Inspection on 01/06/06 for Warberries Nursing Home

This inspection was carried out on 1st June 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Warberries Nursing Home 08/08/07

Warberries Nursing Home 10/05/07

Warberries Nursing Home 01/03/07

Warberries Nursing Home 12/01/06

Warberries Nursing Home 02/08/05

Warberries Nursing Home 06/01/05

Warberries Nursing Home 19/10/04

Similar services:

2 Perhaver Park

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Poldhu

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

CARE HOMES FOR OLDER PEOPLE Warberries Nursing Home Lower Warberry Road Torquay Devon TQ1 1QS Lead Inspector Fiona Cartlidge Unannounced Inspection 31st May 2006 10:10 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 Warberries Nursing Home DS0000059901.V292731.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. Warberries Nursing Home DS0000059901.V292731.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Warberries Nursing Home Address Lower Warberry Road Torquay Devon TQ1 1QS 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) 01803 294563 01803 292219 warberries@yahoo.co.uk Red Healthcare Ltd Miss Vasanta Marni Suddock Care Home 28 Category(ies) of Dementia - over 65 years of age (2), Learning registration, with number disability over 65 years of age (1), Old age, not of places falling within any other category (14), Physical disability over 65 years of age (14) Warberries Nursing Home DS0000059901.V292731.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Dementia over 65 years of age (2), Learning disability over 65 years of age (1), Old age, not falling into any other category (14), Physical disability over 65 years of age (14) and 1 service user under the age of 65 years (named elsewhere) 12/01/06 Date of last inspection Brief Description of the Service: The Warberries is a large extended Victorian property, situated in a quiet residential area of Torquay. The property has sea views from some rooms and from both communal rooms. The Warberries is currently registered to provide nursing and or personal care to a maximum of 28 residents of either gender who are over the age of 65 years. There is a registered nurse on duty at all times. The home is owned by Mr Mark Titcombe whom is the Registered Provider, day to day management of the home is done by a registered Nurse Manager. The accommodation is provided on 3 floors and is accessed by passenger lift, stair lift or stairs. Adapted toilets and bathing facilities are available for residents. The home has nursing equipment to meet the needs of residents who require nursing. Communal rooms comprise: A large lounge and dining room on the ground floor with sea views and a smaller conservatory area on the first floor. Bedroom accommodation is offered in 24 single rooms, of which the majority have en-suite facilities, and 2 double rooms. Warberries Nursing Home DS0000059901.V292731.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 7hours and 30 minutes and was unannounced. A partial tour of the home took place when some bedrooms and all communal living rooms were viewed. Personal records of care of 4 residents and personnel records of 3 members of staff were inspected. The inspector spoke with 12 residents, 2 staff members the registered manager, provider and administrator. Written feedback was received from 5 residents and 3 care workers and 2 General practitioners. The homes senior staff had also submitted answers to a pre-inspection questionnaire supplied to them by the Commission. What the service does well: What has improved since the last inspection? To minimise the risk of cross contamination, suitable hand washing facilities have been made available for staff in all resident bedrooms these include a liquid soap dispenser, disposable hand towels and pedal bin. Two bedrooms have had en suite facilities fitted. Warberries Nursing Home DS0000059901.V292731.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. Warberries Nursing Home DS0000059901.V292731.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 Warberries Nursing Home DS0000059901.V292731.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Prospective service users are not provided with the information they need to make an informed choice about living in the home. Service users have their needs assessed before admission to the home but there is no formal mechanism to assure them that these needs will be met. This home does not currently provide intermediate care. EVIDENCE: The inspector spoke with a number of service users about how they had made their choice regarding moving into and living in the home; none of those spoken to were aware of any written information i.e. Service users guide or Statement of purpose. 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 Warberries Nursing Home DS0000059901.V292731.R01.S.doc Version 5.2 Page 9 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. The manager explained that because work has been in progress for a number of months to provide additional accommodation, the statement of purpose and service user guide were not yet available because final decisions about exactly what services are going to be offered have not been made. The inspector looked at four 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 the inspector did not include detailed information on service users needs, preferences and choices. Warberries Nursing Home DS0000059901.V292731.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Each service user has a plan of care however these are not reviewed on a monthly basis or always updated when changes in needs are recognised. This poses a risk that peoples changing needs may not be met consistently. Staff in the home make referrals to specialist health care professionals when needed. The homes medication policies and procedures for dealing with medicines do not completely protect people who use this service. Service users are treated with respect and their right to privacy is usually upheld. EVIDENCE: Service users individualised files included care plans, manual handling assessments, and tissue viability assessments. 2 of the 4 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 social history and interests. Warberries Nursing Home DS0000059901.V292731.R01.S.doc Version 5.2 Page 11 Daily records of care provided were informative but information on them was not always used to plan to meet identified needs. The inspector found that routinely the records are kept by the day staff and was informed by staff during the inspection that the night staff would only right a report if their was a significant change or incident. One resident told the inspector that they had fallen at night, there was no documentation to suggest this had been so, however 2 day staff members did say that they had been told that the resident had had their safety compromised at night when they had been found leaning against bedrails there was nothing in this persons records or any other persons records with regard to risk assessment for the use of bedrails despite this the inspector noted a large number of beds were in deed fitted with bedrails. Reviews of documents have not been completed in detail on a monthly basis so do not capture changes in service users care needs. Daily reports highlighted care being given that was not detailed in care plans. The lack of consistent well-maintained records poses a risk to service users because the staff may not have the information they need to care for the full range of service users needs. The records provided evidence that staff in the home make referrals to specialist health care professionals. One resident who had been referred to a dietician had been seen and a request had been made for the persons weight to be monitored the inspector found the last recorded weight for this person had been 5 months earlier in January. Records also showed a referral had been made to a specialist tissue viability nurse who had visited and assessed the persons wound and had found that staff in the home had been using an array of products one of which is not licensed to be used on open wounds. Records detail visits by General practitioners and also telephone calls made to them about their patients, the records indicate that doctors sometimes prescribe medication for their patients without actually visiting and rely entirely on information given to them over the phone by nurses working in the home. Of the 5 service users who completed and returned written surveys all 5 indicated they ‘always’ receive the medical support they need. The Commission sent surveys to 5 GP practises, 2 were returned, only one was completed, This rated the homes management of health and personal care as good. When speaking to staff whom had been employed at the home for some time they were clearly aware of service users overall care needs such as what they eat, if they needed assistance with washing and dressing and Service users consistently said that they felt cared for and that staff treated them with kindness and respect, taking into account their privacy. During the visit the inspector noted that some staff did not always routinely knock on the doors to residents private accommodation before entering. Of the 5 service users who completed and returned written surveys all 5 indicated they ‘always’ receive the care and support they need. Warberries Nursing Home DS0000059901.V292731.R01.S.doc Version 5.2 Page 12 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. Where tablets had been prescribed, as either 1 or 2 to be given the staff had not indicated exactly how many had been administered. These practices put services users potentially at risk. The storage area for medication has changed since the last inspection and it was noted that a sky line glass pane may cause the temperature in the room to rise above that safe for the storage of medication this was discussed with the registered provider and manager at the time of the inspection. Records for the procurement and removal of medication were incomplete. Warberries Nursing Home DS0000059901.V292731.R01.S.doc Version 5.2 Page 13 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The social and recreational activities offered, meet the preferences and expectations of people living in the home. Service users maintain contact with family/friends/representatives and the local community as they wish. Service users are usually helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet, but are not always aware of options to the main menu. EVIDENCE: Resident’s said that the activities arranged and offered in the home suited their needs and preferences. On the day of the inspection a gentle exercise class was held in the lounge. Some residents were seen enjoying the sun sitting in the garden; others were spending time in their own rooms, which they confirmed was at their request. Residents told the inspector they enjoyed bingo sessions and aromatherapy/massages as well as being well provided with books and videos. Of the 5 residents who completed written surveys when asked ‘Are there activities arranged by the home that you can take part in’? 4 indicated ‘always’ and 1 ‘usually’. Warberries Nursing Home DS0000059901.V292731.R01.S.doc Version 5.2 Page 14 Service users records seen did not include a social history or refer to past interests such as hobbies or if they attended church, and 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. The feedback about food was positive most of the residents spoken to said how good it was; Lunch was served at the time of the inspection which was Roast Lamb with vegetables and potatoes followed by trifle. Residents were not aware of any option to the main menu although one person was seen to have chicken because they did not like lamb. The 4 weekly rotating menus do not advertise an option, some residents said the cook usually knows their likes and dislikes and provides something suitable but others said this sometimes varied because it was not always the same cook on duty. Residents were observed to eat their meals in the dining room, some in the lounge and some in their own rooms. Of the 5 surveys completed and returned all 5 indicated they ‘always’ like the meals at the home. 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. Most residents said they could rise and retire at times that suited them, one told the inspector they went to bed earlier than they would like because the staff shift times did not allow them to go later. Care plan and assessment information did not include information on service users personal preferences and choices. Warberries Nursing Home DS0000059901.V292731.R01.S.doc Version 5.2 Page 15 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives/friends know how to make a complaint. People are safe living in this home. EVIDENCE: Residents spoken with at the time of the inspection told the inspector they knew who to speak to if they were dissatisfied with the care or services provided. Five residents provided written feedback; when asked ‘do you know who to speak to if you are not happy?’ 4 indicated ‘always’ and 1 ‘usually’ with comments such as ‘ oh yes, matron will always help, we also have very good sisters they are helpful’, ‘no trouble here to know who to go to’. When asked ‘do you know how to make a complaint?’ 3 indicated ‘always’ and 2 ‘usually’. Information provided to the Commission from Torbay Social Services department confirms that 8 members of the homes staff have recently attended vulnerable adults alerter’s guidance training. The inspectors read the homes policy and procedure relating to responding to allegations or incidence of abuse or neglect. Staff members spoken to during the inspection including those newly employed had a sound knowledge of who to alert if they witnessed or were told of any kind of abuse or neglect. Three staff returned surveys to the Commission all stated that they are aware of adult protection procedures. Warberries Nursing Home DS0000059901.V292731.R01.S.doc Version 5.2 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): 19,26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A slippage on expected time scales to complete planned building work has impacted negatively on the quality of the environment provided for existing residents. EVIDENCE: Building work to enlarge this home has increased noise levels, decreased levels of cleanliness and adversely affected heating and hot water systems to areas of the home. Some residents told the inspector they had been supplied with cold water only to their en-suite accommodation for over a week. Portable heaters were observed in rooms and residents told the inspector that these had provided heat when it had been chillier the week before the inspection. A tour of the home provided evidence that residents are able to personalise their rooms and those spoken to said they liked their private accommodation. Considerable work has been undertaken to minimise the dust in areas used by existing residents and despite the building work all 5 residents who provided Warberries Nursing Home DS0000059901.V292731.R01.S.doc Version 5.2 Page 17 feedback in surveys returned to the commission state that the home is always fresh and clean and comments included ‘ I have a very nice room and a cleaner comes in daily, the home is always nice and clean’ ‘the home is kept clean’. The inspector found carpets had been removed from landings and was informed this was because of rewiring needed as part of the building works and was told that these would be replaced as soon as practicable. A range of bathing facilities is available and equipment to assist with safe moving and handling of residents, the inspector noted that much of the lifting equipment and some seating in individual rooms was dirty. The flooring around the toilet in one bathroom on the first floor was stained. The inspector observed that hand washing facilities are available for staff and protective clothing including gloves are in ample supply. The inspector found large tubs of creams in bathrooms and on trolleys these tubs had no names on them and this poor practise for purposes of cross infection/contamination was discussed with the manager at the time of the inspection. Creams should be supplied for the use of only one person and there use should be clearly described in that persons care plan. Cleaning substances were fund situated on the sink and in an unlocked cupboard in a sluice room on the ground floor, for the protection of people living in the home, Substances that Could be hazardous to health should be secure at all times when not in use. The inspector found notices displayed on the external side of the doors to some residents accommodation describing boldly their allergies this not only detracts from a homely environment but raises questions about confidentiality of personal information held on behalf of those living in this home and how such information is communicated between the care staff. Warberries Nursing Home DS0000059901.V292731.R01.S.doc Version 5.2 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The skill mix of staff meets Service users needs. 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: The inspector examined the personnel records held on behalf of 3 members of staff the records were incomplete and did not all contain 2 written references, evidence that Criminal Record Checks had been obtained or POVA 1st checks had been performed before their employment commenced. There were no records of 1:1 supervision or individual training needs analysis. Each file did contain a completed application form documentary evidence of induction training although this appeared to be a non-accredited ‘in house’ training. There was indications that the members of staff had received some training in fire safety, moving and handling, infection control, adult protection and managing aggressive behaviours but the records lacked sufficient detail to provide evidence that staff receive the recommended minimum of 3 paid days training/year. 9 care staff have obtained a National Vocational Qualification in care. Resident spoken to during the inspection said the staff were kind and able to meet their needs although they did say they were always busy and when asked Warberries Nursing Home DS0000059901.V292731.R01.S.doc Version 5.2 Page 19 said they rarely had time to sit and have a proper conversation with them, they would however chat whilst attending to a physical care need. One resident said they always went to bed earlier than they would like because the evening shift staff went off duty. Of the 5 residents who returned surveys when asked are the staff available when you need them 3 indicated ‘always’ 1 ‘usually’ and 1 ‘sometimes’, comments included ‘ at the present time with so much rebuilding going on, everyone is very, very busy, but I cannot complain, I understand’. The staff spoken to on the day of the inspection said they were satisfied with the level of training available to them and felt supported and able to fulfil their role. Three care staff returned surveys to the Commission all of these indicated that they had been employed at the home between 6 months and 1 year, one of these stated they had not received a job description, 2 that they hadn’t received induction training, all 3 were aware of the importance of confidentiality one indicated they had not been informed that they must not accept gifts or money from residents. 2 indicated they receive 1:1 formal supervision all three indicated that they do not have group meetings. One commented that they do not feel they have enough support from the care home to do their job well because they need more one to one with managers/sisters of the home. When asked ‘if you could change one thing to improve the way the care home works, what would it be? One did not comment the other two stated ‘more staff’. When asked ‘is there anything that the care home does really well? One said ‘the service users get good care’ another ‘all the service users get 100 care they get what ever they want’, and the other stated ‘care plans, daily intensive reports on each resident’ staff training (in house) given by matron and study days, freedom of choice of residents. Warberries Nursing Home DS0000059901.V292731.R01.S.doc Version 5.2 Page 20 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 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. 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. EVIDENCE: The registered manager is an experienced nurse manager who has a diploma in Management. Most of the staff who provided feedback and all of the service users spoken too confirmed that they felt supported by the homes manager and that the manager was helpful, caring and responsive. Communication systems are in place however much of this was seen to be informal, the most regular formal communication between the management Warberries Nursing Home DS0000059901.V292731.R01.S.doc Version 5.2 Page 21 and staff is through regular handovers between shift, these in the main are to communicate care needs. There has been no staff meetings held in the past 6 months. The home lacks formal internal quality assurance processes; questionnaires are available but are completed randomly and are not collated or reported on. The Commission was supplied with the homes business and financial plan following a request made during the fieldwork visit of the inspection. The registered provider has failed to provide evidence of visits to the home in accordance with regulation 26 of the care homes regulations. 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 medication record keeping, recruitment practices, poor maintenance and poor hygiene practices. Service users financial records were examined and found to be well recorded with receipts in place for items purchased on behalf of service users. A random selection of actual balances were checked against records and found to be correct. Substances that could be hazardous to health (cleaning materials) were found stored in an unlocked cupboard at the time of the inspection visit. Warberries Nursing Home DS0000059901.V292731.R01.S.doc Version 5.2 Page 22 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 1 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Warberries Nursing Home DS0000059901.V292731.R01.S.doc Version 5.2 Page 23 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 OP1 Regulation 4,5&6 Requirement Timescale for action 01/09/06 2 OP3 14 3 OP9 13(2) The registered person must ensure there is a written statement of purpose and service user guide, which is kept under review. A copy of the service users guide must be provided to each service user any revision must be notified to the service users and the Commission within 28days. The registered person must 01/08/06 confirm in writing to service users that having regard to their pre- admission assessment ,the care home is suitable for the purpose of meeting the service users needs in respect of their health and welfare. The registered person must 01/08/06 make arrangements for the recording, handling, safe keeping, safe administration and disposal of all medicines received into the care home. Not met from 01/02/06 This relates to accurate recording of administration and procurement and destruction/removal of medication. DS0000059901.V292731.R01.S.doc Version 5.2 Warberries Nursing Home Page 24 4 OP26 13(3) 5 OP29 19 6 OP33 24 7 OP33 26 The registered person must make suitable arrangements to prevent infection, toxic conditions and the spread of infection in the care home. Not met from 01/02/06 This relates to 1)tubs of cream being used for unidentified individuals with no documented plan. 2)Cleaning of equipment and furniture. The registered person must not employ a person to work at the care home unless he has obtained in respect of that person all of the information and documents specified in paragraphs 1 to 7 of Schedule 2 of the care home regulations. The registered person must establish and maintain a system for reviewing at appropriate intervals and improving the quality of care including the quality of nursing provided at the care home. The registered person must supply to the Commission a report in respect of any review conducted by him for the purposes of reviewing the quality of care and make a copy of the report available to service users, the system of review must provide for consultation with service users and their representatives. The registered provider must visit the home unannounced at least once a month and shall during the visit interview with their consent and in private such of the service users and their representatives and people working at the care home in order to form an opinion of the standard of care provided in the care home, inspect the premises, DS0000059901.V292731.R01.S.doc 01/08/06 01/08/06 01/09/06 01/08/06 Warberries Nursing Home Version 5.2 Page 25 7 OP38 13(4) its record of events and complaints and prepare a written report on the conduct of the home. The registered provider shall supply a copy of the report to the Commission and the registered manager. The registered person must ensure that all parts of the home to which service users have access are so far as is reasonably possible free from hazards to their safety and unnecessary risks to the health and safety of service users are identified and so far as possible eliminated. This relates to Control of Substances that Could be Hazardous to Health (COSHH) 01/09/06 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 Refer to Standard OP7 Good Practice Recommendations Service users plans should be reviewed by care staff in the home at least once a month, updated to reflect changing needs and current objectives for health and personal care and actioned. To enable service users a choice of meals the registered provider should ensure that there is a menu which offers a choice of meals in written or other formats to suit the capacities of the service users which is given, read or explained to them. Accurate records should be kept of the programme of maintenance, renewal of the fabric and decoration of the premises. The home should ensure that the induction training provided in the home meets National Training Organisation specification. 2 OP15 3 4 OP19 OP30 Warberries Nursing Home DS0000059901.V292731.R01.S.doc Version 5.2 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 Warberries Nursing Home DS0000059901.V292731.R01.S.doc Version 5.2 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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