Inspection on 09/05/06 for Warwick Park House

This inspection was carried out on 9th May 2006.

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 05/07/07

Warwick Park House 16/08/06

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 and Fiona Cartlidge Unannounced Inspection 9th May 2006 06:00 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.V292720.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Warwick Park House DS0000003616.V292720.R01.S.doc Version 5.1 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 Mrs Roberta Carole Davina Quarterman 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), Terminally ill (4) Warwick Park House DS0000003616.V292720.R01.S.doc Version 5.1 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. Date of last inspection Brief Description of the Service: Warwick Park Nursing home is privately owned and is registered to provide care for a maximum number of 50 people of either gender with physical frailty, disability or illness. The home is located in the Honicknowle area of Plymouth and is close to shops and near to a bus route. The home was opened in 1993. It is arranged on 2 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 32 single bedrooms and 9 double rooms, most benefit from en suite WCs. The manager is a 1st Level Registered Nurse who leads a team of nurses, care staff and domestic/catering staff. A registered nurse is on duty at all times. Warwick Park House DS0000003616.V292720.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over a day by two inspectors from 6.a.m in the morning until 5 p.m. The inspectors examined a range of documents including staff and service users files, policies, procedures and the homes service users guide. Service users were spoken too in the homes lounge and in private rooms and members of staff were also spoken with. The homes manager was present throughout the inspection and the homes provider/owner was present in the afternoon to receive feedback from the inspectors. Feedback about the home was also received by post in quality questionnaires provided by the Commission and in discussion with visitors to the home. What the service does well: What has improved since the last inspection? What they could do better: Recording in the home must be improved. Recording in the home is poor. Key documents such as assessments and care plans are not consistently completed, so that members of staff are not fully aware of service users needs or how to meet those needs. This puts service users at risk of harm through failure of staff to carry out tasks needed to meet their needs. More flexible routines based on the choices of service users must be introduced into the home. The routines in the home offer limited choices to service users. The home has no way of monitoring the quality of the service it provides. Staff must not be employed in the home without first undergoing recruitment checks. Staff recruitment practices put service users at risk from those unsuitable to work with vulnerable adults as staff are employed with out proper Warwick Park House DS0000003616.V292720.R01.S.doc Version 5.1 Page 6 checks such as police record checks and references. Staff must undergo training, induction and supervision as there is no/limited evidence of staff having received training, induction or supervision and this affects the abilities of staff to provide care to service users with complex needs. The home must be clean and hygienic. The home is not routinely kept clean or well maintained, examples of this are the poor cleanliness and repair of the kitchen and it’s equipment and the poor repair of commode chairs. Medication practices must be improved so that staff sign for medication and medication is kept safely as failure to do so puts service users at risk of taking medication incorrectly. The provider and manager must respond to the Commissions findings and progress with the area and shortfalls identified as some of the issues raised in this report have been highlighted at previous inspections. 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 House DS0000003616.V292720.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Warwick Park House DS0000003616.V292720.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6 The quality of the outcomes for service users in this outcome area is poor. Prospective service users do not have the information they need to make an informed choice about where to live and service users move into the home without having their needs fully assessed. The home does not provide intermediate care. EVIDENCE: On touring the premises inspectors observed service users guides in service users rooms however these documents had not been updated to reflect changes in the home such as staff changes. There was also no evidence of how the service users guides are made available to potential service users or their advocates/ families prior to living in the home. One service users family said that they had had an opportunity to visit the home before the service user lived at the home, but was unable to confirm that they had any written information about the home. The service users guide and statement of purpose should be made available to potential service users and their advocates so that they have a range of information about the home, which will then inform them about the home and the service and facilities available enabling service users to make a more informed choice. Warwick Park House DS0000003616.V292720.R01.S.doc Version 5.1 Page 9 Inspectors looked at seven service users individualised files, which held a range of information. Initial assessments of service users needs were not consistently well completed in that they did not clearly show when and where they had been completed or the full range of service users needs. This initial assessment is important as it should identify service users needs, so that the manager of the home and the service user can be sure that the home can meet the service users needs. This initial assessment also should inform the service users plan of care, with information missing the care plan cannot be fully completed and may miss vital information, which then affects service users care. The initial assessments examined by inspectors did not include detailed information on service users needs, preferences and choices. Some initial assessments had some information, however this was not transferred to initial or ongoing service users care plans. Staff spoken too were not always clear about the full needs of the service users or how they could be addressed for example; one service users assessments prior to coming into the home highlighted limited communication and explained the use of a communication board. This information had not been transferred into the homes assessment or care plans and staff spoken too were unsure where the communication board was, why it had stopped being used and if the service users could still use this aid. These issues remain outstanding as they have been raised at previous inspections Warwick Park House DS0000003616.V292720.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 The quality of the outcomes for service users in this outcome area is poor. The service users health, personal and social care needs are not clearly set out in an individual plan of care, this makes it unclear if service users health care needs are fully met. The service users feel they are treated with respect and their privacy is upheld. The homes policies and procedures for dealing with medicines do not protect the service users from harm. EVIDENCE: Service users individualised files included care plans, risk assessments, manual handling assessments, weight charts and pressure area care charts. The care plans examined were not well completed in that they missed important information that would impact on service users care, as staff would not be consistently aware of service users needs, for example; service users care plans missed wound care information, information on service users mental health needs and information on dressings and the use of creams. Care documents are generally poorly maintained in that they are not consistently signed, dated or fully completed and reviews of documents have not been completed in detail so do not capture changes in service users care needs. Daily reports highlighted care being given that was not detailed in care plans Warwick Park House DS0000003616.V292720.R01.S.doc Version 5.1 Page 11 or part of a reassessment of needs and was misleading using general terms such as “cream applied”, giving no specific information on what cream was being used or if indeed it had been prescribed. These issues remain outstanding as they have been raised at previous inspections. When speaking to staff who had been employed at the home for some time (years) they were clearly aware of service users overall care needs such as what they eat, if they needed assistance with washing and dressing. However more detailed questioning about service users needs such as why service users were taking certain medication or why they had bed rails fitted to their beds, staff struggled to answer or gave varying answers. The lack of consistent wellmaintained records will affect the staffs ability to care for the full range of service users needs. Service users consistently said that they felt cared for and that staff treated them with kindness and respect, taking into account their privacy. Inspectors observed staff starting to dispense medicines on a medication round at 6 a.m. The medication was administered to service users who had not yet had breakfast and the nurse dispensing the medication was not aware of any system in place in the home to identify if the medication administered should be on an empty stomach or with food. The nurse dispensing the medication had worked through the night and was dispensing medication at the end of her shift. Records of medication being administered were not well completed as staff had not always signed or initialled to confirm medication had been given or disposed of. Inspectors observed that a packet of tablets, were left unattended on top of the medication cabinet. These practices put services users potentially at risk of increased side affects from medication, medication errors by tired staff and medication errors due to a lack of clarity if medication has been given or is yet to be given. The storage and removal of medication was well managed. On the day of the inspection the manager said that she was introducing (that day) changes to the medication system that would improve the safe administration of medicines. Warwick Park House DS0000003616.V292720.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15, The quality of the outcomes for service users in this outcome area is poor. Service users find the lifestyle in the home does not match their preferences, and they are not always helped to exercise choice and control over their lives. Service users social, cultural, religious and recreational interests do not appear to be satisfied. Service users maintain contact with family, friends and representatives in the home and local community. Service users receive a wholesome balanced diet in pleasant surroundings, however the times of meals are not always at times convenient to service users. EVIDENCE: On arriving at the home at 6. a.m. and walking around the home inspectors observed several rooms with service users in bed, fast asleep with the light on and the TV or radio on for no apparent reason. Some service users were wide awake and sitting up and when asked service users said that they had “got used to the early morning starts, particularly as they often went to bed early”. When asked if they wanted to go to bed early and get up early service users said “no”, “got used to it now” and “if it helps staff I don’t mind”. Staff spoken too described routines in the home, rather than personal service users choices about how they spend their time. Staff and the manager did identify one service user who chose the time they got up in the morning and this service user said she got up when she wanted too. Care plan and assessment Warwick Park House DS0000003616.V292720.R01.S.doc Version 5.1 Page 13 information did not include information on service users personal preferences and choices. Some service users records give a brief social history or refer to past interests such as hobbies or if they attended church, however there was no information on how service users social needs are met by the home. No records were available of any activities the service users may have participated in or how activities were structured around individual needs for example memory games for service users with poor memory recall. Throughout the inspection service users were observed receiving visits from family and friends and relatives spoken too said that they felt welcomed into the home at any time. Service users also said that they regularly received visits from family and friends and sometimes this was recorded in the daily ongoing records, although this was not consistently completed for all service users. The inspector spent some time in the homes kitchen (also see environment) in discussion with the homes cook and examining menu plans. The food stored in the kitchen and the menu plans indicated that a range of foods were available for service users and the cook confirmed that if service users 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 service users special diets and some preferences. Most of the service users spoken too said that the food was fine but were not always aware that they had a choice of foods. Staff and the cook confirmed that service users can choose were they eat, and service users were observed taking meals in the homes’ dining rooms, lounges or in their private rooms. When entering the kitchen the inspectors observed that a large pan of porridge with a thick layer of skin on the top was sat on the cooker hob and cereals had been poured into individual bowls on trays in preparation for service users breakfast. When asked staff confirmed that breakfast had been prepared prior to the inspectors arriving at the home –so before 6.a.m and that some service users may not receive their breakfast until much later 7.30 onwards. This means that service users food is prepared and left uncovered for long periods so that food becomes cool and needs to be reheated or becomes soft and tasteless. It also indicates that if staff have planned so far ahead that the choices open to service users will be limited to porridge or cereals. There was no evidence that a snack meal is offered in the evening as the interval between this and breakfast the following morning should be no more than 12 hours. Warwick Park House DS0000003616.V292720.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The quality of the outcomes for service users in this outcome area is poor. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users are not protected from abuse. EVIDENCE: The service users guide stored in individual service users rooms included a complaints procedure and service users 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. Staff described an incident of theft that had been dealt with by the manager as an example of how the manager takes action to address issues that affect staff and service users. The manager had involved the police and had reassured and reimbursed the service users, however this incident had not been reported to the Commission under Regulation 26 of the Care Standards Act as an incident affecting the well being of service users and staff, this potentially leaves service users open to abuse as the Commission may have chosen to investigate further at the time, rather than the home conduct an internal investigation. Service users are not protected from abuse as not all staff employed at the home had been subject to thorough recruitment checks such as criminal record checks and employment/personal references. (See Staffing) In addition the use of bed rails for most service users, without this being part of their Warwick Park House DS0000003616.V292720.R01.S.doc Version 5.1 Page 15 assessment and care plans, could be seen as a form of restraint, which is abusive. Service users and staff were unclear why bed rails were fitted to beds. Warwick Park House DS0000003616.V292720.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22,26 The quality of the outcomes for service users in this outcome area is poor. Service users do not live in a well- maintained environment. Service users have access to specialist equipment but this equipment is not well maintained. Overall the home is pleasant, however there are areas that were not clean or hygienic. EVIDENCE: The inspectors observed that the homes kitchen was dirty, with uncovered foods stored in dirty old fridges that had shelves that had become rusted. The cook had made temporary repairs to fridges and freezers so that doors shut. Foods were not clearly dated in the fridge and a birthday cake for a lady whose birthday was the previous day had been left uncovered, next to uncovered meats. Records of fridge temperatures and cleaning schedules had not been maintained. (Please also see standard 15 daily activities) Some of the service users rooms were in the process of being decorated so service users had moved rooms temporarily. Some rooms were clean and had been personalised with service users photographs and furnishings. Some rooms carpets were stained and in need of cleaning and the homes lounge Warwick Park House DS0000003616.V292720.R01.S.doc Version 5.1 Page 17 carpet was in need of cleaning. Throughout the day the domestic staff improved the cleanliness of the home by hovering and cleaning however on arrival at the home food was left on the lounge floor and the general appearance of the home was untidy. This would indicate that the home becomes less clean as the day goes on and staff were not cleaning as they move around the home. Throughout the home in bathrooms, toilets and service users rooms there were aprons, gloves and cleaning agents for staff to use. In one communal shower room there was two soap bars in one dish indicating that staff are sharing soap between service users this is very poor practice as the risk of cross infection is increased. These issues remain outstanding as they have been raised at previous inspections. The home has a range of specialist equipment including special mattresses and hoist equipment, however two of the specialist mattresses alarms were sounding which staff were observed to ignore, when asked staff did not realise that the alarm may mean that the mattress/bed may not be working correctly. One service user has a divan bed with no backrest, the service user indicated that they would like a back rest. The labelling of communal rooms is misleading for example one shower room is marked as a bathroom, this is confusing for new service users, visitor or service users with dementia. Commode chairs were damaged with ripped backs and chipped plastic, also increasing the risk of cross infection and possible injury to service users. Doors have been fitted with a safe hold open device - following consultation with the fire and rescue department. Warwick Park House DS0000003616.V292720.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27.28,29.30 The quality of the outcomes for service users in this outcome area is poor. Service users needs are not fully met by the skill mix of staff as staff are not consistently supervised or trained. Service users are not protected by the homes recruitment policy and practices. The home has enough staff to meet service users needs. EVIDENCE: Members of staff spoken too said that they felt well supported by the homes manager and had access to training if they wished to attend. Staff also said that they had received an appraisal, which had been completed last year by the deputy manager. The inspectors examined staff files, which had a range of documents in, including application forms and contracts of employment. There were significant shortfalls in recruitment records for example no police checks for two staff, no references for two staff, no records or certification of training no records of induction training (other than a format uncompleted by staff), no ongoing record of staff supervision. This poor practice puts service users at risk from abuse from those who are not suitable to work with vulnerable adults and limits how staff care for service users as they do not have the ongoing formal support and up to date skills to care for service users. These issues remain outstanding as they have been raised at previous inspections. The lack of an ongoing training record for all staff makes it difficult for the manager to monitor, plan, budget or oversee training. The numbers of staff on the day of the inspection and on the staff roster were sufficient to meet service users needs. Warwick Park House DS0000003616.V292720.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,37,38 The quality of the outcomes for service users in this outcome area is poor. Service users live in a home, which is run and managed by a person who is fit to be in charge. The manager and provider have not discharged their responsibilities fully and the home is not run in the best interests of the service users. The service users finances are safeguarded, however the health safety and welfare of service users and staff are not protected. EVIDENCE: The registered manager is an experienced nurse manager who confirmed she has a National Vocational Qualification at level 4 in management. The staff and service users spoken too confirmed that they felt supported by the homes manager and that the manager was helpful, caring and responsive. Since the last inspection concerns were raised about the manager’s attitude in correspondence to the Commission, as part of two complaints that had many components to them. Some of the areas of the complaints were upheld while other areas were not upheld. Warwick Park House DS0000003616.V292720.R01.S.doc Version 5.1 Page 20 Throughout the inspection, as detailed throughout the report the manager and provider have failed to meet regulations and standards under the Care Standards Act 2000 potentially putting service users at risk and not protecting their health, welfare or safety, for example recording keeping, recruitment practices, poor maintenance and poor hygiene practices. Inspector’s observed fixed routines in the home that offered limited choices to service users such as getting up and going to bed. Inspectors observed staff hand over from the evening shift to the morning shift by a trained nurse to the manager and care and domestic staff. The hand over of information was very impersonal, task and routine orientated with little personalisation of care, or a picture of the whole person for example; expressions like “bowels open” and “fine”. When asked staff confirmed that this was how the handover was usually conducted. Service users financial records were examined and found to be well recorded with receipts in place for items purchased on behalf of service users. Items of value, which had been stored for safety were not recorded in a formal easily readable way. Some receipts were joint receipts for example chiropody and hairdressing and these should be itemised and personalised for the individual service user. The manager failed to report an incident to the Commission under Regulation 26 of the Care Standards Act as an incident affecting the well being of service users and staff. Warwick Park House DS0000003616.V292720.R01.S.doc Version 5.1 Page 21 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 2 X 1 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 2 X X 2 X X X 2 STAFFING Standard No Score 27 2 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X 2 X X 2 Warwick Park House DS0000003616.V292720.R01.S.doc Version 5.1 Page 22 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 OP4 Regulation 14 Requirement The registered person must confirm in writing to the person having regard to the assessment that the care home is suitable for meeting the individual’s needs in respect of their health and welfare. Previous timescale of 01/09/05 not met Detailed Initial assessments of service users needs must be completed prior to service users living at the home. A detailed service users care plan based on the assessed need of individual service users must be formulated and made available to staff. Residents plans of care should be reviewed at least once a month and updated to reflect changing needs and current objectives. Medication procedures including the recording of medication must be reviewed and updated to safeguard service users from harm The registered person must ensure that service users are DS0000003616.V292720.R01.S.doc Timescale for action 10/08/06 2 OP4 14 10/08/06 3 OP7 14,15 10/08/06 4 OP7 14,15 10/08/06 5 OP9 13 10/08/06 6 OP14 12 10/08/06 Warwick Park House Version 5.1 Page 23 7. OP15 16(i) 8. OP17 13(7) 9. OP18 13(6) 10 OP18 37(1&2) 11 OP26 12,13 enabled to make choices in respect of the care they are to receive and their health and welfare; This relates to the lack of choice the service users have in the routines in the home A snack meal must be offered in the evening and the interval between this and breakfast the following morning should be no more than 12 hours. Previous timescale of 01/09/05 not met The registered person shall ensure that no service user is subject to physical restraint unless restraint of the kind employed is the only practicable means of securing the welfare of that or any other service user and there are exceptional circumstances. Where restraint is used this should be done so after multi disciplinary consultation and regularly reviewed by all concerned in the process. This relates to the use of bed rails Previous timescale of 01/09/05 not met The registered person must ensure that all staff receive training and regular updates to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. Previous timescale of 01/09/05 not met Any event which adversely affects the well-being or safety of any service user must be reported to the Commission as required by this regulation. Previous timescale of 01/09/05 not met The kitchen must be cleaned, new equipment purchased and schedules of cleaning and recording temperatures must be DS0000003616.V292720.R01.S.doc 10/08/06 10/08/06 10/08/06 10/08/06 10/08/06 Warwick Park House Version 5.1 Page 24 12. OP26 13(3) 13. 14. OP26 OP27 13(3) 18(1a) 15. OP29 19 16. OP30 18(1c) implemented. The registered person must ensure soap-bars are not shared. Previous timescale of 01/09/05 not met Cleaning schedules should be in place to ensure the home is clean, hygienic and odour free The registered person must ensure that at all times there are suitable qualified, competent and experienced staff in the care home as appropriate to meet all of the health and social care needs of all persons living in the home. (see also standard 18) Previous timescale of 01/09/05 not met The registered person must not employ a person to work at the care home unless the person is fit to work at the care home; and he has obtained in respect of that person the information and documents specified in paragraphs 1 to 7 of schedule 2 and is satisfied on reasonable grounds as to the authenticity of the references referred to in paragraph 5 of schedule 2 in respect of that person. Previous timescale of 01/09/05 not met The registered person must, having regard for size of the care home, the statement of purpose and the number and needs of service users ensure that persons employed by the registered person to work at the care home receive - training appropriate to the work they are to perform and suitable assistance, including time off, for the purpose of obtaining further qualifications appropriate to such work. Previous timescale of 01/09/05 not met DS0000003616.V292720.R01.S.doc 10/08/06 10/08/06 10/08/06 10/08/06 10/08/06 Warwick Park House Version 5.1 Page 25 17 18 OP30 OP33 18 24 19 OP38 12,13, Staff must receive induction training that meets National Training Organisation Ensure there is a system for monitoring the quality of the services provided and which service users are involved in. Systems must be put in place to ensure the health, safety and welfare of service users. 10/08/06 10/08/06 10/08/06 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. 2 3 Refer to Standard OP1 OP26 OP26 Good Practice Recommendations Ensure that the service users guide is updated and provide evidence that it is offered to potential service users and their advocates prior to living at the home. Correct labels identifying rooms should be put in place Commode chairs should be repaired or replaced Warwick Park House DS0000003616.V292720.R01.S.doc Version 5.1 Page 26 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 Park House DS0000003616.V292720.R01.S.doc Version 5.1 Page 27 - 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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