Inspection on 14/04/05 for Warren Residential Lodge

This inspection was carried out on 14th April 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Warren Residential Lodge 26/08/08

Warren Residential Lodge 17/09/07

Warren Residential Lodge 08/05/06

Warren Residential Lodge 06/10/05

Warren Residential Lodge 21/10/04

Warren Residential Lodge 28/04/04

Warren Residential Lodge 30/06/03

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 Residential Lodge Cherque Lane Lee on the Solent Hampshire PO13 9PF Lead Inspector Michelle Presdee Unannounced 14th April 2005 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 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 Residential Lodge Version 1.10 Page 3 SERVICE INFORMATION Name of service Warren Residential Lodge Address Cherque Lane Lee on the Solent Hampshire PO13 9PF 023 9255 2810 Telephone number Fax number Email 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 Allan Walsh CRH 31 Category(ies) of OP - 31 registration, with number of places Warren Residential Lodge Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 21.10.2004 Brief Description of the Service: The Warren Residential Lodge is a care home registered to accommodate thirty-one service users within the category of OP Old Age only. Warren Residential Lodge is a purpose built single-storey care home with all single room accommodation It is surrounded by large well established gardens which are accessible to all of the residents, some who participate in the maintenance and growing of vegetables. The atmosphere in the home is friendly and homely. The home is situated in a quiet area of Lee-on-Solent. It is a short drive from the coastline and the local amenities. The home is owned by a single provider and is run with family support. Warren Residential Lodge Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 9.30am and was completed at 2.00pm. Twenty-one service users were accommodated. The inspector spent time talking to two service users at length and ten service users more briefly. One visitor and district nurse were also spoken to. The inspector was shown around the home and randomly picked five bedrooms to view. Records were also examined on the day. What the service does well: What has improved since the last inspection? What they could do better: Warren Residential Lodge Version 1.10 Page 6 Record keeping in the home needs to be improved. Records of service users finances need to be clearer. Pre-admission and assessments need to be more detailed and reflect the current needs of the service user. Care plans also need to be more informative, giving a clear picture of each service users needs. Staffing records need to be maintained to ensure all necessary checks are being undertaken. Training is an area, which needs to be given a higher priority in the home. The home needs to ensure all radiators are covered. The views of service users need to be sort. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Warren Residential Lodge Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Warren Residential Lodge Version 1.10 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 standard(s) 3, 5, 6. The system of assessment does not consistently identify all service users needs to ensure that these can be met. Pre-admission visits are promoted. EVIDENCE: Pre admission assessments had been completed, however it was agreed with the two members of the management team, this did not give enough information on the service users basic care needs. Service users had been to see the home before moving in. Two service users spoken to confirmed they had come to spend some time in the home before choosing to move in. Both service users confirmed their placements had been reviewed after a month trial period. Assessments are completed for all service users. The written assessments do not give a clear picture of the service users needs and are not always reflecting the current situation. Verbal information was more helpful than the written information. Service users are not involved with the assessment process. Assessments do not follow the same format for all service users; some had risk assessments, some had moving and handling assessments. It was agreed all Warren Residential Lodge Version 1.10 Page 9 should follow the same format and have all parts of the assessment completed. The home does not provide intermediate care. Warren Residential Lodge Version 1.10 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 standard(s) 7,8,9. Care plans do not ensure service users overall needs are clearly identified and how these needs are going to be met.. The recording of medication administered needs to improve to ensure no mistakes are made. Health care needs are well documented and demonstrated the involvement of other professionals. The recording of medication administere has to improve for the protection of service users. EVIDENCE: Service users plans were available. However it was agreed with two members of the management team these did not reflect the service users, personal and social care needs or how they were going to be met. The written information does not reflect the verbal information given, or the good care given in the home. The inspector was advised the management team had been thinking of changing the recording system as they recognised some information recorded was not relevant and there was no space to record useful information. Reviews were not taking place on a monthly basis and currently service users were not involved with the reviews. Records were maintained of all service users health needs and all visits by health professionals were recorded. It was suggested these should be recorded on a separate sheet to the daily notes. A chiropodist, dentist and optician visit Warren Residential Lodge Version 1.10 Page 11 the home. The district nurse is calling into the home and stated “ the home has excellent communication with them, always calling them in at appropriate times. She also stated the staff “give good care and support to very ill and dying patients”. The home has a clear policy for the receipt, recording, storage, handling, administration and disposal of medicines. The medication was checked for two service users. It was found for one service user medication had been left in the cassette but the records stated the service users had had this medication. The home has agreed to return all its spare medication to the pharmacist. Warren Residential Lodge Version 1.10 Page 12 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 standard(s) 12,13. Recreational activities and social contacts are well managed and service users maintain contact with family and friends. EVIDENCE: All service users spoken to stated the home provided enough social activities. One resident stated, “I don’t get out as much as I would like,” but felt this may improve with the better weather. Service users stated their visitors are always made welcome. Activities in the home include outside entertainers, bingo, sing-a-longs, video afternoons and manicures. Nine service users currently have a paper delivered and crosswords sometimes become the afternoon’s activity. No clergy visit the home at present; this is the service users choice. Service users meetings are going to be introduced. Warren Residential Lodge Version 1.10 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 standard(s) 16,18. The home has a clear and well-publicised complaints procedure which service users feel confident to use. The arrangements for protecting service users from possible abuse are not satisfactory. EVIDENCE: The home has a detailed complaints procedure, which is displayed in the home. Service Users also have a copy in their rooms. Comments from a service users and a visitor demonstrated they were aware of whom to complain to and also; they would have no problems with discussing their complaints with the management of the home. The Commission or the home has received no complaints. No training in the last twelve months has taken place on abuse and adult protection; it was not possible to establish when training had last taken place in the home from records .The Adult Protection Procedure, Hampshire Adult Protection Procedure and Department Of Health “No Secrets” document could not be found. No service users are physically or abusive in the home, although one service user had recently been sectioned due to their behaviour. Warren Residential Lodge Version 1.10 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 standard(s) 19,20,23,24,25,26. The home provides a comfortable, clean and homely environment with individual bedrooms to meet service users needs. EVIDENCE: In general, the home is well maintained and suited to the service users needs. It is decorated and furnished to a standard that creates a comfortable and homely environment. The home has a large lounge and a separate dining room. The home has well maintained gardens, with suitable furniture for the summer months. Service users can bring their own furniture into the home; one new service user to the home stated “I was so pleased to bring all my furniture into my own room”. All areas of the home were clean no unpleasant odours were detected. All service users spoken to confirmed the home is kept very clean. The blinds in the lounge need repairing or replacing, as many strips are missing. Radiator covers are still being fitted to the radiators, whilst progress Warren Residential Lodge Version 1.10 Page 15 has been made this is an outstanding requirement, which will have a short time scale attached. Warren Residential Lodge Version 1.10 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30. Service users are well supported by sufficient staff. The recruitment process is not robust and the lack of training does not provide the safeguards to offer protection for people living in the home. EVIDENCE: The home is well staffed, the home has maintained staffing levels as when the home is full. Five care staff, two members of the management team and a cook and kitchen assistant were on duty. Two members of staff work a waking night duty. Nine members of the 27 staff have an NVQ Level 2 and three more staff are undertaking NVQ Level 2. The staff morale appeared high. Service users spoken to were very supportive of the care staff and the home. The inspector noted comments “Home from Home”, “the girls are very good” and “they always come straight away at night when I ring my bell”. Three members of staff had their files checked. These demonstrated the home had not undertaken all the necessary recruitment checks to ensure the protection of service users. One file had no references and one member of staff was only just having a CRB check done despite working in the home since late 2003. The staff have had very little training; the only training other than NVQ’s has been the safe handling of medicines (level 2) which 15 members of staff are undertaking. On the 6th May, 10 members of staff will be undertaking training in food hygiene. Warren Residential Lodge Version 1.10 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,3536. The acting manager is providing leadership through out the home and is supported by staff, service users and the provider. Records regarding service users finances are not adequate to protect both the home and service users. EVIDENCE: The home has been without a Registered Manager for 21 months; the Commission has now received an application for the registration of a manager. The applicant has worked in the home as the acting manager for twelve months and is currently undertaking NVQ level 4. Visits as required to be undertaken by the provider under Regulation 26 have been started but are not being done on a monthly basis. Whilst service users are not consulted individually about their assessments and care plans, residents meetings are being started and it is hoped their views on the running of the home will become apparent. Warren Residential Lodge Version 1.10 Page 18 The home manages the personal allowance of several service users and is the appointee for two service users. Records need to be maintained on a clearer basis, with receipts being maintained at all times. The signatures of service users should be obtained at all times where appropriate. Training needs to be arranged to promote the health and safety of service users in cross infection (one member of staff answered the door wearing plastic gloves) moving and handling and first aid training will need to be arranged soon, as this was soon to expire for most members of care staff. Fire records and fire training were checked and all found to be up-to-date. Supervision for care staff has been started, but six sessions per year need to be arranged for each member of staff. Warren Residential Lodge Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 3 x x 3 3 2 2 STAFFING Standard No Score 27 3 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 2 x 2 x 2 x x x Warren Residential Lodge Version 1.10 Page 20 Yes 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. 2. Standard 3 7 Regulation 14 (1) (a) 2 (a) 15 Requirement Assessments must give clear details of service users needs. Service user plans must provide sufficient information for staff to meet the care and welfare needs of service users. Service user plans must be reviewed. Care staff must not work in the home until all checks have been made. Training in Adult Protection, control infection and moving and handling must be arranged for staff. Timescale for action 01.06.2005 01.06.2005 3. 4. 29 18 & 30 19 (1) (b) (i) 18 (c ) (i) 01.06.2005 01.06.2005 5. 35 17(2) 6. 33 26 7. 25 23 (2) (p) Records held for service users 01.06.05 must document all monies in and out. Signatures wherever possible must be obtained. All receipts must be kept and be available. Regulation 26visits must be 01.06.05 made with a report being sent to the commission. This remains outstanding from the previous report dated 18.11.03. All radiators in the home must 01.06.05 be covered for the protection of service users. This remains outstanding from the previous report dated 18.11.03. Version 1.10 Page 21 Warren Residential Lodge 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 25 Good Practice Recommendations The blinds in the lounge should be replaced or repaired. Warren Residential Lodge Version 1.10 Page 22 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton Hampshire, SO15 1GW 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 Residential Lodge Version 1.10 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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