CARE HOMES FOR OLDER PEOPLE
Warren Park 66 Warren Road Blundellsands Liverpool Merseyside L23 6UG Lead Inspector
Mrs Julie Garrity Unannounced Inspection 24th February 2006 10:30 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.V283563.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 Park DS0000017261.V283563.R01.S.doc Version 5.1 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.V283563.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. Service users to include 30 OP. Maximum no. registered - 30, of which up to a maximum of 29 N (nursing) and up to a maximum of 1 PC (personal care). The Manager to undertake NVQ Level 4 or equivalent by April 2005. Date of last inspection 13/10/05 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.V283563.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was an unannounced inspection undertaken by on inspector over a day. The total duration of the inspection was 3 hours. An additional a pharmacy inspection was undertaken. CSCI inspects “core” standards over 2 inspections. The core standards not covered in this report were covered in the previous report undertaken on 13/10/05. The inspector undertook this inspection by reviewing on-site records such as medication records, resident’s records, staff training and staff recruitment records. Other records reviewed were previous reports and CSCI records such as notifiable incidents and provider visit reports. Discussions were held with 10 residents, 2 relatives and 6 staff. The inspection was undertaken with the support of the manager and all areas were discussed with the manager as they occurred. Full feedback was given to the manager at the end of the inspection. There were four requirements from the previous report and no new requirements were made from this inspection. What the service does well: What has improved since the last inspection?
There has been a significant improvement in the management of medications a number of good practice examples where available at this inspection including clear documentation of when a medication was not given and why. Other examples of good practice included regular review by the manager and clear records around the giving of medication. The staff have invested considerable time and effort in improving this area and should be commended for their efforts. Warren Park DS0000017261.V283563.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 Park DS0000017261.V283563.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 Park DS0000017261.V283563.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): None of the standards in this area were fully reviewed at this inspection. EVIDENCE: An up to date Statement of Terms and Conditions (contract) is still not available for all residents. Warren Park DS0000017261.V283563.R01.S.doc Version 5.1 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): 9 The management of medicines has significantly improved. Residents are protected by the home’s policies and procedures. EVIDENCE: An additional pharmacy inspection was undertaken at the same time as this inspection. A separate report for this is available upon request. The inspection showed that the home had made significant improvement. The manager had spent considerable efforts in making sure that medicines are managed in an appropriate manner and records regarding medications clearly reflected the time spent in improving this area. Additional the management of medications had improved to the degree that the staff were able to identify a dispensing error from their supplying pharmacist. Warren Park DS0000017261.V283563.R01.S.doc Version 5.1 Page 10 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): None of the standards in this area were fully reviewed at this inspection. EVIDENCE: Conversations with residents and their families detailed that they were generally “happy” with the home. A resident said that “the staff are very kind” and “I feel safe living here”. Warren Park DS0000017261.V283563.R01.S.doc Version 5.1 Page 11 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 Residents and their relatives are confident that their concerns will be addressed and dealt with. EVIDENCE: Information is available for new residents and their relatives when they are admitted to the home. This includes information on raising concerns. When concerns are raised formally the home investigates these concerns and documents any actions to be taken. There have been no formally raised concerns within the last 6 months. Three residents spoken with said “I haven’t lived here very long. It takes some getting used to but staff made sure that all the things I liked were available”, “I would never have any reason to complain, I’m sure the staff would be mortified if I did” and “there have been the odd occasion when I didn’t like something or thought it wasn’t right. Matron made sure it never happened again and sorted it for me” Warren Park DS0000017261.V283563.R01.S.doc Version 5.1 Page 12 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): None of the standards in this area were fully reviewed at this inspection. EVIDENCE: Residents spoken with said that the home was “lovely and clean”, “just like home” and “decorated very nicely”. Warren Park DS0000017261.V283563.R01.S.doc Version 5.1 Page 13 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): None of the standards in this area were fully reviewed at this inspection. EVIDENCE: Staffing files and training records were viewed. Not all the relevant records regarding staff employment where available at the time but were forwarded later to the inspector. The home is aware that staff with a Protection of Vulnerable Adults check can start in employment before a police check is completed. However staff need to be supervised until the Police check is received and this is to occur in “exceptional” circumstances only. Staff training information detailed that there were gaps in staff’s health and safety training including moving and handling. Warren Park DS0000017261.V283563.R01.S.doc Version 5.1 Page 14 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): None of the standards in this area were fully reviewed at this inspection. EVIDENCE: The registered provider has not undertaken monthly unannounced visits to the home with a copy retained by the home and a copy forwarded to CSCI. Warren Park DS0000017261.V283563.R01.S.doc Version 5.1 Page 15 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X Warren Park DS0000017261.V283563.R01.S.doc Version 5.1 Page 16 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP2 Regulation 5 (1) (b) 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. (Outstanding from the previous report) All staff with a Protection of Vulnerable Adults check and awaiting a Criminal Records Bureau must work supervised at all times until the Criminal Records Bureau is received Timescale for action 24/04/06 2. OP29 19 (1)(b) (i) 24/03/06 3. OP33 26(1)(3)( 4) (a)(b)(c) (5) (a)(b) The registered provider must 24/03/06 make monthly visits with a report submitted to CSCI and the manager. (Outstanding from the previous report) 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. (Outstanding from the previous report) 24/03/06 4. OP38 18 (1)(c)(i) Warren Park DS0000017261.V283563.R01.S.doc Version 5.1 Page 17 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. 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. 2. OP33 3. OP27 Warren Park DS0000017261.V283563.R01.S.doc Version 5.1 Page 18 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
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