Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 02/08/05 for Warberries Nursing Home

Also see our care home review for Warberries Nursing Home for more information

This inspection was carried out on 2nd August 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

What has improved since the last inspection?

The process for the recruitment of staff has been improved and now provides evidence that the process is safe, fair and consistent. The records held in the home about personal finances of residents that are handled by the staff have been improved and are readily checkable and clear and transparent, therefore safeguarding the financial interest of those living in the home. One WC on the ground floor has been redecorated and redecoration of bedrooms is on going. As well as a new central heating system, a sluicing machine has been purchased which meets the specifications required for homes that provide nursing care.

What the care home could do better:

To ensure that any issues raised about the service by residents/relatives or others, are readily acted upon. All concerns and complaints, verbal or written should be clearly documented and include a record of any investigation and actions taken to prevent a re-occurrence. A recommendation concerning this has been made in the report. To minimise the risk of cross contamination and encourage `best practise` in control of infection, liquid soap dispensers should be available at all wash hand basins. A recommendation regarding this has been made in the report. To safeguard the residents and professional staff of the home, any changes or additions to prescribed medications must be validated by the residents General Practitioner and the legal order regarding administration placed on the prescription label must be adhered to. If a medication administration record needs adapting this must be done by the prescribing doctor. A recommendation to adhere to this has been made in the report. To promote the safety of all those living and working at the Warberries - `Safe` hold open devices (approved by the Devon Fire and Rescue Department), must be fitted where residents want the fire doors that are doors to their bedrooms held open. A requirement regarding this issue has been made in the report.

CARE HOMES FOR OLDER PEOPLE Warberries Nursing Home Lower Warberry Road Torquay Devon TQ1 1QS Lead Inspector Fiona Cartlidge Announced 2 August 2005 nd 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 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 D54-D07 S59901Warberries V231892 020805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Warberries Nursing Home Address Lower Warberry Road, Torquay, Devon, TQ1 1QS Telephone number Fax number Email 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 mark@atholestill.co.uk (provider) warberries@btconnect.com (Home) 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 D54-D07 S59901Warberries V231892 020805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 06/01/05 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 registered to provide nursing and or personal care to a maximum of 28 residents of either gender. 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 D54-D07 S59901Warberries V231892 020805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 6 and a half hours and was announced. Information was received from the registered provider before the inspection as was written feedback from 5 residents and 5 visitors/relatives. A full tour of the home took place and personal records of 3 residents and 3 staff were inspected. The inspector spoke to 2 members of staff on duty and 15 of the residents as well as the registered owner, manager and administrators. What the service does well: What has improved since the last inspection? Warberries Nursing Home D54-D07 S59901Warberries V231892 020805 Stage 4.doc Version 1.40 Page 6 The process for the recruitment of staff has been improved and now provides evidence that the process is safe, fair and consistent. The records held in the home about personal finances of residents that are handled by the staff have been improved and are readily checkable and clear and transparent, therefore safeguarding the financial interest of those living in the home. One WC on the ground floor has been redecorated and redecoration of bedrooms is on going. As well as a new central heating system, a sluicing machine has been purchased which meets the specifications required for homes that provide nursing care. 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 D54-D07 S59901Warberries V231892 020805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Warberries Nursing Home D54-D07 S59901Warberries V231892 020805 Stage 4.doc Version 1.40 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 standard(s) 2,3,4,5 The admissions procedure is safe; it enables the staff to make a professional judgement about how the needs of individuals will be met. EVIDENCE: The inspector examined the personal records held within the home on behalf of 3 of the residents these contained copies of contracts/terms of residency. All three records contained evidence that a full and detailed assessment had been performed on the resident prior to admission. Service Users spoken to confirmed that the Matron found out about them before they came into the home. The inspector found that information about the individuals’ health, personal and social care had been sought and most residents are visited in their current settings to enable the registered nurses to make a professional judgement about how needs will be met before offering the individual the opportunity of admission. Residents told the inspector that they or their relatives had visited the home to view it and meet other residents and the staff before any decision about Warberries Nursing Home D54-D07 S59901Warberries V231892 020805 Stage 4.doc Version 1.40 Page 9 admission had been made. One lady said that she had been prepared to wait until a room became available because it was the best home her daughter had viewed from a number of others in the area. A relative spoken to said she was pleased with the choice of home. Warberries Nursing Home D54-D07 S59901Warberries V231892 020805 Stage 4.doc Version 1.40 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 standard(s) 7,8,9,10 The health care needs of residents are regularly reviewed and action is taken to meet those needs. EVIDENCE: The home provides a comprehensive care planning process for residents, based on continual assessment of their needs. Three care plans viewed during the inspection were fully completed and appropriately reviewed. Written feedback from 5 residents indicated that they feel well cared for. Documentation provided evidence that General Practitioner’s, chiropodist, dentist and opticians visit residents and that they are referred to specialist community and hospital health specialists when necessary. The inspector was informed that a massage therapist also visits and residents enjoy both the therapeutic and relaxing benefit of this as well as the social contact. Written feedback from 5 relatives/visitors indicates that they are kept informed of important matters affecting their relative/friend and all but one were satisfied with the overall care provided. Warberries Nursing Home D54-D07 S59901Warberries V231892 020805 Stage 4.doc Version 1.40 Page 11 Registered nurses manage the medication system; the inspector looked at storage and recording – some controlled drug stock was checked against records and found to be correct. Storage was safe and orderly the home uses a monitored dosage system, which is well organised and easily audited. Records provided evidence that a legal order to change the prescribed administration times had not been sought when it should have been. A recommendation to stop that practise has been made in this report. The inspector examined the policies and procedures in relation to medication and found that one guidance record for Registered nurses was out of date and despite seeing a policy for self medication was told that because the residents did not have locks on their bedroom doors or secure facilities within their rooms no – one actually self medicates. Warberries Nursing Home D54-D07 S59901Warberries V231892 020805 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 Social activities are organised and meet the needs of the residents. Meals are nutritious and balanced and offer a healthy and varied diet for residents. The visiting arrangements are flexible and meet the needs of residents and visitors alike. Residents are encouraged to make choices about how they live their lives within the community of this home. EVIDENCE: Resident’s said that the activities arranged and offered in the home suited their needs and preferences particularly commenting favourably about the exercise sessions. The written feedback received from 4 residents indicated that 3 of them were always satisfied with the social activities provided in the home and one was sometimes satisfied. On the day of the inspection an outside entertainer was providing a sing- song most of the residents really enjoyed the session. Some residents stated that they preferred to spend time in their own rooms. One resident said she could get up when she wanted and have lie - ins if she chose. Observation confirmed some people were being cared for in bed. The inspector noted that a library is available and was informed that the books are changed regularly by the Torbay Community library service. Warberries Nursing Home D54-D07 S59901Warberries V231892 020805 Stage 4.doc Version 1.40 Page 13 The feedback about food was positive all of the residents spoken to said how good it was; Resident’s weights are regularly monitored and recorded. Visitors are able to have their meals in the home and these are currently provided free of charge. The people living in the home told the inspector they were happy with the visiting arrangements, written feedback from 5 relatives/visitors indicate that they feel welcomed into the home and are able to visit their relative/friend in private. Warberries Nursing Home D54-D07 S59901Warberries V231892 020805 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 People are safe living in this home and know who to speak to if they are dissatisfied. EVIDENCE: The home has a comprehensive complaints procedure, which stated that oral complaints would be recorded, however there was no evidence that this actually happens. The inspector looked at the complaint file and this contained information only about written complaints received in previous years that had been referred to the home via the commission for social care inspection. Those residents’, who were asked, said that they knew who to complain to if they had any concerns and felt confident that these would be dealt with in a sensitive way by the staff. The inspector also examined the Protection Of Vulnerable Adults policy and procedural manual and the homes whistle blowing policy. All Staff are also shown a video about how to recognise and report incidence of abuse. The 5 residents who provided written feedback to the commission indicated that they feel safe living in the home and know who to speak to if they are unhappy with their care. Written feedback was also received from 5 relatives/visitors, 4 of these indicated that they were aware of the complaints procedure all 5 said they had not needed to make a complaint. Warberries Nursing Home D54-D07 S59901Warberries V231892 020805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,26 The home is clean and well maintained with suitable equipment to meet the needs of people with physical disability/frailty. The safety of residents is compromised because of the lack of safe ‘hold open devices’ on bedroom doors. There is a risk of cross contamination between residents because the staff do not have access to liquid soap dispensers in the residents own accommodation. EVIDENCE: Warberries Nursing Home D54-D07 S59901Warberries V231892 020805 Stage 4.doc Version 1.40 Page 16 The accommodation is provided on 3 floors accessed by stairs, stair lift or a passenger lift. Steps have to be negotiated to access the gardens although some rooms have private balconies, which can be accessed following risk assessment procedure. Repairs / redecoration also take place on a need to do and informal basis, the home employs its own maintenance person for 30 hours/week. Observation confirmed that the handy man’s book is left in the office for staff to write in requests. During the inspection there was evidence of some building work as the home is to be enlarged through the purchase of the next-door property and its conversion to meet the needs of people with disability, frailty or illness. A tour of the building confirmed that the home appeared well maintained. The home has three main communal areas. On the ground floor the home has a large lounge and dining area with sea views. On the first floor is a conservatory area with seating and books. Bedrooms were all seen to be comfortably and pleasantly decorated on an individual basis. Observation confirmed that Service users are given an option and were seen to provide their own furnishing. The property was clean, tidy and free from offensive odours on the day of inspection. The inspector noted a lack of liquid soap dispensers beside sinks in residents rooms for easy use by staff to negate the risk of cross contamination. It was also noted that when residents want to sit with their bedroom doors open that these are propped open with various wedging devices – none suitable for the purpose of maintaining fire safety. All of those spoken to said they liked their rooms, some were pleased that their rooms had sea views. The home appeared well equipped to meet the needs of those residents identified with moving and handling risks and disabilities that affect their capability to bathe. Specialist mattresses were seen in place for those residents requiring them as were height adjustable beds. Warberries Nursing Home D54-D07 S59901Warberries V231892 020805 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 The procedures for the recruitment of staff are robust and offer protection to people living in the home. The number and skills of staff available in the home meets the needs of those living in the home. EVIDENCE: The residents told the inspector that there were enough staff on duty, they said they ‘worked hard’ and were ‘very caring’ –‘nothing is too much trouble’. The staff spoken to also advised the inspector that they felt there was sufficient numbers of staff on duty and said they had plenty of training opportunities. The inspector examined the personnel files of 3 recently employed members of staff these provided evidence that the recruitment process is fair, equitable and safe. The inspector examined training records these indicate that most staff receive regular training/updates. Written feedback from 5 relatives/visitors was received 3 indicated that in their opinion there is always sufficient numbers of staff. Written feedback from 5 residents indicates that they all feel well cared for and are treated well by the staff. Warberries Nursing Home D54-D07 S59901Warberries V231892 020805 Stage 4.doc Version 1.40 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,35,38 The home is being managed properly, there is clear leadership, guidance and direction to staff to ensure residents receive consistent quality care. EVIDENCE: Residents, visitors and staff made positive comments about the management team in the home saying they felt comfortable approaching them with Issues. One member of staff who had worked in other homes in other parts of the country commented on how much they are enjoying working at the Warberries stating ‘there is a good team structure, good communication and a homely atmosphere. Communication systems are regular through staff handovers - one was observed during the inspection and provided evidence that staff have the opportunity to express their ideas and discuss issues. The provider demonstrated a responsible attitude towards health and safety – notices were displayed throughout the home. Equipment is regularly maintained and staff are trained on health and safety matters during their Warberries Nursing Home D54-D07 S59901Warberries V231892 020805 Stage 4.doc Version 1.40 Page 19 induction and updated regularly. A plan to expand the home and replace carpets provides evidence of reinvestment in the business. All of the records seen during the inspection were clear, well maintained and secure. The inspector examined the finance records for personal money held on behalf of residents - the inspector witnessed that the money and records were held in individual envelopes and these were checked and found correct. Records are made of all transactions and receipts are maintained. Warberries Nursing Home D54-D07 S59901Warberries V231892 020805 Stage 4.doc Version 1.40 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 4 x x x 3 x x 3 Warberries Nursing Home D54-D07 S59901Warberries V231892 020805 Stage 4.doc Version 1.40 Page 21 no Are there any outstanding requirements from the last inspection? 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 19&38 Regulation 13.4 Requirement Where residents wish to have their bedroom doors open and these doors are designated as fire doors they must only be held open by safe hold open devices that have been agreed as safe by the Fire and Rescue service. Timescale for action 01/09/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 9 26 Good Practice Recommendations Nurses should ensure they follow the legal order for medication administration, in accordance with the NMC guidelines for the administration of medicines. To minimise the risk of cross contamination suitable hand washing facilities should be available for staff use in all residents bedrooms and include: a liquid soap dispenser, disposable hand towels and pedal bin. Warberries Nursing Home D54-D07 S59901Warberries V231892 020805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 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 D54-D07 S59901Warberries V231892 020805 Stage 4.doc Version 1.40 Page 23 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!