Inspection on 28/11/08 for Warren Lodge Care Centre

This inspection was carried out on 28th November 2008.

CSCI found this care home to be providing an Good service.

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 Lodge Care Centre 15/11/06

Warren Lodge Care Centre 05/01/06

Warren Lodge Care Centre 22/09/05

Warren Lodge Care Centre 01/02/05

Warren Lodge Care Centre 22/07/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Warren Lodge Care Centre Warren Lane Finchampstead Wokingham Berkshire RG40 4HR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Amanda Longman     Date: 2 8 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Warren Lodge Care Centre Warren Lane Finchampstead Wokingham Berkshire RG40 4HR 08444725186 08444120631 warrenlodge@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Phoenix Healthcare Ltd The registered provider is responsible for running the service Name of registered manager (if applicable): Name of registered manager (if applicable) Mrs Sharon Leslie Williams Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Warren Lodge is a privately owned large country house that is registered to provide residential care for older people; it has an additional ground floor wing registered to provide personal care and support for older people who have dementia but do not need nursing care. The rooms are large and individual. Bedrooms are located over three floors; there is a shaft lift for access. Some double rooms are available but most are single and have en suite facilities. Care Homes for Older People Page 4 of 25 care home 41 Over 65 0 41 41 0 Brief description of the care home The property is situated near to Finchampstead in an attractive secluded area with views over the countryside at the rear. There is large well-maintained garden with a small aviary. Ample car parking spaces are available and public transport is nearby. Local amenities include shops and a doctors surgery. The fees for the home range from 650 pounds to 750 pounds depending on the room size and the dependency of each person. Additional charges are made for extra services such as hairdressing and for personal expenditure such as newspapers or magazines. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection of the service was an unannounced Key Inspection. It was a thorough look at how well the service is doing. It took in to account information received from the manager prior to the site visit which was undertaken by Amanda Longman, Regulatory Inspector, primarily on 28 November 2008. A supplementary visit was made on 23 January 2008. During the initial site visit we (the Commission) toured the home, observed care practices, spoke with service users, visitors and staff and examined care records. During the supplementary visit we reviewed staff records and spoke further with the manager and the administrator. The manager and staff spoken with were aware of peoples possible diverse individual needs and a range of policies procedures and knowledge are in place to meet these. The previous inspection was undertaken on 15 November 2006 and we completed an Care Homes for Older People Page 6 of 25 annual service review report on 14 April 2008. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who come to live at Warren Lodge have enough information and can be confident that the home can meet their needs. Evidence: Warren Lodge has a Statement of purpose and a Service User Guide (Welcome Pack) in place. They provide relevant information for service users and prospective service users about the home, its facilities and staff and its philosophy of care. These documents have been recently reviewed (January 2008) but the Statement of Purpose contains the wrong address for the Commission for Social Care Inspection. This has been pointed out to the manager who is in the process of changing it. The people we spoke with during the course of our site visits stated they had enough information about the home. We reviewed the assessment information for the last two people who moved in to Warren Lodge. In both cases there was detailed information enabling a decision to be Care Homes for Older People Page 10 of 25 Evidence: made that the home could suitably meet their needs. However, any new admission is subject to four weeks trial by both parties to ensure that the person is happy and the home is appropriately meeting their needs. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Warren Lodge benefit from having detailed care plans. Their health care needs are met, including medication and they are treated with dignity and respect. Evidence: We reviewed the care plans for four people who live at Warren Lodge in the main house and for two people who live in The Courtyard. The care plans were detailed and up to date and are regularly reviewed. Medical and health needs are detailed in the individual plans and district nurses assist with care as appropriate. Staff spoken with were familiar with peoples care plans and their individual needs and preferences. We spoke with several people living at Warren Lodge who all told us they can choose when to get up or go to bed, that they can come and go as they please and choose whether they wish to be in their rooms or in the communal areas. They also confirmed they can see family and friends in private and can see medical practitioners in private. Medication in the home is securely stored, records are up to date and only staff who are trained to do so, administer medication. Confirmation of medication training was Care Homes for Older People Page 12 of 25 Evidence: seen. A pharmaceutical inspection was undertaken by by West Berkshire Primary Care Trust on 19 November 2008 which confirmed that medication standards were met and did not require any actions to be taken. People we spoke with stated that staff were polite and courteous and that they were treated with dignity and respect. Staff we spoke with were familiar with individuals needs and preferences and were aware that people have differing personal, emotional and spiritual needs. We spent time observing care practices in the home. In the main home staff were polite, courteous and interested in what people had to say. Care plans for people living in the Courtyard were detailed, for example they contained a lot of relevant information about their past lives and the staff we spoke with were knowledgeable about peoples individual histories and experiences. We observed care practices in the Courtyard during our site visit. Staff were again polite and courteous and were seen to socially engage people with activities going on around them. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at Warren Lodge enjoy the lifestyle, opportunities and choices offerred by the home. Evidence: Warren Lodge employs a part time activities co-ordinator whose hours have been increased since the previous inspection. A variety of activities are offered to the people who live there. On the day of the site visit we observed a Christmas flower arranging demonstration in the main lounge and a game of carpet bowls in the lounge in the courtyard. Staff in the Courtyard spent time engaging all the people in the game and people enjoyed the activity. There was also plenty of evidence of other activities such as puzzles and arts and crafts. The Courtyard has its own garden which staff explained is used a lot in warmer weather. Staff we spoke with in the Courtyard knew the people who live there well and knew their individual interests as noted in their care plans. We spoke with several people in the main lounge who enjoyed the exhibition of flower arranging and confirmed this was a regular activity. They also confirmed that other activities are regularly on offer such as film sessions and manicures. The mobile library visits regularly and there are occasional trips out. People we spoke with confirmed Care Homes for Older People Page 14 of 25 Evidence: they are free to spend the day or evening in the lounge or in their rooms and can come and go as they please. The people we spoke with confirmed that relatives and friends are always welcome in the home and are involved in the social life of the home. People are able to express their individual faiths and beliefs and religious ministers visit the home regularly. For example a Roman catholic minister was visiting on the afternoon of our site visit. The home does not hold cash on behalf of the people who live there. People are entitled and encouraged to bring personal possessions and small items of furniture with them and we saw evidence of this in peoples rooms. Any electrical appliances must be tested to ensure they are safe. The information provided to us by the manager prior to the site visit stated that one of their development plans was to help residents and relatives access advocacy services. The home has a varied menu offering three meals a day with drinks and snacks in between. The people we spoke to confirmed that they can have a cooked breakfast if they wish. They said the food in the home was very good, that there was plenty of choice and plenty of good quality food. The main meal is served at lunch time, with a glass of wine for those that wish. We saw homemade cakes and tea/coffee served in the lounge in the afternoon and were told by the people who live there that a high tea is served at 5.30pm. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Warren Lodge know their concerns will be listened to and they are safeguarded from possible abuse. Evidence: The home has in place an appropriate complaints procedure. The manager stated, in the pre-inspection information that they have an open approach to comments and complaints and people we spoke with said they knew who to speak to if they were not happy. Staff and residents commented that the manager is approachable. The information we received from the manager prior to the site visit showed that no complaints had been received in the proceeding 12 months and the Commission has not been made aware of any complaints. There is an appropriate procedure in place for safeguarding vulnerable adults and records show that staff have received training in this area. This was confirmed by the staff we spoke with. Two safeguarding referrals had been made to the local authority social services department by the home in the previous 12 months. This follows the correct procedure where any concerns exist. In both cases the manager worked closely with the social services department in an appropriate manner to ensure the well being and safety of these people. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Warren Lodge benefit from a home which is comfortable, safe and well maintained. Evidence: Warren Lodge has 36 bedrooms, 11 of which are in the Courtyard, which is registered for dementia care. Five of the rooms in the main house are registered for double occupancy. Most of the rooms have en-suite facilities and assisted bathing facilities are also available. We toured part of the home and found it to be well furnished, homely and comfortable. The people we spoke with confirmed that it is a very comfortable and homely home. It is a character building set in a large, attractive and accessible garden. Bathrooms and hallways have been improved since the previous inspection and thermostatic valves have been fitted to all radiators. The home has plans for a separate dining room for The Courtyard, subject to planning permission. The home was assessed by the fire service in September 2008 and all the recommendations made have been signed off by the fire inspector as being done. Its most recent environmental health inspection gave it a four star rating. Infection control procedures are in place and most staff have received infection control training. Arrangements are in place for new staff to receive this training in the near future. Regular maintenance checks are undertaken on all electrical and other equipment in line with manufacturers recommendations. Care Homes for Older People Page 17 of 25 Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at Warren Lodge are supported by staff who are appropriately recruited, well trained and well qualified. Evidence: Warren Lodge has an appropriate recruitment policy in place. We checked the records for the last two recruited members of staff. All appropriate checks were in place including references and clearance from the Criminal Records Bureau. The home checks people have a full employment history and asks appropriate questions to cover gaps. Staff in the home are very well qualified. Three quarters of care staff are qualified to NVQ level 2 or above with a further 10 currently undertaking this qualification. Minimal use of agency staff is made and the manager plans to develop a more effective bank system over the next 12 months to further limit the use of agency staff. Staff currently work on a shift system with most staff working a rotation of seven and 13 hour day shifts to ensure there are always enough staff on duty to meet peoples needs. People we spoke with living in the home said that staff were well trained and were helpful and courteous and available when you needed them. Information from the manager stated that assistance is provided for staff to improve their English if necessary and such help was being provided for four staff prior to our site visit. The managers plans for the next 12 months include developing the skills of the Care Homes for Older People Page 19 of 25 Evidence: kitchen assistants to enable them to become assistant cooks. The home has a training plan in place for all staff which covers the statutory training sessions including manual handling, fire safety, first aid and the protection of vulnerable adults. It also includes additional courses such as diabetes care, stoma care and continence promotion. All staff in the home who work in the area known as The Courtyard, where people with dementia are supported, have received training in dementia care. Over the whole home 75 of the staff have also received training in dementia care to an NVQ level 2 standard. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at Warren Lodge benefit from living in a home which is well managed and run in their best interests. Evidence: Warren Lodge is managed by a person who is suitably qualified and experienced to run the home, who has undertaken the Registered Managers Award and who is registered with the Commission in line with the Care Standards Act. She is supported by an administration manager, a deputy manager and a team of senior carers, carers and ancillary staff. The people we spoke with on the day of the site visit spoke highly of the manager and her team. The staff we spoke with said the manager was approachable and a good manager. We interviewed the administrator. This was her first job in the care industry. She has been responsible for several innovations in the home. For example she had prepared individual gift calendars for all the people living in the home with individual photographs of themselves. The manager stated she is running the home in the best interests of the people who live there. She has instigated regular Care Homes for Older People Page 21 of 25 Evidence: residents meetings and twice yearly meetings for relatives. A supervision programme is in place for all staff and staff spoken with confirmed they had regular supervision meetings. Senior carers are supervised every two months by the manager and the senior carers supervise the carers. The home has detailed health and safety policies and procedures in place. All care staff have received induction training and training in moving and handling. Additional training in fire safety, first aid, food hygiene, COSHH and infection control has been provided. At the time of the site visit not all staff had received all of this training but the manager is currently sourcing additional health and safety training for the newer staff. Risk assessments and risk management plans were seen to be in place for individuals and activities. Accidents and incidents are appropriately recorded in peoples individual records and in a central register. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!