Inspection on 05/01/06 for Warren Lodge Care Centre

This inspection was carried out on 5th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Lodge Care Centre 28/11/08

Warren Lodge Care Centre 15/11/06

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Warren Lodge Warren Lane Finchampstead Wokingham Berkshire RG40 4HR Lead Inspector Stewart Mynott Unannounced Inspection 5th January 2006 10:20 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 Lodge DS0000011404.V274395.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 Lodge DS0000011404.V274395.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Warren Lodge Address Warren Lane Finchampstead Wokingham Berkshire RG40 4HR 0118 973 4576 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) Phoenix Healthcare Limited Mrs Sharon Leslie Williams Care Home 41 Category(ies) of Dementia - over 65 years of age (11), Old age, registration, with number not falling within any other category (30) of places Warren Lodge DS0000011404.V274395.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd September 2005 Brief Description of the Service: Warren Lodge is a large adapted house with a ground floor wing added. A communal lounge and separate sun lounge is provided along with dining room and two assisted bathrooms on the ground floor. The majority of the rooms are en-suite with showers and/or baths. A shaft lift is available to the second floor, which has another two bathrooms. The home is well decorated with attention to detail with its furnishings. The rooms are all individualised with their carpets and curtains. The rooms vary in size and design, one of which has the benefit of a small conservatory. The home is situated in secluded area with views over the countryside at the rear. There is large well-maintained garden with a small aviary. The home is registered to provide care for eleven individuals with a primary diagnosis of dementia who do not require nursing care. This unit is called The Courtyard, the unit provides different activities and also benefits from garden which is safe and secure and was designed specifically for the needs of the service users, it has a large ramp to enable access for less mobile service users to the garden. Warren Lodge DS0000011404.V274395.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection during the day lasting for 7 hours. The focus of this inspection was to concentrate on how residents chose to move into this home, the lifestyle and the management arrangements at the home. This was a positive inspection. The ownership of the company responsible for Warren Lodge has recently changed. As such there is now a newly registered manager at the home. The majority of this inspection was spent talking to the residents and most of the staff on duty to gain an insight into their everyday experiences and views about the home. Two relatives, a visitor and a health professional were also spoken to during the inspection to gain their impressions of the home. Time was spent at the beginning and end of the inspection with the registered manager. Some records relating to the care of residents and the running of the home were examined during the inspection. Service users spoken to preferred to be called “residents” and hence this term is used throughout this report. What the service does well: What has improved since the last inspection? The previous requirements made during the last inspection have been fully met. Warren Lodge DS0000011404.V274395.R01.S.doc Version 5.1 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 Lodge DS0000011404.V274395.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Warren Lodge DS0000011404.V274395.R01.S.doc Version 5.1 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 the following standard(s): 1, 3 and 5 Prospective residents receive information about the home to assist them to make an informed choice. The statement of purpose and service users guide need updating to record the changes to the management of the home. Prospective residents are only admitted after an assessment of needs to ensure that these can be fully met. Prospective residents and their families are encouraged to visit prior to admission. EVIDENCE: The home has an admission policy and information contained in the statement of purpose and service user guide. Residents spoken to were clear about their reasons for choosing to move to Warren Lodge and in most cases had visited the home prior to admission and felt they had received a good level of information to assist in their choice. The new registered manager is reviewing the services provided at the home and the statement of purpose and service users guide will be reviewed and updated at this time. The deputy care manager explained that potential new residents are sent a copy of a “care assessment fact book” to complete and return before admission. This document was viewed for the last two admissions and Warren Lodge DS0000011404.V274395.R01.S.doc Version 5.1 Page 9 contained useful individual background information about life history and recent past. One resident remembered completing this document with family assistance. A further “admission information” document is completed on admission. This was seen to be overly lengthy and detailed, more akin to initial care planning, and in the last three admissions these documents were mostly incomplete. It is a recommendation that the use of this admission tool is reviewed. The new registered manager now completes pre-admission needs assessments for all prospective residents. Evidence of this was seen for the last two admissions. Warren Lodge DS0000011404.V274395.R01.S.doc Version 5.1 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 the following standard(s): Standards 7 to 11 were not assessed during this inspection. EVIDENCE: Warren Lodge DS0000011404.V274395.R01.S.doc Version 5.1 Page 11 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 and 15 Residents are satisfied with the daily routines and lifestyle at the home. Organised social activities meet resident’s expectations. The provision of activities for residents with a diagnosis of dementia must be reviewed and developed to ensure choice and suitability. The registered manager should consider the provision of an activities coordinator that is trained to organise and further monitor an activity program particularly for residents with a diagnosis of dementia. Residents are offered a choice of menu and receive an appropriate diet in a comfortable setting. EVIDENCE: Several residents in the “main house” discussed their experiences of the daily life at the home. Residents reflected that the lifestyle at the home is positive. Residents spoken to were aware of the daily activities organised at the home and felt that the current program met their expectations and they could chose to attend if they wished. The activities program was viewed outside the main dining room. All residents stated that they felt able to exercise their choice in their personal daily routines and staffs were respectful of such choices. A visitor from a local church confirmed that residents receive regular visits to fulfil their religious needs. Two residents confirmed the importance of these visits to them. Warren Lodge DS0000011404.V274395.R01.S.doc Version 5.1 Page 12 Residents confirmed that they receive their visitors without restriction and in private as required. Two relatives spoken to felt that they were made welcome by the staff and always offered refreshments. The arrangements for activities in the “Courtyard” were reviewed. Staff spoken confirmed that daily activities are provided but that these tended to be mostly the same each day. Some staff stated they were not confident in this area particularly in engaging residents at the start of activities. The registered manager confirmed that further training had been arranged in the near future, which might assist staff in this area. However a review of the activities in the Courtyard must be undertaken to ensure sufficient range and suitability is available to those residents with a dementia. It is further recommended that consideration be given to the coordinating and monitoring of activities (in the courtyard) being delegated to a staff member or an activities coordinator. Several residents discussed the arrangements for mealtimes. Nearly all residents confirmed that they are very happy with the food and choices available. Residents confirmed that they had a choice of where they ate their meals and described the timings of main meals as meeting their needs. Many service users did however comment that they choose their menu a week in advance but are mostly unable to remember their choices so far in advance. This arrangement may benefit from a review. Lunchtime was viewed in both the Courtyard and main dining room. There was a calm and unhurried atmosphere and staffs were attentive and discreet when providing assistance. The food was presented in an attractive manner. Warren Lodge DS0000011404.V274395.R01.S.doc Version 5.1 Page 13 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): Standards 16 to 18 were not assessed during this inspection. EVIDENCE: Warren Lodge DS0000011404.V274395.R01.S.doc Version 5.1 Page 14 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): Standards 19 to 26 were not assessed during this inspection. EVIDENCE: Warren Lodge DS0000011404.V274395.R01.S.doc Version 5.1 Page 15 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): 28 and 29 Residents are protected by the homes recruitment policy. Residents are supported by a qualified care team. EVIDENCE: The registered manager stated that there is currently nineteen staff employed in a care capacity and eleven staff have completed at least an NVQ level 2. This means the home has achieved over a 50 ratio of qualified care staff. Not all the certificates to evidence this ratio were available as the registered manager was currently in the process of updating the training records and had requested staff to bring in copies of all certificates as part of the training audit. This will be followed up at the next inspection. The previous requirement was revisited in relation to ensure appropriate pre employment checks are received for new staff. The registered manager was able to demonstrate a sound understanding in relation to good recruitment practise. Evidence was viewed to verify that the registered manager is currently auditing all staff records. Warren Lodge DS0000011404.V274395.R01.S.doc Version 5.1 Page 16 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 and 38 The new registered manager is experienced and competent to run the home and is currently reviewing the services provided in the home in the best interests of the residents. The registered manager must ensure that the systems and records relating to the health, safety and welfare of residents are complete and maintained to include fire records and drills, servicing of boilers and gas equipment, testing of electrical equipment and risk assessments for safe working practises. EVIDENCE: The ownership of the company that is responsible for Warren Lodge has recently changed. As such there is now a new manager that has successfully registered with the CSCI. The registered manager is suitably experienced and is a registered nurse. The registered manager will be required to complete a registered managers award or equivalent in due course. Warren Lodge DS0000011404.V274395.R01.S.doc Version 5.1 Page 17 Residents and staff spoken to were positive about the new manager and described her as approachable and friendly but were still in the process of getting to know her. Staff confirmed that there has not been any marked change at present in their day-to-day role but would be positive about future change or development when consulted. The registered manager with support from the area manager have undertaken a review of the home and formulated a development and action plan. This plan was seen to be a thorough initial review of some of the systems and services provided at the home. The registered manager has further organised a residents meeting in March to seek their views and discuss any proposed changes to enhance the service. At this time consideration of the possibility of a forming a residents committee will be decided. The registered manager stated that resident’s representative’s views made at the Christmas party were recorded. The registered manager confirmed that during this year residents and families would receive satisfaction questionnaires to review the service and the impact of any future changes. The Provider has commenced Regulation 26 visits and Novembers record was viewed and the scope of this visit was wide-ranging and well recorded. The registered manager confirmed that resident’s monies are not held in the office. Additional costs incurred for amenities and additional services are invoiced retrospectively direct to residents or their representatives. Records relating to this were seen and clearly state the reason for the charges. Two residents spoken to dealt with their own finances and were happy with the current arrangements. The registered manager does not hold any valuable items for residents at present. The safe was seen to be empty. Observations and staff discussion during the inspection revealed an understanding of safe practises to protect resident’s welfare. Staff confirmed that they had received training in topics relating to safe working practises and records held by the manager demonstrated that update training is arranged as needed. Records to evidence systems of safety and welfare were incomplete or not available in many cases. The fire records were examined and the weekly testing of the alarms is currently not delegated in the maintenance person’s absence and as such had not been tested for the previous 2 weeks. Emergency lighting according to the registered manager should be checked monthly although the records revealed that this has been checked only once in the last year (excluding external service inspections). Fire risk assessments are difficult to understand require updating. The arrangements for fire drills were unclear with no obvious record maintained. The deputy care manager recalled a drill “a few months ago” and other staff had described that the drill is “when the Warren Lodge DS0000011404.V274395.R01.S.doc Version 5.1 Page 18 fire alarm goes off by accident”. Residents appeared unsure if there had been a recent fire drill. These arrangements should be reviewed. Records relating to electrical equipment safety, boiler and gas certificates and safe working guides and risk assessments for equipment and the general environmental were absent. The new registered manager was aware of this. Records kept to ensure hot water temperature monitoring are complete. Warren Lodge DS0000011404.V274395.R01.S.doc Version 5.1 Page 19 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 2 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 X X 1 Warren Lodge DS0000011404.V274395.R01.S.doc Version 5.1 Page 20 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 OP1 Regulation 6 Requirement Timescale for action 30/04/06 2. OP12 16(2)(n) 3. OP31 9(2)(b)(i) 4. OP38 12(1)a 13(4) 23(4)e The registered manager must update the statement of purpose and service users guide after the initial review has been completed to ensure prospective and current residents receive the correct information. A copy of these documents must to be sent to the CSCI The registered manager must 31/03/06 review and develop a range of suitable activities for residents with a diagnosis of a dementia. The registered manager must 30/06/06 enrol and commence the registered managers award or equivalent. The registered manager ensures 30/04/06 that the systems and records relating to the health, safety and welfare of residents are complete and maintained to include • Fire records and drills • Servicing of boilers and gas equipment • Testing of electrical equipment • Risk assessment for safe working practises DS0000011404.V274395.R01.S.doc Version 5.1 Warren Lodge Page 21 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 OP3 OP12 Good Practice Recommendations That the registered manager should review the resident admission documents to ensure it use is of practical and relevant value. The registered manager should consider the provision of an activities coordinator that is trained to organise and further monitor an activity program particularly for residents with a diagnosis of dementia. Warren Lodge DS0000011404.V274395.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA 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 Lodge DS0000011404.V274395.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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