, the people using the service and their advocates. Staff surveys highlighted continued concerns at the use of divan beds for those people who have difficulty getting in and out of bed. The use of divan beds meant that members of staff were bending over for long periods and that they were unable to use hoist equipment. No written risk assessment for the use of divan beds had been completed. This presented as a risk to members of staff and to the people using the service. The owner confirmed that some of the divan beds had been replaced and the manager agreed that assessments covering the use of these beds would be completed. Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 24 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 2 x x x N/A 2 x x x x x x 2 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 STAFFING Standard No Score 27 2 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x 3 x x 2 Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 25 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 OP12 Regulation 16 Requirement The registered persons must ensure that people are consulted with and have a choice to participate in activities, based on people’s interest’s and/ their needs. Staff must receive consistent training in key areas such as moving and handling, dementia care, first aid, staff induction. Previous timescale of 01/09/05, 10/08/06, 02/02/07, 21/05/07 not met. Timescale for action 15/08/07 2. OP27 18(1a) 15/08/07 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 OP3 Good Practice Recommendations Continued to extend the admission procedure and assessments to include the person using the service and DS0000003616.V338660.R01.S.doc Version 5.2 Page 26 Warwick Park House their advocates in this process. 2 OP7 Include information in care plan assessment and ongoing records that show how the people using the service or/and their advocates are actively involved in decisions about their care. Continue to fully and consistently complete all documents related to the care of the person using the service. Continue to review the system for medication administration so that medicines are dispensed within a shorter time. Record how people are consulted with about how their medication is administered. Continue to extend activities for people to enjoy in a group or individually. Record the activities that people have participated in The use of bed rails should be assessed and recorded for every person who has a bed rail fitted to their bed. Continue to update people’s rooms with new floor coverings/carpeting. Continue as planned the ongoing supervision and induction of staff. Continue to extend the home’s quality assurance system. 3 4 5 6 7 8 9 10 11 OP7 OP9 OP9 OP12 OP12 OP19 OP24 OP30 OP33 Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Warwick Park House DS0000003616.V338660.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!