Inspection on 14/12/05 for The Warren Nursing Home

This inspection was carried out on 14th December 2005.

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

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

Other inspections for this house

The Warren Nursing Home 29/06/09

The Warren Nursing Home 28/06/07

The Warren Nursing Home 02/02/06

The Warren Nursing Home 19/01/05

The Warren Nursing Home 23/09/04

The Warren Nursing Home 17/02/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE The Warren Nursing Home Cluden Road Northam Bideford North Devon EX39 3QF Lead Inspector Susan Taylor Unannounced Inspection 14th December 2005 13:00 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 The Warren Nursing Home DS0000026727.V253096.R01.S.doc Version 5.0 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 Nursing Home DS0000026727.V253096.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Warren Nursing Home Address Cluden Road Northam Bideford North Devon EX39 3QF 01237 476932 01237 421214 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) Riverbank Care Limited Mrs Jacqueline Thisby Mrs Laura Jane Hobbs Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places The Warren Nursing Home DS0000026727.V253096.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Notice of Proposal to Grant Registration staffing/environmental conditions of registration was issued 20/4/2001 Registered for 30 - Elderly General Nursing Care. Registered for 2 Elderly Residents Total number registered is 32 Authorised person in charge is Laura Hobbs RGN Date of last inspection 19th January 2005 Brief Description of the Service: The Warren provides 24-hour nursing care to older people. The home is a detached property situated within easy reach of the facilities of Northam, Westward Ho! and Bideford. Originally an older type property it has been converted and also extended to provide accommodation in 21 single and 5 double bedrooms. A passenger lift enables service users to access all areas of the home. There is a car parking area. To the front is a lawn area that is pleasant and easily accessed. Riverbank Care Limited is a member of the Registered Nursing Homes Association, and has achieved the Investors in People Award. The Warren Nursing Home DS0000026727.V253096.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took four hours over one day. Six residents and three visitors gave their views about the home, as did three staff. The focus of the inspection was key national minimum standards covering daily life and social activities, the environment and staffing. In addition to this, legal requirements covering medication storage and infection control measures were followed up. At the last inspection, the people living at the Warren told the inspector that they preferred to be referred to as ‘residents’. This term is used throughout the report. Residents comments included: “we’re so lucky, we were given presents at that party and I’m told we’ll be getting them on Christmas day .. [the registered providers] are so kind to us”. “This is a splendid home. A friend commented to me that years have been taken off me through good care”. “The food is excellent”. “It’s lovely we’re always doing something, we’ve had all sorts of things happening this week in particular”. “The food is excellent they have a good reputation here for it”. What the service does well: The home was festive and had an open atmosphere. Varied and interesting activities to suit individual resident’s expectations, preferences and capacities are provided at the Warren. During the inspection, a large group of residents, their relatives and staff enjoyed a carol service performed by Bideford Choir. Few restrictions exist at the Warren and residents have a great deal of freedom about their lives there. Every effort is made to ensure that residents maintain close links with their families and friends. The week before the inspection, residents had invited their friends and relatives to a Christmas party at the home. Relatives are made to feel welcome when they visit. Meals are varied, appetising and provide residents with plenty of choice and the home is said to have a good reputation for this. Comfortable homely accommodation is provided, and maintained to a high standard. The home has a competent team of staff that are in sufficient numbers to meet the needs of residents. There is a training and development culture that The Warren Nursing Home DS0000026727.V253096.R01.S.doc Version 5.0 Page 6 ensures that residents are cared for by properly qualified and experienced staff. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Warren Nursing Home DS0000026727.V253096.R01.S.doc Version 5.0 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 Nursing Home DS0000026727.V253096.R01.S.doc Version 5.0 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): None EVIDENCE: The Warren Nursing Home DS0000026727.V253096.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 The storage of medicines has improved following the installation of an air conditioning system. This ensures that resident’s healthcare needs are safely met. EVIDENCE: A requirement made at the last inspection was followed up, which meant that standard 9 was not fully inspected. Since the last inspection, an air conditioning system had been fitted in the treatment room to ensure that temperatures are kept within acceptable limits. The inspector was shown a contract for the disposal of medication. ‘Doop’ containers were also seen, which the home is using to dispose medication that is no longer being used and this meets pharmaceutical requirements for registered homes providing nursing care. The inspector saw that gels and creams were labelled. An audit of the controlled drug register was done, and balances found to tally with those in the register. Mar charts were filled in correctly. The Warren Nursing Home DS0000026727.V253096.R01.S.doc Version 5.0 Page 10 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 There are varied and interesting activities to suit individual resident’s expectations, preferences and capacities at the Warren. Few restrictions exist at the Warren and residents have a great deal of freedom about their lives there. Residents are enabled to maintain close links with their families and friends. Meals are varied, appetising and provide residents with plenty of choice. EVIDENCE: The inspector met an activities organiser who is employed for 30 hours per week. The organiser told the inspector that they had attended a training session that had helped them develop a good activity programme for residents. In addition to this, the organiser said that the home is a member of NAPPA an organisation that promotes appropriate activities for older people. Assessments had been done with residents and their families using the ‘Pool Activity level instrument’. This had enabled staff to then arrange activities at the right capability and interest level for each individual. During the afternoon, the Bideford choir arrived and the inspector joined a large group of residents, relatives for a carol service. Residents told the inspector that during the week they had attended an in house pantomime and had a Christmas party to which they had invited their families and friends. The Warren Nursing Home DS0000026727.V253096.R01.S.doc Version 5.0 Page 11 Residents said “we’re so lucky, we were given presents at that party and I’m told we’ll be getting them on Christmas day .. [the registered providers] are so kind to us”. “This is a splendid home. A friend commented to me that years have been taken off me through good care”. “The food is excellent”. “It’s lovely we’re always doing something, we’ve had all sorts of things happening this week in particular”. “The food is excellent they have a good reputation here for it”. Two relatives comments were positive and included: “This is the best home, it’s wonderful. I’m always made welcome, and offered meals at no extra charge” A four week menu was seen, and records of meals provided. Residents told the inspector that alternatives were offered at every meal. The Warren Nursing Home DS0000026727.V253096.R01.S.doc Version 5.0 Page 12 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): None EVIDENCE: The Warren Nursing Home DS0000026727.V253096.R01.S.doc Version 5.0 Page 13 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): 19,26 Residents live in comfortable accommodation that is suitable for their needs and is maintained to a high standard. Infection control procedures are evidence based, and minimise the risk of cross infection to residents. EVIDENCE: The Warren Nursing Home DS0000026727.V253096.R01.S.doc Version 5.0 Page 14 The inspector saw the newly completed conservatory during the tour of the building. Residents were enjoying the use of this new space, which is light and airy. The home was maintained to a high standard, and spotlessly clean. Routine maintenance had been carried out to the heating, gas & fire precaution systems and equipment. Staff and residents told the inspector that prompt action was always taken in respect of maintenance. The grounds were tidy, and attractive with herbaceous perennials and shrubs. The accommodation provided comfortable, homely fittings and fixtures. Comments from residents were positive about the home: “I’m very satisfied here, the home is clean and warm and beautifully kept.” “The house is cleaned from top to bottom every day.” “We have loads of cleaners in every day”. Written records demonstrated that advice had been sought from the infection control nurse specialist about procedures used in the home with regard to minimising the risk of cross infection. The nurse specialist had confirmed the measures used with the hopper sluice, which were reported upon following the last inspection, are acceptable. The Warren Nursing Home DS0000026727.V253096.R01.S.doc Version 5.0 Page 15 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): 27,28,30 The home has a competent team of staff that are in sufficient numbers to meet the needs of residents. There is a training and development culture that ensures that residents are cared for by properly qualified and experienced staff. EVIDENCE: Residents verified that their needs were well met. Throughout the day staff were observed to have time to carry out their duties. The duty rosters accurately recorded the names of staff, and duties that had been worked. Every shift had been managed by a registered nurse. The pre-inspection questionnaire received by the Commission earlier in the year verified that a wide range of training had been provided. Eleven out of twenty one care staff (52 ) had attained the NVQ level 2 in care. Seven of the care staff had also completed the NVQ level 3 award in care. Another member of staff told the inspector that their training needs had been discussed during supervision and that they would be shortly starting the NVQ level 2. This exceeds the minimum standards. The inspector was shown individual training files, which included certificates for courses undertaken. Staff told the inspector that they felt well supported, and had been supervised and appraised annually. New staff verified that the induction course had included care values, health and safety matters, being supernumery and shadowing senior staff. The Warren Nursing Home DS0000026727.V253096.R01.S.doc Version 5.0 Page 16 The Warren Nursing Home DS0000026727.V253096.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): None EVIDENCE: The Warren Nursing Home DS0000026727.V253096.R01.S.doc Version 5.0 Page 18 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 4 29 x 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x x x x The Warren Nursing Home DS0000026727.V253096.R01.S.doc Version 5.0 Page 19 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. Standard Regulation Requirement Timescale for action 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 Nursing Home DS0000026727.V253096.R01.S.doc Version 5.0 Page 20 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. 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