Inspection on 02/02/06 for The Warren Nursing Home

This inspection was carried out on 2nd February 2006.

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 14/12/05

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 2nd February 2006 12:30 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 Nursing Home DS0000026727.V274165.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. The Warren Nursing Home DS0000026727.V274165.R01.S.doc Version 5.1 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.V274165.R01.S.doc Version 5.1 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 14th December 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.V274165.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took five and half-hours over one day. The purpose was to focus on key standards covering individual needs, personal and health care, complaints and protection, staffing and management issues. The inspector looked at records, policies and procedures and interviewed staff. Seven residents gave their views of the home to the inspector. Four staff and the manager were interviewed. Prior to the inspection, the Commission received a pre-inspection questionnaire and this data is also incorporated into the report. The people living at the Warren told the inspector at the last inspection that they preferred to be referred to as ‘residents’. Therefore, this term is used throughout the report. What the service does well: The Warren is a well run home. Residents are fully involved in decision making about their lives there. They are confident that staff understand their needs because they are discussed with them and written up in a plan. Health care professionals regularly visit the home to see residents on a needs basis. Residents said “They just sort it out, we get very good care here” The staff are well trained, and understand how to deal with complaints and how to protect residents. Residents said, “there are no complaints” and “It’s tip top here”. Appropriate checks are done when new staff join the team, which ensures that residents are protected. The home has safeguards in place to ensure that residents’ personal money is correctly managed. Health and safety issues take priority. Everyone, residents and staff alike are made aware of procedures such as what to do in the event of a fire. Equipment in the home is well maintained. The Warren Nursing Home DS0000026727.V274165.R01.S.doc Version 5.1 Page 6 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.V274165.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 The Warren Nursing Home DS0000026727.V274165.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): 3,6 The admissions process is well managed ensuring that resident’s needs are assessed prior to moving into the home. Intermediate care is not currently provided at the Warren. EVIDENCE: Three residents’ assessments were inspected. The home’s assessment process and documentation is good, ensuring that comprehensive information is known about people moving into the home. The person in charge verified that where possible the manager visited people prior to their move into the home. The statement of purpose for the home verifies that an intermediate care service is currently not provided at the home. The Warren Nursing Home DS0000026727.V274165.R01.S.doc Version 5.1 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): 7,8,10 Individual care plans have been developed, whereby resident’s personal, social and health care needs are identified and planned for. The privacy and dignity of resident’s is maintained. EVIDENCE: Three care files were inspected. Care plans were set out in a logical format, with action, goals and reviews clearly stated. Evaluations showed that care had been appropriate and successful in meeting resident’s needs. Input from the Parkinson’s disease nurse specialist had been sought for a resident, and it was clear from the records that the team had implemented advice given. Risk assessments covered a wide range of issues such as falls, manual handling and tissue viability. All had been regularly reviewed, and strategies for minimising risks were clearly outlined in care plans. Residents told the inspector that the home had good links with healthcare professionals. One person said “They just sort it out, we get very good care here”. The visitors signing in book also verified this. Over the previous week a number of professionals had visited the home and included GP’s, Nurse Specialists, and a Physiotherapist. The Warren Nursing Home DS0000026727.V274165.R01.S.doc Version 5.1 Page 10 The inspector observed that staff treated residents respectfully, and seen knocking on doors before entering bedrooms. All of the residents who were able said that they felt their privacy and dignity was maintained. The Warren Nursing Home DS0000026727.V274165.R01.S.doc Version 5.1 Page 11 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): None EVIDENCE: The Warren Nursing Home DS0000026727.V274165.R01.S.doc Version 5.1 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): 16,18 The Warren has a satisfactory complaints process with evidence that resident’s views are listened to and acted upon. Residents are protected from the risk of abuse or harm by well-informed staff. EVIDENCE: Residents spoken to felt that they could talk to the manager, owners or staff about any issues of concern. They went on to tell the inspector “there’s no complaints” and “it’s tip top here”. Staff spoken to were confident that concerns would be dealt with in a professional manner. One person commented, “Complaints are always taken seriously and are not seen as being negative. People always receive feedback on how it [the investigation] is progressing. The complaints procedure is displayed in the hallway.” All of the staff spoken to were aware of the Alerter’s guide and Protection of Vulnerable Adults procedure. A member of staff told the inspector that abuse issues are covered in the NVQ level 2 and 3 awards in care. A new member of staff verified that they had done a comprehensive induction course, which had made them aware of what constituted abusive practice and how they should report it under the whistle-blowing policy of the home. The Warren Nursing Home DS0000026727.V274165.R01.S.doc Version 5.1 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): None EVIDENCE: The Warren Nursing Home DS0000026727.V274165.R01.S.doc Version 5.1 Page 14 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): 29 The home had followed it’s own robust recruitment procedures, thus ensuring that residents are protected. EVIDENCE: The inspector saw that the home’s recruitment procedure had been followed when three staff files were inspected. Satisfactory references, including CRB and POVA checks had been obtained prior to the employment of the new staff. One carer said that they had received an excellent induction, and that they felt well supported by senior staff. The Warren Nursing Home DS0000026727.V274165.R01.S.doc Version 5.1 Page 15 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): 31,33,35,38 The Warren is well run by a suitably qualified manager. The safeguard to ensure residents’ personal monies is correctly managed and is robust. Quality assurance systems are in place to take account of staff and residents views. However, these need to be developed further to fully meet the regulatory requirements. The health and safety of residents and staff is promoted and prioritised at the Warren. EVIDENCE: The manager showed the inspector written feedback from North Devon College that verified that she had achieved the Registered Manager’s Award and NVQ level 4 in management. The manager told the inspector that no progress had been made with regard to collating and reporting quality assurance measures, but advice was being sought from a specialist consultant about this. In view of this the inspector The Warren Nursing Home DS0000026727.V274165.R01.S.doc Version 5.1 Page 16 agreed to extend the timescale so that the home would be able to meet this requirement. From discussions with residents and staff, it was clear that feedback is sought in a number of ways and is acted upon to improve the services in the home. Residents told the inspector that the kitchen and care staff always ask them for feedback about the meals served to them and make changes where needed. Minutes of meetings verified that these are regularly held with staff. An annual meeting had been held to which relatives had also been invited, but the manager said that the team had been disappointed this year with low attendance levels. Relatives are also invited to seasonal events such as the annual pancake race and are used for discussion and expressing views. The inspector examined three records and storage of residents’ monies at the home. The majority residents were able to manage their own finances with the help of their families. The home had a petty cash system, into which residents pay in or take out cash. The records were itemised and clear. Receipts had been kept for any items bought on behalf of residents. An audit of receipts against records found that there were no discrepancies. The storage of these records and money was secure. The manager told the inspector that changes had been made to the system run by the home following government guidance to prevent fraudulent activities occurring. A health and safety audit had been carried out by an external consultant for the home. Recommendations made in respect of one bedroom window restrictor, which was not working, had been addressed. The electrical system had been inspected and a compliance certificate was seen. Engineer’s reports showed that regular maintenance was carried out to the lift, hoists and other equipment, including fire precautionary equipment, in the home. Manual handling training had been provided for staff during 2005, and certificates were seen on three personnel files. Fire training had been provided for all staff by an external trainer in 2005. A member of staff told the inspector “Everyone had to do the first aid training. Records are kept and as soon as it runs out you have to go and have an update. It’s mandatory.” Accident records were seen, and had been regularly audited by the manager. The Warren Nursing Home DS0000026727.V274165.R01.S.doc Version 5.1 Page 17 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 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x x 3 The Warren Nursing Home DS0000026727.V274165.R01.S.doc Version 5.1 Page 18 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 OP33 Regulation 24(2) Requirement The registered person shall supply to the Commission a report in respect of any review conducted by him for the purposes of paragraph (1), and make a copy of the report available to service users. Timescale for action 30/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Warren Nursing Home DS0000026727.V274165.R01.S.doc Version 5.1 Page 19 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 The Warren Nursing Home DS0000026727.V274165.R01.S.doc Version 5.1 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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