Inspection on 25/10/06 for Warren Farm Lodge

This inspection was carried out on 25th October 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

Warren Farm Lodge 30/11/05

Warren Farm Lodge 24/05/05

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 West Midlands B44 0PU Lead Inspector Amanda Lyndon Key Unannounced Inspection 25th October 2006 10:15 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 Warren Farm Lodge DS0000016920.V309948.R02.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. Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Warren Farm Lodge Address 123 Warren Farm Road Kingstanding Birmingham West Midlands B44 0PU 0121 472 8449 0121 415 2720 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) Anchor Trust Ms Janet Bennett Care Home 30 Category(ies) of Learning disability over 65 years of age (30), registration, with number Old age, not falling within any other category of places (30) Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 30th November 2005 Brief Description of the Service: Warren Farm Lodge is a purpose built two-storey home, which is situated close to a local health centre, shops and public transport in the Kingstanding area of Birmingham. The Home provides accommodation for thirty residents for reasons of old age and learning disability. Accommodation is provided in single flats each with kitchenette and en-suite facilities consisting of toilet and wash hand basin. There are communal assisted bathing/shower and toilet facilities strategically placed in the Home and staff are available to provide assistance in these areas as required. A passenger lift gives access to the first floor. There is a lounge, conservatory and dining room situated on the ground floor and there are smaller quiet seating areas located throughout the Home. The main kitchen is adjacent to the dining room and is well equipped. Parking is available to the front of the property and attractive enclosed gardens are situated to the rear with access through the conservatory. The Home and gardens are well maintained and provide a warm homely atmosphere and there is a no smoking policy within the building. Aids and adaptations are provided for residents with physical disabilities. There is a notice board displaying forthcoming events and other information of interest to residents and their visitors. The most recent CSCI inspection report is available in the reception area of the Home. The weekly fee to live at Warren Farm Lodge is £368 with an additional “top up” of £15. Hairdressing is not included within this fee. Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report reflects the findings of a one day unannounced field work visit undertaken by one Inspector when there were thirty residents living at the Home. The management team were not available on the day of the visit, therefore the inspection was conducted with the assistance of the care staff. Information was gathered by speaking with residents and staff, case tracking, examining care, medication and health and safety records and observing the staff perform their duties. A tour of the Home was undertaken. Prior to the field work visit positive comments were received from residents about the service provided including: “ Staff are always co operative and helpful” “Before admission to the Home there was sufficient information and help from staff answering any questions we asked” “If I want to see my Doctor the staff will contact him for me” “I can always find a member of staff” A negative comment was received from a resident about the quality of the meat purchased and this may prevent residents from enjoying their meal. Prior to the field work visit the Registered Manager had completed a pre inspection questionnaire, giving some information about the Home, residents and staff which was taken into consideration. What the service does well: Residents are involved in the planning if their care and this ensures that their preferences in respect of their daily lives and routines are maintained whilst living at the Home. Residents have access to a range of Health and Social Care Professionals and this ensures that their health care needs are met. Residents are cared for in a respectful manner by staff working at the Home and this ensures that their self esteem and dignity are maintained. Residents Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 6 are encouraged and supported by the staff team to maintain their independence dependent on their individual abilities. One resident said “ The staff always give me a gentle knock and call before they come in my room” Another resident said “ I like the staff to call me by my first name which they do, it is less formal” Residents are able to exercise control over their daily lives and the activities that they choose to participate in which promotes their individuality. There is a wide variety of activities on offer at the Home for the residents to participate in should they choose and visitors are made to feel welcome. One resident said “My nephew visits and there is a proper friendly atmosphere” Another resident said “ We have a say in everything, you can do just what you want here. I enjoy my breakfast in my flat and my other meals in the dining room” Another resident said “ The meal times are set but you please yourself in between times, you can go to your flat or stay in the lounge. I like to watch the television in my flat in the afternoons” Residents are offered a choice of wholesome meals and these meet any special dietary requirements for reasons of health, taste or cultural/religious preferences. One resident said “ They always offer us a choice of food. It is nicely served and appetising”. Residents and their visitors are encouraged to voice any concerns that they may have about the service provided at the Home and complaints are investigated in an appropriate and timely manner. One resident said “ I have had no complaints since I came to live here”. Residents are provided with a clean, comfortable and well maintained living environment in which they feel safe and secure and their privacy is maintained. The Home is suitable for people with physical disabilities and aids and adaptations are provided to promote the independence of these residents. One resident said “ When I buzz for the staff they come immediately, I feel safe here” Residents receive a good standard of care from appropriately trained and vetted staff and staff are provided in adequate numbers to meet their care needs. One resident said “ The staff are very friendly and it’s always the same staff here”. The management team are approachable and friendly, residents’ meetings were held regularly and there was evidence that any suggestions made by residents about the service provided at the Home were acted upon. One resident said “ The Manager came and spoke to us all at lunch time yesterday” One staff member said “ My Manager is great, she is the best”. Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 7 There were regular maintenance checks and servicing of equipment used at the Home and this ensured that they were safe to use. What has improved since the last inspection? What they could do better: An assessment had not been undertaken about a resident’s care needs prior to coming to live at the Home and this had resulted in distress to both the individual resident and other residents living at the Home for a period of time. This situation is now resolved. Risk assessments and compliance checks were not always undertaken regarding residents who had chosen to self administer their own medication Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 8 and this may result in individuals not receiving the correct dosage of medication at the prescribed times. The letter boxes on the doors of residents’ flats may not comply with fire regulations and would not prevent the spread of fire in the event of an emergency. Cleaning products had been left unattended in a resident’s flat and sterilising fluid had been left in another resident’s flat and these would pose a risk to the health of vulnerable residents if accidentally swallowed or inappropriately handled. Suitable closures that were linked in to the fire alarm system had not been fitted to the main lounge or office doors. As a result of this the doors were either wedged open which would not prevent the spread of fire in the event of an emergency or were kept shut and residents were experiencing difficulties mobilising in and out of the lounge whilst the door was shut and this did not promote their independence and may cause them to fall. 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 DS0000016920.V309948.R02.S.doc Version 5.2 Page 9 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 Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4 & 5 Quality in this outcome area is adequate. This judgement had been made using available evidence including a visit to this service. Admission and care reviewing processes are thorough however a lapse in procedure did not safeguard residents. Residents make informed decisions about whether they would like to live at the Home. EVIDENCE: Prospective residents are encouraged to visit the Home in order to sample what life would be like to live there and during this time a pre admission assessment is undertaken by senior staff to ensure that the person’s individual care needs could be met whilst living at the Home. The assessment document used for this was found to be comprehensive and informative however these were not always signed and dated by the person undertaking the assessment. One resident said “ I didn’t get to see my room before I came here because I was ill but everyone was so welcoming and helpful”. Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 11 An exception to this was that the Home’s staff had failed to undertake a pre admission assessment regarding a resident who had come to live at the Home as an emergency placement. This identified resident had moderate to severe dementia care needs and challenging behaviour which initially could not be met by the Home’s staff and distress was caused to the individual and other residents living at the Home for a period of time as a result of this. Warren Farm Lodge does not have a category of registration to accommodate people with dementia. It was noted that following multi disciplinary input this identified resident was now more settled living at the Home. Residents come to live at the Home on a four week trial period and a care review involving the resident, their family, Social Worker and Home’s staff is undertaken on completion of this. This provides all involved with the opportunity to discuss whether the resident’s individual care needs could continue to be met whilst living at the Home and whether the resident wished to remain there. Intermediate care is not provided at Warren Farm Lodge Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 12 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 good. This judgement had been made using available evidence including a visit to this service. Care planning and health care provision are good and residents receive personalised care and this promotes their individuality. Residents are supported in a respectful manner by the staff team and this ensures that their self esteem and dignity are maintained. EVIDENCE: Comprehensive assessments of residents’ individual abilities, health , interests and preferences in respect of their daily lives are completed on admission to the Home. These are written by the staff team with the involvement of the resident or their family and included good detail in order to ensure that residents preferred routines could be maintained whilst living there. Interesting life histories were completed and this provided staff with information about residents’ lives and interests and the reasons for coming to live at the Home. This assists in planning their future care. Individual care plans derived from this information had been devised with the involvement of the residents and their families. These included excellent detail Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 13 of the specific support required by staff in order to meet residents’ individual care needs. Care plans identified that the majority of residents wished to be checked regularly by staff during night time hours and residents confirmed that this support was being provided. One resident said “ Every two hours in the night, Security come to check on me, it makes me feel safe” Separate social activity care plans had been undertaken and these gave good detail of any hobbies/interests and religious wishes of residents and comprehensive dietary preference assessments had been undertaken. A care plan was available regarding the mental health needs of a resident and this included good detail of the support required by staff regarding this. Care plans were reviewed each month and the evaluations included good detail of any progress made or any concerns raised in respect of each care need. The care planning system is audited each month by the Deputy Manager to ensure that care plans are up to date and reflect the current care being afforded to residents. Personal risk assessments had been undertaken as deemed necessary including the risk of falls and malnutrition. Residents were weighed at least monthly in order to ensure that they were not losing or gaining weight. Residents were supported by the Home’s staff to access Health and Social Care Professionals and all residents met during the visit expressed their satisfaction about the level of health and medical care input that they received whilst living at the Home in order to ensure that their well being was protected. Residents regularly had access to their General Practitioner, Dentist, Chiropodist and Optician and Social Worker. District Nurses visit the Home daily in order to administer an insulin injection to a resident who has diabetes. A number of residents had recently been given the influenza vaccine. One resident said “ I have got the same Doctor here as when I lived in my own house so he knows me well”. Care reviews were undertaken regularly and staff were proactive in arranging urgent reviews should a resident’s care needs change rapidly. This ensures that residents are receiving the appropriate care that they require with the support of the Home’s staff and Health and Social Care Professionals. Residents appeared to be well supported by the staff team to maintain their personal care needs and choose clothing and jewellery that was appropriate for their age, gender, cultural preferences and the time of year. There was a robust system in place for the management of medicines and this safeguards residents. Staff met during the field work visit had a good knowledge of the system and had received relevant training in this area. Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 14 Medication administration charts were well maintained, medication storage was well organised and regular auditing was undertaken in order to monitor the system for accuracy. Stock balances of medicines sampled during the field work visit were found to be correct. One resident had chosen to self administer her own inhalers however a self administration risk assessment was not available in respect of this. It is recommended that all medication received in to the Home is checked in by two members of staff. A number of residents chose to lock their flats when they were not in there and during night time hours in order to maintain their privacy. Residents confirmed that they were cared for in a respectful manner by the staff team, they were greeted by their preferred names and staff always waited for permission before entering their flats. Any correspondence received by post is delivered to residents unopened. One resident said “ The staff always give me a gentle knock and call before they come in my room” Another resident said “ I like the staff to call me by my first name which they do, it is less formal” There was a public telephone available for residents’ use located in the corridor and this did not afford privacy. A number of residents had chosen to have a private telephone line installed in their flats or the senior carers office could be used if privacy was required. Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 15 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 good. This judgement had been made using available evidence including a visit to this service. Activities on offer meet the needs and expectations of residents living at the Home. Residents exercise control over their daily lives so that their independence and individuality are maintained. The choice of wholesome and well presented meals meet any special dietary needs of residents for reasons of health or cultural/religious beliefs. EVIDENCE: There was currently no activities co ordinator employed at the Home and all staff had the responsibility of ensuring that activities were provided in the absence of this person. There was a range of activities on offer for residents to participate in should they choose including bingo, arts and crafts, quizzes, sing a longs and exercises. Barbeques are held during summer months and trips outside of the Home are arranged. A Christmas coffee morning is planned. Bingo was played on the day of the field work visit and this was displayed on the notice board in order to inform residents that it was due to take place. Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 16 One resident said “ We are not forced to do anything here” Another resident said “ I had beginners luck playing darts, they call me the Champ” One resident had chosen to have satellite television in his flat and there is a computer available for residents’ use. A comprehensive register of daily activities provided was maintained and this assists in planning future events. Holy Communion is available at the Home each month and “Songs of Praise” is played in the main lounge each Sunday. Opportunities for worship for residents of non Christian faiths can be arranged as required and some residents are supported by their friends and family to attend their places of worship outside of the Home. There was an open visiting policy and visitors were made to feel welcome at the Home. One resident said “My nephew visits and there is a proper friendly atmosphere” There were no rigid rules or routines and a number of residents were able to go outside of the Home either on their own or with their families as they chose, following assessment. This promotes their independence whilst maintaining their safety. One resident said “ We have a say in everything, you can do just what you want here. I enjoy my breakfast in my flat and my other meals in the dining room” Another resident said “ The meal times are set but you please yourself in between times, you can go to your flat or stay in the lounge. I like to watch the television in my flat in the afternoons” The menus identified a good choice of wholesome meals and residents confirmed that they were consulted about what they would like to eat on a daily basis. In addition to the main meal, a cooked breakfast was available, a hot or cold meal option was available at tea time and a snack meal was available at supper time and during the night time hours. Special diets were prepared for reasons of health or dietary/cultural preferences. One resident enjoyed Caribbean food and a number of residents were diabetic and suitable meals were prepared for these people to enjoy. The main meal options on the day of the field work visit were gammon or chicken nuggets. These were served with fresh vegetables and sauces and residents expressed their satisfaction about the taste and quality of these. Residents were encouraged to serve their own vegetables and sauces that were available on the dining tables and this ensured that they had control over the portion sizes. Fresh fruit was available in the dining room. The dining tables were laid attractively, cold drinks were served, appropriate music was being played and there was friendly banter between residents and staff during the lunch time meal, making it an enjoyable social event. More Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 17 independent residents were assisting other residents with their meal in an appropriate manner and it was evident that friendships had been made between residents living at the Home. Appropriate adapted cutlery and a lipped plate was provided for a resident to enable her to feed herself, thus preserve her independence and dignity. One resident said “ My meal is lovely, it’s gorgeous” Another resident said “ They always offer us a choice of food. It is nicely served and appetising”. The menu on display did not reflect the meals available for that day and menus were not available on dining tables for residents to refer to and this does not remind some residents about what they had ordered to eat. Prior to the field work visit a negative comment was received from a resident about the quality of the meat purchased, however all residents met during the visit expressed their satisfaction about the quality of meals served. Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 18 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 had been made using available evidence including a visit to this service. Complaints are investigated in an appropriate and timely manner. Measures are in place to protect vulnerable residents from harm. EVIDENCE: A comprehensive complaints procedure was attached to the notice board however residents or their visitors were not able to read this as it was covered by a fire door. Since the last field work visit, CSCI, Social Care and Health and the Organisation had jointly investigated a complaint of an adult protection nature and work practices had been reviewed as a result of this with the agreement of the staff team. Unannounced visits to the Home by the management team have been undertaken during night time hours in order to ensure that residents receive a consistently good standard of care during that time. The complaints register held at the Home identified five complaints since the last field work visit that had been investigated by the management team in a timely manner to the satisfaction of the complainants. These included two episodes of residents’ inappropriate behaviour and bad language and a resident who complained that her money had gone missing, all of which were now resolved. Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 19 A number of compliments had been received from residents and their visitors about the care, support and food provided at the Home. One resident said “ I have had no complaints since I came to live here”. Staff had received training about the protection of vulnerable adults and staffs’ knowledge about this was good. The adult protection policy included local multi agency guidelines and this ensured that all senior staff were aware of the correct action to take in the event of alleged or actual abuse. Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 20 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, 20, 21, 22, 24, 25 & 26 Quality in this outcome area is good. This judgement had been made using available evidence including a visit to this service. Residents are provided with a clean, comfortable and well maintained living environment in which they feel safe and secure and their privacy is maintained. Aids and adaptations provided meet the needs of residents and promote their independence. EVIDENCE: The internal environment of the Home was furnished and decorated to a high standard and the reception area was welcoming. The building was secure, key pad locks were fitted to areas of the Home that vulnerable residents did not have access to and a suitable lock was fitted to the front door in order to prevent vulnerable residents from leaving the Home unsupervised. The main lounge was decorated attractively, in a homely style and the furniture and floor coverings were of a high standard. There were a number of Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 21 smaller seating areas leading off from corridors throughout the Home and these were cosy and comfortable. A well lit and spacious conservatory lead off from the main lounge as an alternative seating area for residents to use. The secure and well maintained garden was accessed through the conservatory and this was suitable for wheel chair users. There were assisting bathing and showering facilities available and in addition to these there were two domestic style baths. Residents had the choice of these facilities based on their preferences and physical abilities. A number of residents had chosen to bath on their own, thus maintaining their privacy and independence and there were call bell facilities within easy reach in all bathrooms in order for residents to summons assistance from staff. Other residents required full assistance from staff in order to meet their personal hygiene needs and the facilities available were suitable to meet their needs. One resident said “I tend to choose a shower, I just say when I want one and the staff help me” Bathrooms were clean and decorated in a homely style, however bars of soap had been left in one shower room and this may cause cross infection. There were two mechanical hoists available for residents with limited mobility and to be used in the event of a resident falling on the floor. The staff said that this equipment met the needs of the residents currently living at the Home. Hand rails were provided in corridors and near to toilets and raised toilet seats were available. One resident was partially sighted and had a selection of talking books and a wall clock that had black numbers and hands so that she could tell the time, thus improve her quality of life and maintain her independence. There was a hearing loop system in the lounge for those with hearing aids. Each resident had their own flat and this consisted of a sleeping and seating area, a fridge and kitchen work surface, ample storage space and an en suite toilet. Residents coming to live at the Home provide their own bed linen, curtains and furniture and are encouraged to bring their personal possessions in order to feel comfortable in their surroundings. A lockable storage facility was provided in each flat for the safe keeping of residents’ personal items. A number of residents had chosen to have hot drink making facilities in their flats for when their friends and family visit and this promotes their independence. There was a call bell facility in each flat and this had been placed within easy reach of a resident who was visually impaired so that she could use it as she wished. One resident said “ When I buzz for the staff they come immediately, I feel safe here” A service user guide was available in each residents’ flat providing information about the services provided at the Home. Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 22 Letter boxes were fitted on to residents’ flat door and following the visit the Registered Manager confirmed that these complied with fire regulations in order to safeguard residents. Bedroom furniture in one resident’s flat had become damaged which may result in an injury to the resident or staff. This was brought to the attention of the person in charge and remedial action was taken without delay. A comprehensive infection control audit had recently been undertaken by the Health Protection Agency and the overall score was a positive 94 . The Home was also found to be clean and fresh on the day of the field work visit and residents met stated that they were satisfied with the level of cleanliness at the Home. There was an effective and hygienic system in place for the laundry of residents’ personal clothing and bed linen and residents praised the speed and quality of service in which their clothing was returned to them. Residents clothing is washed separately and residents said that they particularly liked this facility. Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 23 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 good. This judgement had been made using available evidence including a visit to this service. Residents receive a good standard of care from appropriately trained and vetted staff and staff are provided in adequate numbers to meet residents’ care needs. EVIDENCE: All staff met during the field work visit were friendly, helpful and welcoming and residents confirmed that this was always the case. There was one senior carer and three care assistants on duty during mornings, one senior carer and two care assistants during afternoons and two care staff overnight with on call support from a senior member of staff. Kitchen, laundry, domestic and maintenance staff provided ancillary support on a daily basis and this ensured that residents were supported in all aspects of their daily lives. Residents and staff met during the field work visit expressed their satisfaction at these staffing levels. The staffing rotas identified that these staffing levels were maintained and agency staff were not used as the Home’s own staff and “bank” staff provided shift cover in the event of staff sickness or holidays. In addition to this the Deputy Manager provided shift cover as required however details of the hours worked by the management team were not identified on the staffing rota thus the staffing rotas did not always reflect the actual number of staff provided. Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 24 All new staff recruited to work night duties at the Home gain experience on day duties prior to working at night to ensure that they gain the appropriate knowledge before working unsupervised and this safeguards residents. One resident said “ The staff are very friendly and it’s always the same staff here”. This ensures continuity of care for residents. Staff files sampled included all pre recruitment information required and this safeguards residents. The system for the filing of this information was found to be well organised. New staff undertake comprehensive “Skills For Care” induction training and this ensures that they have the appropriate knowledge to support residents in a competent manner. There was an individual staff training profile for each staff member and these identified that staff had undertaken recent training relevant to their job roles including dementia and bereavement care. 70 of care staff had achieved a minimum of NVQ level 2 or above and this ensures that they had the appropriate knowledge to work in a competent manner. Staff training scheduled for the near future included palliative care and back care. Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 25 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, 32, 33, 35, 36 & 38 Quality in this outcome area is good. This judgement had been made using available evidence including a visit to this service. This is a well managed Home, run in the best interests of the residents living there and it is regularly monitored for quality and health and safety. The systems in place for resident consultation are good, ensuring their involvement in the running of the Home. EVIDENCE: There was a stable and effective management team at Warren Farm Lodge and each member had their own designated responsibilities in respect of the running of the Home. Residents and staff said that the management team were approachable and friendly and this promotes a positive living and working environment in which residents feel secure and staff are supported. Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 26 One resident said “ The Manager came and spoke to us all at lunch time yesterday” One staff member said “ My Manager is great, she is the best”. The Registered Manager had undertaken recent training in health and safety, fire safety risk assessments and palliative care in order to gain up to date knowledge to lead the staff team. A residents’ meeting had been held recently and this provided residents with the opportunity to put forward their views about the service provided at the Home. The main topics for discussion were suggestions for forthcoming activities and menu options, the premises and staffing issues. There was evidence that any recommendations made by residents were acted upon. Staff meetings were held regularly and this ensured that staff were informed about any new procedures or services provided for residents living at the Home. Individual meetings were held for different staff groups so that information specific to their job roles could be discussed in depth. The minutes of these confirmed that staff were consulted about any changes that are introduced at the Home. Quality monitoring records were not available on the day of the field work visit however it was apparent that regular auditing of the care planning, medication, environment and residents’ personal monies were undertaken in order to monitor the standard of service provided at the Home. The Home did not manage the personal finances of residents and the majority of residents were supported in this area by their families. There was a facility for the safekeeping of small amounts of residents’ money and jewellery if the resident chose to use this facility, however this could only be accessed by the management team and on the day of the field work visit residents would not have been able to access this. Receipts of all items bought out of residents’ money were kept as proof of purchasing and this system was audited regularly for accuracy. Staff confirmed that they were having formal supervision sessions with their line managers at least every two months and this ensured that they were supported within their job roles. Maintenance checks of equipment used at the Home were undertaken regularly to ensure that they were safe to use. There was a rolling programme of statutory staff training in place including health and safety, first aid, food hygiene and fire safety. A fire drill had been undertaken recently and a record of the positive outcome of this was available. The Home’s staff inform CSCI of any incidents or accidents that affect the health and welfare of residents living at the Home however it was not possible Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 27 to assess whether a system for the auditing of accidents takes place as the documentation supplied to the Inspector by the person in charge of the shift on the day of the visit did not include this information. This will be assessed during the next visit at the Home. Cleaning products had been left unattended in a resident’s flat and sterilising fluid had been left in another resident’s flat and these would pose a risk to the health of vulnerable residents if accidentally swallowed or inappropriately handled. Suitable closures that were linked in to the fire alarm system had not been fitted to the main lounge or office doors. As a result of this the doors were either wedged open which would not prevent the spread of fire in the event of an emergency or were kept shut and residents were experiencing difficulties mobilising in and out of the lounge whilst the door was shut and this did not promote their independence and may cause them to fall. Fire doors must be held open by suitable means that is linked in to the fire alarm system and a risk assessment must be completed in respect of this in the interim. Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 28 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 2 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 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 Standard No Score 16 3 17 x 18 3 3 3 3 3 x 2 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 2 3 x 2 Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 14(1) Requirement Pre admission assessments must be undertaken for all prospective residents prior to coming to live at the Home and these must be signed and dated by the person undertaking the assessment. Risk assessments and compliance checks must be undertaken and reviewed regularly for residents that choose to self administer their own medication The bedroom furniture in an identified resident’s flat must be repaired. Timescale for action 15/11/06 2 OP9 13(2)(4) 15/11/06 3 OP24 13(4) 16(2)(c ) 23(2) 25/10/06 4 5 OP27 OP38 17(2) 23(4) The Registered Manager received this in the form of an immediate requirement The duty roster must identify all 15/11/06 persons providing care at the Home Fire doors must be held open by 26/10/06 suitable means that is linked in to the fire alarm system and a risk assessment must be completed in respect of this in the interim. Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 30 Timescale for risk assessment: The Registered Manager received this in the form of an immediate requirement Cleaning products must be 25/10/06 stored securely at all times The Registered Manager received this in the form of an immediate requirement 6 OP38 13(4) 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 3 4 5 Refer to Standard OP9 OP15 OP16 OP26 OP35 Good Practice Recommendations All medication received in to the Home should be checked by two staff members The menu on display should reflect the meals available for that day and menus should be available on dining tables for residents to refer to The complaints procedure should be moved to a prominent position within the Home. Bars of soap should be removed from the communal bathroom. Residents should be able to access any monies held by the Home for safekeeping by the Home at any time that they choose within reason. Warren Farm Lodge DS0000016920.V309948.R02.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Birmingham 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 DS0000016920.V309948.R02.S.doc Version 5.2 Page 32 - 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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