Inspection on 06/10/05 for Warren Residential Lodge

This inspection was carried out on 6th 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 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 14/04/05

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 Mrs Michelle Presdee Unannounced Inspection 6th 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 Residential Lodge DS0000011771.V255685.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 Residential Lodge DS0000011771.V255685.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Warren Residential Lodge Address Cherque Lane Lee-on-the-solent Hampshire PO13 9PF 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) 023 9255 2810 Mr Allan Walsh Ms Nicola Smith Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Warren Residential Lodge DS0000011771.V255685.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14.04.05 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. Whilst accepting service users may develop an age related mental health problem after admission, the home must ensure it does not admit a service user outside the category of Old age.Warren Residential Lodge is a purpose built singlestorey 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 Leeon-Solent .It is a short drive from the coast line and the local amenities.The home is owned by a single provider and is run with family support. Warren Residential Lodge DS0000011771.V255685.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced inspection in a twelve-month period. Time was spent checking what progress had been made on the out-standing requirements made at the last inspection and ensuring all the core standards had been covered during the two inspections. The inspection lasted over three hours and during this time records were looked at, service users and a visitor were spoken to and a tour of the building was undertaken. What the service does well: What has improved since the last inspection? What they could do better: Whilst a new set of paperwork has been created for the assessment and care planning process it was found these had not been used. Assessments have to be carried out on all service users ensuring all their needs, wishes and risks are recorded. All service users need a care plan giving details of hoe carers are going to all service users needs. Training on adult protection, abuse and Warren Residential Lodge DS0000011771.V255685.R01.S.doc Version 5.0 Page 6 manual handling must be provided in the home. Supervision of staff must be re-started and be programmed into the diary. The provider has not complied with some matters that were identified at the last inspection. These matters for action are repeated and the provider and manager must ensure these matters are complied with in the given timescales. 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 Residential Lodge DS0000011771.V255685.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 Residential Lodge DS0000011771.V255685.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): 3 The current assessment system does not ensure service users needs are identified or provide staff with sufficient information to ensure all service users needs can be met. EVIDENCE: The assessments of the last three service users admitted to the home were looked at. It was found whilst the new paperwork introduced by the manager was in place, it had not been completed. The only information completed was the pre-admission assessment. One of the service users was admitted to the home in May. No information had been added to the assessment which, did not allow staff to know a service users currents needs. Discussions were held and the manager explained assessments were the responsibility of the service users key worker. Further discussions were held and it was expressed how important it is that each service user has an assessment completed identifying their needs. It is the manager’s responsibility to ensure this is carried out, which could be discussed during staff members supervision. Warren Residential Lodge DS0000011771.V255685.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): 7,10 The lack of care plans does not ensure all service users reflecting all the service users personal, health and social care needs are identified and state how these are going to be met. Service users and staff have a good relationship and staff respect service users privacy. EVIDENCE: The three service users who were last admitted to the home had not had a service user plan completed. Information was held on their basic details including their name, address, date of birth and their next of kin details were recorded. Discussions were held on the importance of completing a service user plan for each service user to ensure carers have the necessary information to meet all service users needs. From observations and discussions it appeared service users were treated with respect and their right to privacy is upheld. Service user spoken to stated, “the girls are good. All staff seen, knocked on service users doors before entering. Staff spoke to service users in a pleasant manner. One service user and his relative felt the staff worked hard and always respected their privacy. Warren Residential Lodge DS0000011771.V255685.R01.S.doc Version 5.0 Page 10 Warren Residential Lodge DS0000011771.V255685.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): 14, 15 Service users are allowed to control their own life where possible. Meal times are relaxed and provide service users with a choice of nutritious meals. EVIDENCE: Most service users in the home do not manage their own finances; it is usually their families who manage these; this is down to service users choice. Service users can bring their own possessions into the home and a record is maintained. One couple that came into the home brought some of their own furniture, which was incorporated into the smaller lounge. The manager explained all service users could have access to their records, but no service user had ever expressed an interest in viewing their records. The home has a four week planned menu. The menu is displayed in the dining room and all service users will be offered a choice if they do not like the choice of the two main meals. On the day of the inspection service users had a choice of chicken casserole or curry. One service user did not like the choice so asked for a fry up, which was provided. All choices are recorded. Service users are encouraged to have their lunch in the dining room but some service users prefer to eat in their room, which is respected by staff. Service users spoken to stated they enjoyed the meals in the home and stated a choice was always available. One service user enjoyed having a cooked breakfast every morning. Warren Residential Lodge DS0000011771.V255685.R01.S.doc Version 5.0 Page 12 All service users are asked each night what they would like for the breakfast, which includes a cooked breakfast. Warren Residential Lodge DS0000011771.V255685.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 No progress has been made in training on Adult Protection issues and abuse, which needs to be arranged for the protection of both service users and staff. EVIDENCE: The home has now obtained copies of an adult protection procedure, Hampshire abuse procedure and a copy of the Department of Health guidance “No Secrets” and has a whistle blowing procedure. However no training has taken place on abuse and adult protection despite this being a requirement in the last report. The manager advised at the present time the home does not have any service users who are verbally or physically aggressive. There have been no allegations of abuse since the last inspection. Warren Residential Lodge DS0000011771.V255685.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 The home provides a clean, comfortable environment for service users. EVIDENCE: The manager showed the inspector around the home and it was noted all areas were clean and no unpleasant odours were detected. Service users and the visitor spoken to confirmed the home is kept clean. The inspector was advised new curtains have been purchased for the lounge but are currently been altered to fit the windows. All radiators except one in the bathroom have now been covered, the inspector was advised the radiator in the bathroom had been missed, but it would soon be covered. A sofa has been placed in the foyer area for service users and visitors to the home. Warren Residential Lodge DS0000011771.V255685.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): 29, 30 Appropriate checks are being carried out on all new staff members to ensure the safety of service users. Training in adult protection and moving and handling are not adequate in the home, which could put staff and service users at risk. EVIDENCE: Two members of staff who had recently joined the home had their files checked. These demonstrated the home had undertaken all the necessary recruitment checks to ensure service users are protected. Application forms had been completed; the manager now interviews all staff and the necessary checks had been completed. Training in first aid took place two days before the inspection, ensuring there is always one member of staff on duty who is trained in first aid. Food hygiene has been completed by all staff that completed a distance learning pack. All staff have completed a safe handling of medicines level 1 and are now starting a level2. Care staff are also undertaking infection control level 1. However no training has been arranged for moving and handling or adult protection; this will be a repeated requirement. Warren Residential Lodge DS0000011771.V255685.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): 31,35,36,38 The manager offers an open style of management. Service users welfare could be compromised by the lack of staff training and supervision. All necessary checks on equipment are completed to ensure the building provides a safe environment for service users. EVIDENCE: The home now has a registered manager, who must ensure she takes charge of the running of the home. Service user meetings have been started but the atte4ndance has been poor. Service user surveys have been started; the inspector was advised the feedback has all been positive. The finances and the records held by the home for service users were checked. It was found there were clear records maintained. It was possible to see when money comes in and out and signatures are maintained. Receipts are now Warren Residential Lodge DS0000011771.V255685.R01.S.doc Version 5.0 Page 17 kept. The balance was checked on five service users finances, which matched the records. Supervision had been started in the home at the last inspection. However it is now over three months since any care staff member has received supervision. Discussions were held on the need to ensure supervision sessions are programmed into the diary to ensure all staff receives the adequate number of supervision sessions. The home has a risk assessment and relevant policies on health and safety. The fire logbook had been completed and it was possible to establish the necessary checks are being carried out in the agreed timescales. The fire alarm had been serviced on 25.7.05 and the fire extinguishers on 17.3.05. Fire training for staff members is through an outside trainer twice a year. The bathroom hoist had been serviced on 12.10.04 and the portable electrical appliances had been tested on 9.9.05. An accident book is kept in the home and appropriate Regulation 37 notices are sent to the Commission. Warren Residential Lodge DS0000011771.V255685.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 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 3 X X X X X X X STAFFING Standard No Score 27 X 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 2 X 3 Warren Residential Lodge DS0000011771.V255685.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 3 Regulation OP3 Requirement Assessments must be completed for all service users and give a clear picture of their needs. Timescale of 01.06.2005 not met. Service user plans must be completed and provide sufficient information for staff to meet the care and welfare needs of service users. Service users plans must be reviewed. Timescale of 01.06.2005 not met. The provider must ensure care staff receive training in moving and handling and adult protection. Timescale of 01.06.2005 not met. All members of care staff must receive a minimum of six supervision sessions in a twelvemonth period. Timescale for action 01/12/05 2 7 OP15 01/12/05 3 29 OP18 01/02/06 4 36 OP36 01/12/05 Warren Residential Lodge DS0000011771.V255685.R01.S.doc Version 5.0 Page 20 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 Good Practice Recommendations Warren Residential Lodge DS0000011771.V255685.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW PO30 2AA 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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