Inspection on 24/05/05 for Warren Farm Lodge

This inspection was carried out on 24th May 2005.

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

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

Other inspections for this house

Warren Farm Lodge 25/10/06

Warren Farm Lodge 30/11/05

Warren Farm Lodge 11/01/05

Warren Farm Lodge 03/08/04

Warren Farm Lodge 20/01/04

Warren Farm Lodge 12/08/02

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Maple Lodge

Polesworth Group 32 Station Road

Heathlands

Aston Court Nursing Home

Polesworth Group 70 Long Street

Breme

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

CARE HOMES FOR OLDER PEOPLE Warren Farm Lodge 123 Warren Farm Road Kingstanding Birmingham B44 0PU Lead Inspector Ann Farrell Unannounced 24 May 2005 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. Warren Farm Lodge E54 S16920 Warren Farm Lodge V228415 240505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Warren Farm Lodge Address 123 Warren Farm Road Kingstanding Birmingham B44 0PU 0121 472 8449 0121 415 2720 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) Anchor Trust Janet Bennett Care Home 30 Category(ies) of Old Age , Learning Disability - over 65 (30) registration, with number of places Warren Farm Lodge E54 S16920 Warren Farm Lodge V228415 240505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11 January 2005 Brief Description of the Service: Warren Farm Lodge is a purpose built two-storey home, which is situated close to community resources and public transport in the Kingstanding area of Birmingham. The home currently provides accommodation to 30 service users for reason of old age and learning disability. Accommodation is provided in single bed-sits each with kitchen and en-suite facilities. In addition, there are communal bathing/shower and toilet facilities strategically placed in the home. A passenger lift gives access to the first floor. Communal areas consist of one lounge, conservatory and dining room, are decorated and furnished to a good standard. They are situated on the ground floor and look out onto a very pleasant garden. The main kitchen is adjacent to the dining room and is well equipped. There is parking to the front of the property, with pleasant enclosed gardens to the rear. The home and gardens are well maintained and provide a warm homely atmosphere. Warren Farm Lodge E54 S16920 Warren Farm Lodge V228415 240505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted on an unannounced basis over a full day commencing at 8.30am on 24th May 2005. The registered manager and deputy were present for the duration of the inspection. During the inspection process the inspector toured the home, sampled residents files and other documentation. The home was clean warm and well maintained providing a homely environment. The managers, two members of staff, ten residents and two visitors were spoken to. What the service does well: What has improved since the last inspection? The home has an ongoing staff training programme and have arranged a range of training to include not only the basic training, but to include areas relating to residents conditions. Staff and residents meetings are occurring regularly and the manager stated that formal staff supervision is taking place on a regular basis. Warren Farm Lodge E54 S16920 Warren Farm Lodge V228415 240505 Stage 4.doc Version 1.30 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. Warren Farm Lodge E54 S16920 Warren Farm Lodge V228415 240505 Stage 4.doc Version 1.30 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 Warren Farm Lodge E54 S16920 Warren Farm Lodge V228415 240505 Stage 4.doc Version 1.30 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) 3,4,5,6, The home has a good system for admitting residents to the home. Further development of the records is required to ensure all staff are fully aware of residents needs. EVIDENCE: The home has a statement of purpose and service users guide, but these were not seen at the time of inspection. The home admits residents for long-term care and have recently commenced offering respite care. The statement of purpose and service users guide will need to be updated to reflect this. At the time of visiting the inspector spoke to a resident who had recently moved into the home. She stated the staff had made her feel very welcome; she confirmed that she had visited the home before moving in and it was stated that her daughter had received the information. The home liaises with social workers who provide written assessments or care plans for residents who wish to enter the home. The home also invite prospective residents to the home enabling them to view the facilities, meet staff and other residents and partake in a meal. Warren Farm Lodge E54 S16920 Warren Farm Lodge V228415 240505 Stage 4.doc Version 1.30 Page 9 At this stage the home is also able to undertake an initial assessment to determine if they are able to meet residents needs and these were available on file. Following admission to the home a more comprehensive assessment is undertaken which includes a history of their background and an individual lifestyle agreement (ILA) is drawn up. There is a trial period of one month when a review is held with relatives, staff and family. On inspection of the records relating to the homes admission some of them lacked information and did not cover all areas in standard three of the National Minimum Standards. A moving and handling assessment had been undertaken, but there was no evidence of any further risk assessments e.g. falls, the use of electrical equipment in flats etc. The home writes to residents or their representatives following initial assessment to inform them if they are able to meet the needs. In order for the home to develop a comprehensive care plan and meet all resident’s needs a full assessment must be undertaken. Although the home is not registered to care for people with dementia there are some residents who have a degree of confusion plus there has been a staff turnover recently and they would benefit from some training in this area. Some of the staff have undertaken training in respect of caring for people with dementia and it was stated that they are in the process of organising training for the remaining staff. The deputy manager stated that they were in the process of arranging the training in addition to some training in respect of epilepsy. Warren Farm Lodge E54 S16920 Warren Farm Lodge V228415 240505 Stage 4.doc Version 1.30 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 There are good systems in place to meet health care needs and the medication system is of a good standard, so protecting residents. The care plans need to be developed further to ensure consistency in care. EVIDENCE: The home draws up an individual lifestyle agreement (ILA) for each resident following admission to the home outlining how the resident’s needs are to be met by staff. On inspection of a sample of records they were found to be orderly and included a number of the residents needs. However, some areas lacked clarity and some needs had not been included in the plan of care. There is one resident in the home with a urinary catheter and the care plan did not indicate any care related to the catheter. The ILA’s had been reviewed monthly and a record of the progress had been made, but this had not been reflected in the plan of care. This meant that information was available, but a member of staff would have to read through the whole document to find the information. A care plan should be updated to reflect any changes in need and indicate how the needs should be met enabling a member of staff to be able to meet a residents needs from reading it. On talking to senior members of staff they demonstrated a good knowledge of residents needs and were aware of any issues. Warren Farm Lodge E54 S16920 Warren Farm Lodge V228415 240505 Stage 4.doc Version 1.30 Page 11 Also during inspection it was noted that charts in respect of moving a resident regularly were being recorded, pressure relieving equipment was in use although these details were not consistently recorded in the plan of care. This is reliant on good verbal communication and memory. In order for a consistent approach in care to be afforded detailed care plans should be in place for all staff to access. Manual handling assessments had been completed, but details had not been included in the plan of care and other risks had not been identified or there was a lack of information in respect of how to minimise the risk. The home monitors resident’s nutritional status through regular weighing and nutritional screening. However, it was noted on one file that this had not been completed. It was stated that the member of staff responsible for this aspect of assessment was not in the home currently and another member of staff was to be trained in this area. Staff liaise with health professionals from the multidisciplinary team such as district nurses, social workers, CPN’s, continence adviser. Residents informed the inspector that they saw the chiropodist, optician and dentist when required. The staff responsible for medicine management had implemented good systems to receive, administer, record and dispose of medication. On inspection the majority of the audits were satisfactory. It was noted that eye drops had been open in excess of one month. These should be discarded after open month due to the risk of bacterial infection. Records were clear and concise. On discussion with resident’s they stated they were happy living in the home and the staff treated them well “They are a lovely lot of girls”. They confirmed that they had a choice of how to spend their time. They confirmed they had keys to their flats and during the inspection staff were observed to treat residents with respect and their they were afforded privacy. Residents were well presented. There is a public telephone available in the corridor, which does not afford privacy. It was stated that the senior carers office could be used or residents may have one installed in their own flat. Warren Farm Lodge E54 S16920 Warren Farm Lodge V228415 240505 Stage 4.doc Version 1.30 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) 12,13,15 Catering and meals are well managed with a choice and variety available. Residents are able to make choices about daily living activities and there is a relaxed, flexible and homely atmosphere in the home with a range of leisure activities available. EVIDENCE: The home employs an activities co-ordinator, who arranges a variety of activities. On inspection there was a notice available indicating that exercises occur each morning in the lounge. Some residents attend adult education classes; others area involved with domestic activities in the home and a group of residents went on holiday to Blackpool recently. Residents are free to come an go as they wish and they are able to exercise choice in relation to daily routines, such as getting up, going to bed and where to take meals. The hairdresser visits the home on a regular basis and ministers of various religions visit the home as requested. Visiting is fairly flexible and this was evidenced at the time of inspection from discussion with relatives. They stated they could visit at any time, “the staff are superb and they did a marvellous job looking after their mother.” Warren Farm Lodge E54 S16920 Warren Farm Lodge V228415 240505 Stage 4.doc Version 1.30 Page 13 The manager stated residents meetings occur regularly and she hopes to set a relative consultation group in the home. There is one dining room adjacent to the kitchen, which is furnished and decorated to a good standard. Tables were appropriately laid with cutlery and condiments, providing very pleasant surroundings for taking meals. The inspector had lunch with residents and found the meal to be of a good standard. Lunch consisted of a three-course meal and potatoes and vegetables were served in serving dishes enabling residents to help themselves and staff were available to give assistance as required. Meals were unhurried and fresh fruit was freely available in the dining room. Residents are offered three full meals a day with a choice at all meals. They are consulted about the menu on a daily basis and where they do not want either choice on the menu an alternative is available. There is a four-week rotating menu that indicated a varied and nutritious diet. The manager stated she is hoping to review the arrangements for meals and introduce more choices, she hopes to arrange some tasting sessions initially. Feedback from residents indicated that the meals were of a good standard. The home has a comments book in the dining room and all comments were favourable. Drinks are available between meals and a snack meal is available in the evening. In addition service users have kitchen facilities in their own flats and the home provides appropriate supplies for making drinks, if requested. Warren Farm Lodge E54 S16920 Warren Farm Lodge V228415 240505 Stage 4.doc Version 1.30 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 Feedback indicated a lack of knowledge in some of the procedures for the protection of residents. Residents and their relatives are confident that the home deals with complaints appropriately. EVIDENCE: The home has procedures in respect of complaints and protection of vulnerable adults. On inspection the home had received two complaints since the beginning of the year and had dealt with them appropriately. On discussion with staff they were aware of the complaints procedure, but some were not conversant with the local guidance in respect of the vulnerable adult procedures. This area will need to be addressed by further training. On discussion with a resident who had recently moved into the home she stated she was not aware of the complaints procedure. It is recommended that the home review the method in which they provide information about the complaints procedure to residents. Warren Farm Lodge E54 S16920 Warren Farm Lodge V228415 240505 Stage 4.doc Version 1.30 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) 19,20,21,23,24,25,26 The standard of décor and furnishings in the home is good providing residents with a pleasant, warm and homely environment to live. EVIDENCE: Warren Farm Lodge E54 S16920 Warren Farm Lodge V228415 240505 Stage 4.doc Version 1.30 Page 16 The home is a modern two-storey building, which is clean, odour free and well maintained. There is limited parking to the front with a very pleasant garden to the rear of the building. There is one dining room on the ground floor that in decorated and furnished to a good standard. There is a choice of one lounge or conservatory to sit which looks out onto the garden. All flats have an en-suite facility that includes toilet and hand basin. In addition, there are four communal bathrooms, which have assisted bathing facilities and have been pleasantly decorated. There are also seven toilets strategically placed through the home. All flats are provided with locks and letterboxes to doors; they are carpeted and generally service users provide all their own furnishings, which enhances a home from home environment. Samples of rooms were inspected and were found to be decorated to a good standard, comfortable and personalised. Flats are individually and naturally ventilated and windows are provided with restrainers. Radiators are of the low surface temperature type and water from hot water outlets is regulated. Laundry facilities were appropriately sited with a washing machine with sluice cycle and segregated sluice facilities. Warren Farm Lodge E54 S16920 Warren Farm Lodge V228415 240505 Stage 4.doc Version 1.30 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) 27,28,29 Adequate staffing levels are maintained to meet resident’s needs. The homes recruitment policies are adequate to ensure residents are protected, but evidence indicated they are not fully complied with. EVIDENCE: The manager and deputy work full time from Monday to Friday. Rota’s indicated there are one senior carer and three carers on duty during the morning; a senior carer and two carers on duty during the evening with two carers overnight, which is adequate for the current number and dependency of residents. In addition, there are catering, domestic, laundry, administration staff and handy man who support the care staff. At least 50 of care staff have completed NVQ level 2, there are three staff currently undertaking the training and one member of care staff is undertaking NVQ level 3. A small number of staff files were examined and were found to be generally satisfactory. Some did not have a full range of documents to verify identity, but there was evidence of POVA and CRB checks. Warren Farm Lodge E54 S16920 Warren Farm Lodge V228415 240505 Stage 4.doc Version 1.30 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) 31,32,38 The manager, who is supported by the senior team, provides good leadership with an open, positive approach. The home is managed in the interests of the residents and their health, safety and welfare is protected. EVIDENCE: Warren Farm Lodge E54 S16920 Warren Farm Lodge V228415 240505 Stage 4.doc Version 1.30 Page 19 The registered manager has been in post for a number of years and has considerable experience of caring for the client group. The deputy manager’s post has been filled by a member of staff from the home, following promotion of the existing deputy manager. There are regular meetings for residents and staff and the manager hopes to introduce meetings with relatives. On discussion with residents they stated they were happy in the home and they felt they could approach the managers. Staff were happy working in the home, they felt they got on well, the management were good and there was good forms of communication at the change of shift. A sample of records was inspected in relation to maintenance and they were found to be of a generally good standard. At the last inspection there were some outstanding issues with eh electrical wiring and the passenger lift, which the manager was following up. The basic mandatory training within the home is ongoing with fire, basic first aid and epilepsy training being organised. On discussion with some staff there was a lack of clarity in respect of the procedure in the event of a fire. This will need to be followed up with regular drills. Warren Farm Lodge E54 S16920 Warren Farm Lodge V228415 240505 Stage 4.doc Version 1.30 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 2 x 2 2 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 2 x 3 2 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 3 x x x x x 3 Warren Farm Lodge E54 S16920 Warren Farm Lodge V228415 240505 Stage 4.doc Version 1.30 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 1 Regulation 4 Requirement The registered person must review and update statement of purpose to indicate arrangements for respite care. The registered person must review and update the service user guide to reflect arrangements for respite care. The registered person must ensure a full assessment covering all areas in standard 3 is completed for all residents entering the home. Timescale of October 2003 not met. The registered person must ensure that all care plans set out in detail the action to be taken by staff to meet all needs identified and ensure they are updated where there are any changes. Timescale of October 2003 not met. The registered person must ensure all staff files include proof of identity e.g. copy of passport and birth certificate. Timescale of January 2005 not met. The registered person must; Provide evidence to demonstrate the issues in respect of the electrical wiring have been Timescale for action 30/7/05 2. 1 5 30/7/05 3. 3 14 30/9/05 4. 7 15 30/9/05 5. 29 17(2) 20/7/05 6. 38 13(4) 30/7/05 Warren Farm Lodge E54 S16920 Warren Farm Lodge V228415 240505 Stage 4.doc Version 1.30 Page 22 addressed. Follow up the issues identified in respect of the passenger lift and retain records in the home. Timscale of January 2005 not met. 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 16 Good Practice Recommendations It is recommended that the date eye drops are opened is recorded on the container. It is recommended that the home review the procedure for informing residents of the compliants procedure. Warren Farm Lodge E54 S16920 Warren Farm Lodge V228415 240505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Birmingham & Solihull Local Office 1st Floor, Ladywood House 45-46 Stephenson Street Birmingham, B2 4UZ 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 Warren Farm Lodge E54 S16920 Warren Farm Lodge V228415 240505 Stage 4.doc Version 1.30 Page 24 - 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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