Inspection on 14/11/07 for The Warren

This inspection was carried out on 14th November 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Warren 06/06/06

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE The Warren 157a Wroxham Road Sprowston Norwich Norfolk NR7 8AF Lead Inspector Alan Buttery Unannounced Inspection 14th November 2007 10:30 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 The Warren DS0000067710.V354878.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. The Warren DS0000067710.V354878.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Warren Address 157a Wroxham Road Sprowston Norwich Norfolk NR7 8AF 01603 426170 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) www.barchester.com/oulton Barchester Healthcare Homes Limited Mrs Carol Norton Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (44) of places The Warren DS0000067710.V354878.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th June 2006 Brief Description of the Service: The Warren provides personal care for up to 44 elderly people. All of the bedrooms are single. The homes accommodation, communal areas and administrative areas are all located on the ground floor. The Home extended the property last year to add a further thirteen bedrooms all with shower ensuite facilities. The home is located in a suburban area of Norwich. It is set back from the main road in secluded grounds. The garden extends around the building and outside seating is provided on the lawn. There are pleasant flowerbeds and mature trees. To the front of the home there is a large area for parking. The Warren is owned and operated by Barchester Healthcare. The fees charged by the home depend on individual need, and the room available, but start at £580.00 per week. A copy of the most recent inspection report is available on request, and included with brochures sent to prospective new admissions. The Warren DS0000067710.V354878.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit and looked at the key standards for older people. As part of the inspection process an annual quality assurance assessment was completed by the manager of the service, and a large number of comment cards returned by people living in the home, and the information in these is reflected in this report. All rooms in the home are currently occupied, and a full staff team is in place. During the inspection we spoke to some of the residents and to staff on duty, and in addition received a large number of surveys for staff, relatives and residents, and the report reflects the comments received. What the service does well: What has improved since the last inspection? Since the last inspection, new care plans have been introduced which provide better information for the care staff supporting the residents, but don’t show how the individual residents were involved in their preparation. The home now has a wider range of evening snacks available, and recent changes to the menu have improved the choices available to the people living in the home. The home is now seeking a 5star commendation within the group for its dining facilities and menus. Plans for the coming year include a greenhouse and sensory garden, and revisions to the lounge and office facilities, and o the laundry area. It is also hoped a new conservatory will be built. The Warren DS0000067710.V354878.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Warren DS0000067710.V354878.R01.S.doc Version 5.2 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 The Warren DS0000067710.V354878.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3 4, 5 and 6 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Detailed information is available to anyone looking to move into the home, and the service ensures full assessments are undertaken before anyone can move in to ensure that all identified needs can be met. The Warren DS0000067710.V354878.R01.S.doc Version 5.2 Page 9 EVIDENCE: The home is owned and operated by a large provider and follows there policies and procedures for the admission of new residents. During our visit, we looked at the records for 3 of the people living in the home, including one person who had recently moved to the home. The records seen clearly demonstrated that the procedures are being followed, and that before anyone moves into the home a detailed pre admission assessment is carried out, which wherever possible includes a visit to the individual in their own home or in hospital, a visit to the service by the prospective resident and/or family members, obtaining any local authority assessment information available and other important information. This enable the service to be clear that they are able to meet the identified needs of any individual moving to the home. On the day of admission, the person arriving at the home receives a welcome pack, with detailed information about the home and the facilities and service available, and contractual details are confirmed. The initial stay is always on a trial basis to ensure all parties are happy with the arrangements made. The home does not offer intermediate care. The Warren DS0000067710.V354878.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Although individual plans have detailed information, they do not show how the person they relate to has contributed. The Warren DS0000067710.V354878.R01.S.doc Version 5.2 Page 11 EVIDENCE: Following the initial assessment process referred to above, and the service being satisfied that they are able to meet the individual needs identified, initial care plans are prepared. Since the last inspection, a new format for the individual plans has been introduced, and again evidence was seen on the individual files examined. This clearly showed that the plans took into account the person’s individual likes and dislikes, and their social history and background. The initial plans are reviewed within the first few days, to ensure that the information is correct, and the plans suit the person, and then reviewed at least once a month. The plans takes into account both health and social care needs, but the new format of care plan did not demonstrate sufficiently evidence of involvement from individuals and their families. People living in their home are all registered with a local GP practice, and where they previously lived in the local area, have retained their own GP. In addition, the home receives support from district nurses and other health professionals where needed. The service has a detailed policy on medication, and ensures any staff member responsible for administering medication has the necessary training and competency checks. At the present time, two people living in the home are able to manage their own medication. This is kept in locked units in their room, and staff regularly monitor the individuals concerned, to ensure medication is being taken. In addition, risk assessments are in place to ensure the safety of the arrangements, which are kept under review. The arrangement appears to work well, although some delays in receiving prescriptions were noted in survey forms returned by residents and family members. The Warren DS0000067710.V354878.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Varied activities are available for those that wish to participate, which often include friends and families, and food offered is of good quality with choice and variety available. EVIDENCE: The individual care plans and social backgrounds have been used to identify the likes and dislikes of people living in the home, and a wide range of activities are provided to meet these. Among the day to day activities available are art and craft sessions, musical entertainment, quiz sessions, a bridge ‘club’ and theatre trips, and recent events have included a fish and chip supper, and a Halloween night. With Christmas approaching, planned events include trips to see the Christmas lights, a carol service, a visit by a local choir and a Christmas tea, and along with other activities and events mentioned above, families and friends are welcome to attend these. The Warren DS0000067710.V354878.R01.S.doc Version 5.2 Page 13 An example of how the home tries to meet individual needs was also seen, with one male resident accompanied to a local Pub once a week to a jazz night. The staff member who normally goes with him is the home maintenance man. The individual assessments ensure that the spiritual needs of people in the home are met and a monthly church service held in the home. In addition, one survey returned identified that the person is also able to take communion in her room when she wishes to. Other surveys, particularly from relatives indicated where although always asked, people are not pressurised into taking part in activities, and able to spend time quietly in their own room, watching television or reading. The residents we spoke to during the inspection all felt the food was of a high standard, and during the visit, lunch was being served. A varied menu is produced and the people living in the home are able to make choices from the menu at their table. The dining room is a particularly pleasant room, well laid out, with tablecloths and flowers on the small tables. Lunch is a social event, and it was noted that a number of people remained at their tables after lunch, talking to friends. Many of the survey reports received by us also commented on the standard of food, for example one said the ‘food was usually very good, plenty of it and well prepared’ The Warren DS0000067710.V354878.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Standards 16 and 18 This judgement has been made using available evidence including a visit to this service. Appropriate procedures and training are in place to ensure comments, complaints and allegations are appropriately dealt with. EVIDENCE: As part of a large organisation, the service has a detailed complaints procedure, which is made available to everyone living in the home and to their families, and which is also available in the home’s reception area. In the last year, one major complaint has been investigated with the CSCI, and resolved, and the Annual Quality assurance assessment indicated one other complaint received, again resolved. All staff receive training to ensure they are aware of the procedures to be followed in the event of any allegations of abuse being made, which is included within the services induction training and annually thereafter. One POVA referral has been made this year, which was `dealt with in line with the procedures, resulting in a member of staff being dismissed, and a referral made to the POVA list for the person concerned. The Warren DS0000067710.V354878.R01.S.doc Version 5.2 Page 15 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): Standards 19 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The accommodation provided to those living in the home is of good standard, homely and well maintained. EVIDENCE: Shortly before the last inspection, the building work on a large extension was finished, and this is now fully utilised, offering spacious, well maintained and well presented facilities for the people living there. Further plans are in place top extend the lounge facilities with the addition of a conservatory, and to have a greenhouse and sensory garden accessible to the people living in the home. In addition, the updating of some of the original rooms in the home will continue. . The Warren DS0000067710.V354878.R01.S.doc Version 5.2 Page 16 On the day of our inspection, the home was clean, and no unpleasant smells were noted, and the home has dedicated domestic staff in post to ensure the high standards of cleanliness are maintained. The Warren DS0000067710.V354878.R01.S.doc Version 5.2 Page 17 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): Standards 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Robust recruitment procedures ensure staff are suitable to their role, well trained and competent in meeting the needs of the people living in the home. EVIDENCE: The people living in the home are supported by a dedicated staff team, with a full compliment of staff in post. Many of the service user and relatives surveys returned commented on perceived staff shortages at time over the last few months, and a more flexible working pattern is now in place to try and ensure staff are available at the most appropriate times to meet the needs of the people in the home. The service has a detailed recruitment procedure, and the staff records examined indicate that this is followed, and the records required in place. Staff all receive a high level of training, and this was commented upon by the staff who returned survey forms, and seen from records examined. The service are hoping one of the staff will be trained as an NVQ assessor shortly, which will make the assessment of staff undertaking NVQ training a lot easier in the future. The Warren DS0000067710.V354878.R01.S.doc Version 5.2 Page 18 All staff receive a handbook, which provides details of the terms and conditions of their work, and policies and procedures that they need to follow, and a copy of the revised handbook given to us. The Warren DS0000067710.V354878.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is well managed, and the health and safety of people living and working in the home protected by procedures and training that is in place. The Warren DS0000067710.V354878.R01.S.doc Version 5.2 Page 20 EVIDENCE: The home is well managed, and the registered manager has been in post for a number of years, supported by an experienced deputy manager. The relationship between management and staff appeared good, and staff surveys received were all positive, and happy with the management approach and style. Equally, the surveys received from relatives and from people living in the home all indicated that management in the home was good, and that the registered manager was approachable at all times. A monthly management audit takes place, ensuring issues are quickly identified and met, and regular staff and resident meetings ensure that the views of everyone living and working in the home are taken into account. The service does not hold any personal money for people living in the home, and pays for items such as hairdressing on their behalf, submitting monthly invoices. There is however a fund available for people who need cash for activities or purchases, and which they then repay, ensuring that ad hoc activities can take place. A full time maintenance person is in post and responsible for all aspects of health and safety, and all staff receive appropriate training. The Warren DS0000067710.V354878.R01.S.doc Version 5.2 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 X X 4 4 4 N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The Warren DS0000067710.V354878.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15(1) Requirement Individual plans must show that the person has been involved in their preparation to ensure their views are included Timescale for action 31/03/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Warren DS0000067710.V354878.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 The Warren DS0000067710.V354878.R01.S.doc Version 5.2 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. 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