Inspection on 25/01/06 for Warnford House

This inspection was carried out on 25th January 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

Warnford House 10/09/08

Warnford House 14/09/06

Warnford House 01/02/05

Warnford House 29/07/04

Warnford House 16/02/04

Similar services:

21 High Street

Vale House

Chestnut Walk

The Old Vicarage

Cherwood House Care Centre

Ashley House

Ascot Nursing Home

Fountain View

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

CARE HOME ADULTS 18-65 Warnford House Warnford Close Gosport Hampshire PO12 3RT Lead Inspector Anita Tengnah Unannounced Inspection 25th January 2006 10:00 Warnford House DS0000011846.V279363.R01.S.doc Version 5.1 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 Warnford House DS0000011846.V279363.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 Adults 18-65. 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. Warnford House DS0000011846.V279363.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Warnford House Address Warnford Close Gosport Hampshire PO12 3RT 023 9260 1533 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) Southern Focus Trust Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (12) of places Warnford House DS0000011846.V279363.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the category MD referred to above, to only be admitted between the ages of 18 and 65 years. 13th July 2005 Date of last inspection Brief Description of the Service: Warnford House is a purpose built home situated in a quiet cul de sac in Gosport. The home is registered with the Commission for Social Care Inspection (CSCI) to accommodate and provide personal care to 12 service users with mental health problems in the younger adults category. All the bedrooms are single; there is a lounge on the first floor with access to a computer for service users. There is a lounge and kitchen/ dining room on the ground floor. The home is situated close to local amenities in Gosport and within easy reach of Portsmouth city. Warnford House DS0000011846.V279363.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection took place over one day on the 25th of January 2006. This was the second inspection for the year 2005/2006. As part of the inspection process, a tour of the building was undertaken. The inspection took place over 3and half hours. The process included examining care records, staff records and discussions with service users, staff and a visitor. The views of four service users were sought as part of the inspection. Positive comments were received and service users expressed a high degree of satisfaction with the care that they were receiving. What the service does well: The home demonstrated that staff have gained a good understanding of the needs of service users through their assessment process. Care plans were in place for all service users, based on their assessed needs and included regular reviews to ensure that care needs are met. The home has a detailed pre admission process in place to ensure that service users are appropriately placed. Support is provided for service users to access health services and regular reviews of the service users’ health needs are undertaken. The home looks after and administers medication well. The home is homely and well maintained. Service users commented that his was “a happy home” and they liked living at the home. The core values of dignity, autonomy and choice were maintained and service users are empowered to make choices with regards to daily living. Warnford House DS0000011846.V279363.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. Warnford House DS0000011846.V279363.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Warnford House DS0000011846.V279363.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The home’s pre admission assessment process is good and enables an informed decision about admission to the home. EVIDENCE: There is a detailed pre admission assessment process in place. The care records of a prospective service user demonstrated that a thorough needs assessment is undertaken. These included involvement of the service user and other health care professional. A comprehensive needs assessment was available. As part of the process the service users has been visiting the home at least twice o week over a long period of time. Staff reported that overnight stays are offered. Records of the visits were maintained in the service user’s plan. A review is undertaken after 28 days period with the involvement of the placing authority. Warnford House DS0000011846.V279363.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,9 The home has good care plans in place reflecting needs and personal goals and these were reviewed regularly to ensure that care needs are met. Service users are supported to take risks with regular reviews to protect the service users. EVIDENCE: The care plan of a recently admitted service users was seen as part of the inspection. An individual care plan was formulated, which set out how the assessed needs and personal goals of service users and how they should be met. The care plans were detailed and appropriate to the assessed needs of the service users. These included personal care, medication, mental health and wellbeing. There was evidence of regular reviews undertaken with the service users to reflect any changing needs. The home has in place a good system of risk assessments for all service users and included action that should be taken to minimise the identified risks. These are reviewed at regular basis with the involvement of the service users. Warnford House DS0000011846.V279363.R01.S.doc Version 5.1 Page 10 Warnford House DS0000011846.V279363.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15,17 The personal and social needs of the service users are well managed. The dietary needs of service users are well catered for with a balanced and varied selection of food available. Service users are empowered and make choices regarding their meals. EVIDENCE: The home has an open visiting policy. Service users are supported in maintaining links with the local community. The manager was reviewing the policy around sexuality. The company had in place a working group and the managers were involved in the development of a cross gender policy. Service users spoken with confirmed that they are supported and there were no restrictions in receiving visitors. Any restrictions are reflected in the service users’ risk assessments and they are involved in the decision process. The home has a planned menu that is rotated on a four weekly basis. A number of service users had care plan in place to support them with preparing Warnford House DS0000011846.V279363.R01.S.doc Version 5.1 Page 12 their own meals. Three service users said that they had prepared their own meal at lunchtime on the day. A weekly menu was displayed. Meals appeared well balanced and nourishing. A daily record of all meals taken was maintained. Staff said that service users are encouraged to assist them with the weekly shopping. Service users reported that they enjoyed cooking and the facilities were adequate. All service users have a fridge in their rooms and fridge freezers were available in the communal kitchens. Food was stored appropriately and labelled. Warnford House DS0000011846.V279363.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20 The personal and health needs of service users are well met with evidence of access to a range of NHS services. The medication system at the home is well managed, which protects service users. EVIDENCE: Records showed that the manager and staff monitor the healthcare needs of the service users. This was particularly evident in the case of a service user whose mental health needs has deteriorated last week and prompt referral was undertaken and the service user was admitted for treatment. The home has developed and maintains close links with other healthcare professionals including the Community Psychiatric Nurse (CPN) who visits and reviews service the users on a regular basis. The home has a medication policy in place. There was no service user who was administering his medication at present. Risk assessments were in place for all to support this decision. A record of all medication administered was maintained. Staff said that they had received training in the administration of medicine and have the support of the Pharmacist as needed. The home had Warnford House DS0000011846.V279363.R01.S.doc Version 5.1 Page 14 comprehensive information of the current medication for all the service users and included guidance on side effects. Warnford House DS0000011846.V279363.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The complaint process at the home is satisfactory, however the service users should be provided with the complaint procedure to inform practice. The prevention of abuse process is good with evidence of appropriate referral as required. EVIDENCE: The home has a complaint procedure in place. Service users spoken with said that they had no complaints and were satisfied with the care. Two service users said that they would approach their support workers if they had any issues and were comfortable in doing so. Two service users said that they were not aware of the complaint procedure or that they could contact the CSCI office. The manager should ensure that a copy of the complaint procedure is available to all the service users. The home has an adult protection procedure in place. Staff have undertaken training in the prevention of abuse and dealing with difficult behaviour. The staff spoken with were aware of the needs to report and record all allegations of abuse. The manager had recently reported an allegation of abuse to the appropriate authority and records of these were available. Warnford House DS0000011846.V279363.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The core standards were inspected at the last visit in July 2005 and were satisfactory. EVIDENCE: Warnford House DS0000011846.V279363.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 There is a training programme in place, however the lack of mandatory training record does not protect the service users. EVIDENCE: The home has an ongoing training programme in place. Three staff have completed the NVQ training at level 3. Three staff members have undertaken their personal development plan. The manager is undertaking NVQ 4 in care. One care staff said that he was planning to commence the NVQ level 3 in April. Some of the trainings planned include updates in medication, food hygiene and fire. Records of training for three staff were examined, only one carer’s personal development record contained evidence of training undertaken. The lack of updated training record was discussed with the manager who agreed that this would be addressed. Staff spoken with confirmed that they had undertaken training in health and safety and are aware that records of these must be kept. Warnford House DS0000011846.V279363.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,40,42 The home has an effective staff team and there are clear lines of accountability within the home. Policies and procedures are in place, however these should reviewed regularly and reflect local procedures to inform practice and safeguard the welfare of service users. There is good system of checks and servicing of equipment to protect the service users. EVIDENCE: The home has a manager in post; discussion was undertaken that the manager is required to submit an application so that he can be registered with the commission. It was evident that staff and service users have developed good relationships. Service users comments included that “this was a happy home and that staff were very good”. There are clear lines of accountability within the home. Staff said that they felt supported in their work. Warnford House DS0000011846.V279363.R01.S.doc Version 5.1 Page 19 The home has in place policies and procedures for the promotion of the health and safety of service users and staff. Staff said that these were corporate policies and they were not involved in their development. The manager must ensure that there are local policies in place to reflect the practices at the home and in order to provide guidance for staff and service users. One example was the absence/ missing from home policy. A review of all policies should be undertaken at least yearly in order to take into account any changes in legislations. Record showed that policies were currently updated three yearly. A sample of servicing records showed that there was an ongoing programme to ensure that equipments are maintained safely. The home carried out weekly testing of the fire alarm, six monthly checks of emergency lighting and fire extinguishers. Staff were provided with gloves and aprons, and from the practices observed, it was evident that staff and service users were aware of infection control procedures. Warnford House DS0000011846.V279363.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 3 X X X X 3 X 3 X Warnford House DS0000011846.V279363.R01.S.doc Version 5.1 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. 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 Warnford House DS0000011846.V279363.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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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