Inspection on 13/10/05 for Warren Park

This inspection was carried out on 13th October 2005.

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 Park 09/07/07

Warren Park 10/07/06

Warren Park 24/02/06

Warren Park 16/03/05

Warren Park 03/11/04

Warren Park 24/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Warren Park 66 Warren Road Blundellsands Liverpool Merseyside L23 6UG Lead Inspector Mrs Julie Garrity Unannounced Inspection 13th October 2005 10:00 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 Park DS0000017261.V259456.R01.S.doc Version 5.0 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 Park DS0000017261.V259456.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Warren Park Address 66 Warren Road Blundellsands Liverpool Merseyside L23 6UG 0151 932 0286 0151 932 1380 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) Mr John Lysaght Mrs Alison Anne Gale Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Warren Park DS0000017261.V259456.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Maximum no. registered - 30, of which up to a maximum of 29 N (nursing) and up to a maximum of 1 PC (personal care). Service users to include 30 OP. The Manager to undertake NVQ Level 4 or equivalent by April 2005. Date of last inspection 16th March 2005 Brief Description of the Service: Warren Park is a Care Home with nursing which provides care for 30 residents. The Home is a converted building in a residential area. The home has two floors with a lift to access all floors. There are 27 single rooms, 7 rooms have ensuite facilities and 2 double rooms all with ensuite facilities. Bedrooms are situated on all floors with 1 lounge area, a dinning room and conservatory available for use of service users on the ground floor and a lounge dinning area on the 1st floor. There is parking to the front of the building and well established and maintained gardens to the side and the rear. There are public transport systems within 5 minutes walk. Warren Park DS0000017261.V259456.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 1 day and was a total of 5 hours. It was a routine unannounced inspection. A tour of the premises took place, thirteen residents, three relatives, four staff and the manager were spoken with. A variety of records were reviewed including the care records of residents, medication records and medication storage, accident records, certificates of maintenance and staff training. A brief review of the premises was also part of the inspection. What the service does well: What has improved since the last inspection? What they could do better: The home needs to address the staff competency in dealing with medications and in undertaking supervision of junior staff. Both of these issues have been on previous inspection reports and consistency in maintaining a good standard has not happened. Warren Park DS0000017261.V259456.R01.S.doc Version 5.0 Page 6 Information to residents regarding their choices is weak and in need of further development. This is particularly relevant for residents who are unable to actively participate in the care that they receive and in the contacts between the Home and the resident. Further development is also needed in keeping staff training up to date and checks on staff before they start working in the Home. Both of these areas are outstanding from previous reports. 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 Park DS0000017261.V259456.R01.S.doc Version 5.0 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 Park DS0000017261.V259456.R01.S.doc Version 5.0 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): 2,3 Thorough and relevant assessments are undertaken, these make sure that residents needs are fully identified and help staff deliver the care that residents need. The lack of a formal up to date contact does not safe guard residents rights. EVIDENCE: An up to date Statement of Terms and Conditions (contract) is not available for all residents. The contracts do not detail the differing amounts paid, residents and relatives are unaware of their payment responsibilities. Each of the residents admitted has been assessed before they move in to the Home. The manager uses the Homes own assessments, information from the resident and their relatives, Social services assessments and information from the health service to form the basis of a care plan for the residents. Warren Park DS0000017261.V259456.R01.S.doc Version 5.0 Page 9 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 Residents care plans, give staff clear instructions on how to appropriately care for the resident. The care plans and the staff in the Home promote residents dignity and staff make sure that residents privacy is maintained. Care plans also reflect that resident’s health care needs are fully detailed and staff take appropriate action to meet those needs. There has been no improvement in the management of medications and the current inaccuracies and poor record keeping place the residents at risk. A pharmacy inspector has been arranged to review the Homes medication practices. EVIDENCE: Each resident has an individual care plan. Most of the care plans had been well written and were clearly individual to the resident good examples of individual care were detailed within the care plans. All care plans viewed had been reviewed and monitored regularly. Many of the care plans had been signed by a resident or relative as appropriate. Warren Park DS0000017261.V259456.R01.S.doc Version 5.0 Page 10 A number of medical assessments such the development of pressure ulcers and nutritional status of residents are undertaken. The home has accessed health care provision as needed including GP’s, opticians, dentistry and out patient appointments. There is an appropriate system in place for the ordering, delivery and returning of medications. A number of medication records were unclear and did not have sufficient checks in place to reduce administration errors. An audit of 5 medications detailed that the amount of tablets remaining to be given was not correct. Medication issues have been addressed on many occasions only to reoccur again at the next inspection. The owner and manager have previously committed to addressing these concerns, however these issues continue to present a risk to residents. A resident said that staff are “caring, know how to look after me well and always treat me very nicely.” They detailed that they are always spoken to appropriately and dealt with in a dignified manner. The staff observed during the day dealt with residents in a dignified and respectful manner at all times. Warren Park DS0000017261.V259456.R01.S.doc Version 5.0 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): 12,13,14,15 Residents have contact with family, friends and the community and this is supported by the staff. Residents have a suitable diet available to them but are not formally informed of choices available where they don’t like a menu item. Staff are very caring in their approach to residents and with the best intentions often make choices for the residents. This approach runs the risk of resident’s personal preferences being over looked and incorrect choices made on behalf of residents. This is particularly likely for residents who are unable to actively participate in the available choices. EVIDENCE: Daily on-going activities were available such as ensuring that newspapers were available and residents were able to access their favourite television programmes. One resident said “I prefer to spend my time in my bedroom, staff know this and make sure that I get everything I need”. Families detailed that they are always welcome to come to the Home. The Home has a tradition were by most of the decisions with regards to the running of the Home are undertaken by the manager and the nursing staff. Examples of this include a lack of residents meetings, residents not included in the formation of menus and very little recording of resident’s choices or how they would prefer to manage their daily routines. Warren Park DS0000017261.V259456.R01.S.doc Version 5.0 Page 12 Three residents said that the food was “very good”, and “tasty”. Two residents said there is “ no choice” at lunchtime. The staff and the manager said that if the resident did not like the meal an alternative would be available. Discussions with residents detailed that many were unclear that a choice was available. The Home serves each item at meal times separately, one resident said “its nice just having on my plate what I want.” This opportunity is not available for residents who prefer to eat in their bedrooms they receive their meals completed. Warren Park DS0000017261.V259456.R01.S.doc Version 5.0 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): 18 The Home has made a considerable effort in making sure that staff are aware of the ways to protect residents. Residents are significantly better protected than previously. EVIDENCE: All staff have received and signed a copy of the Homes guidance to protect vulnerable adults and how to report their concerns. Staff were able to clearly detail what they thought was potential abuse and how they would deal with it. The majority of the staff have undertaken further basic training to cover a variety of areas and includes a particular emphasis on the protection of the residents that they care for. Warren Park DS0000017261.V259456.R01.S.doc Version 5.0 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): 19, 26 Warren Park is well maintained and well presented. On the day of inspection it was clean, pleasant and with good levels of hygiene maintained by the staff. EVIDENCE: Resident’s bedrooms are refurbished and redecorated as required. The residents and families appreciate the appearance of the Home. One resident said, “I have all the things that I need around me, plenty of space. I can stay in my own room or sit with others if I want”. A relative described “when ever I visit its always tidy and clean, with staff running around trying to keep it really nice”. There are large extensive gardens with ramps available for residents to access the garden. It is unfortunate that uneven crazy paving must be negotiated before residents can access the garden. Maintenance records of the Home were up to date a regular monitoring of equipment in the Home undertaken. The staff are effective in ensuring that the home remains hygienic to a satisfactory standard. There are regular cleaning schedules in place that make sure that good levels of hygiene are maintained. All of the bedrooms were cleaned regularly. Warren Park DS0000017261.V259456.R01.S.doc Version 5.0 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): 27,28,29,30 The Home continues to maintain staff to levels that support them to care for the residents. The Home has increased staff training in many areas such as induction training, which includes the protection of vulnerable adults. They have also increased checks on the staff before they commence. Lack of making sure that all staff are appropriately checked, mandatory training not maintained up to date and supervision of staff, places residents at risk. EVIDENCE: The manager informally monitors the needs of the residents and the staff available. When she identifies a need to make alterations to the staffing levels this is done. Two residents said, “ there’s always enough staff” and “if I want anything I ask the staff and they deal with it quickly. I very rarely have to wait for anything”. Staff detailed that they were happy with the staffing levels and felt as though they could take their time with caring for the residents. The Home has increased it vetting of new staff and has been able to recruit a number of experienced staff. Appropriate checks are done before the staff commences working including a check of qualifications, references and Criminal Records Bureau. There was one member of staff who did not have a current Criminal Records Bureau before they commenced working in the Home. A staff training programme has been developed all staff receive a full induction. This has makes sure that all staff have the same level of training and is good practice. Seven staff have not received an up to date training in moving and handling. Warren Park DS0000017261.V259456.R01.S.doc Version 5.0 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, 33, 35, 36, 38 In general the manager provides leadership, guidance and support that assists the staff to deliver consistent levels of care. Some of the practices in the Home are in need of further development in order to safeguard the residents and maintain good levels of Health and Safety at all times. EVIDENCE: The manager has worked in Warren Park for 13 years, she is the registered manager and has completed a suitable qualification in management. The displayed extensive knowledge of the clinical needs of residents. Residents were complimentary with regards to both the manager and the owner, one resident said “the manager and owner are always ready to talk, happy to help and very kind”. As part of their on-going development staff are to receive supervision from a line manager on a regular basis this has not been done. Warren Park DS0000017261.V259456.R01.S.doc Version 5.0 Page 17 The Home has completed a recognised external quality assurance system however they have not yet created a development plan this for the future. There have not been monthly visits to the Home and copy of this is sent to Commission for Social Care Inspection by the registered owner for several months. The Home manages very little money for the residents. In general families request that the Home keeps small amounts of funds for residents to access. The Home undertakes regular checks on Health and Safety equipment in the Home and the fire system has been expanded to include good arrangements for resident’s bedroom doors. Not all the staff have received the appropriate health and safety training updates including moving and handling. Warren Park DS0000017261.V259456.R01.S.doc Version 5.0 Page 18 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 1 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 1 x 2 Warren Park DS0000017261.V259456.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement All residents must have an up to date contract that details the provision of services and details of all the fees payable and by whom. The manager must action the points raised on the pharmacy inspection report when received. 2 OP9 13 (2) (A timescale for this has not been set on this report but will be detailed on the pharmacy inspection). Medication issues remain outstanding from previous reports. Proof of Criminal Records Bureau check such as the unique number must be recorded when Criminal Records Bureau check’s are received by the Home. (Outstanding from previous report) The registered provider must make monthly visits with a report submitted to CSCI and the manager. 26(1)(3)(4) (a)(b)(c) (5) (a)(b) Staff records must demonstrate that staff are competent to undertake their job role. This must be undertaken as part of regular staff supervision. DS0000017261.V259456.R01.S.doc Timescale for action 13/12/05 1 OP2 5 (1) (b) 13/11/05 3 OP29 19 (1)(b) (i) 13/11/05 4 OP33 26 13/11/05 5 OP36 18 (1)(a) 13/12/05 Warren Park Version 5.0 Page 20 7 OP38 18 (1)(c)(i) All staff who have not received moving and handling training are not to take part in any activities regarding moving and handling until training is completed. (re-occurring from a previous report in the last 12 months) 13/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard OP14 Good Practice Recommendations Social interests of service users should be identified, recorded and an where necessary a care plan developed that ensures all staff are aware of the social needs of service users and can action these needs. The manager should review the quality assurance undertaken and develop a plan to further enhance quality within the Home. The manager should build on the good practice of informally monitoring staffing levels and formally monitor staffing levels in accordance with residents dependency needs. 1 2 OP33 3 OP27 Warren Park DS0000017261.V259456.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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