Inspection on 15/01/07 for Warren The

This inspection was carried out on 15th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 The 30/01/08

Warren The 19/01/06

Warren The 07/02/05

Warren The 01/07/04

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

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

CARE HOMES FOR OLDER PEOPLE Warren The 84 Coombe Road Croydon Surrey CR0 5RA Lead Inspector Margaret Lynes Key Unannounced Inspection 15th January 2007 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 The DS0000025856.V327031.R01.S.doc Version 5.2 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 The DS0000025856.V327031.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Warren The Address 84 Coombe Road Croydon Surrey CR0 5RA 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) 020 8688 7022 0208686 8808 Mr James Emmanuel Kwabena Safo Mrs Bernadette Joan Redmond Care Home 18 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (0) of places Warren The DS0000025856.V327031.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A variation has been granted to allow one specified resident under the age of 65 to be admitted. 19th January 2006 Date of last inspection Brief Description of the Service: The Warren is situated in a pleasant residential area of Croydon, opposite a Tramlink stop and overlooking Lloyd park. The house itself is well named, with the two double bedrooms being situated in the turret of the home, and the top floor comprising of four single rooms each of intriguing dimensions. The accommodation comprises of the aforementioned two double rooms and fourteen single. There is a large lounge on the ground floor, which leads into the conservatory dining area. Part of the conservatory can be curtained off to provide a more secluded space for meetings. There is a second, smaller conservatory, which serves as the designated smoking lounge. The home has an extremely attractive garden, the feature of which is a large fishpond. The stated aim of the home is for it to be run to a very high standard and to give effective environmental, physical and psychological care for the elderly, incorporating quality job satisfaction and status to the people it employs. Warren The DS0000025856.V327031.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over the course of 5 hours. It consisted of examination of documentation, a tour of the communal areas and some of the bedrooms, and meeting with the service users and staff. All of those who contributed to the inspection are thanked for their time and input. The last visit to this home was carried out in January 2006. At that time no new requirements were made, and there were no outstanding requirements from earlier visits. This inspection has resulted in just two further requirements. This low number is reflective of the continuing good service provided by this home. What the service does well: What has improved since the last inspection? What they could do better: In almost every aspect it was felt that the Standards that were assessed on this visit were being fully met. The two requirements made pertain to the need to ensure that new staff provide full employment histories (and account for any gaps) and state why they have left any previous employment working with vulnerable people; and the need to ensure that fire alarms are tested weekly and that this is recorded. Warren The DS0000025856.V327031.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Warren The DS0000025856.V327031.R01.S.doc Version 5.2 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 The DS0000025856.V327031.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (6 is not applicable) Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. From the file inspected it was determined that service users were adequately assessed prior to being admitted to the home. This means that the service user and their relatives can be reassured that the home has taken into account their individual needs, and feels that it can meet them; and the staff in the home can be as familiar as possible with new service users, and have an understanding of what specific service they will need to provide. EVIDENCE: There had only been one admission to the home since the last inspection visit. The file for this service user contained an in-house pre-admission assessment, which was supplemented by good documentation, including a CPA summary, from the placing Authority. Warren The DS0000025856.V327031.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. As was found at the last inspection, the service user plans adequately covered the health, personal and social care needs of the service users. This means that the staff team are aware of the differing needs of their residents, and know what specific care needs to be given. Staff ensure that each resident is able to access community based health facilities as and when required, and good recording was in evidence. The medication administration records were examined. These were all in order, which means that the service users are protected by the home’s good practice. From observation and discussion, service users were treated with respect, and their right to privacy was upheld. Warren The DS0000025856.V327031.R01.S.doc Version 5.2 Page 10 EVIDENCE: Service user files contained good documentation with regard to care plans, personal and medical history, keyworking notes, daily records, risk assessments and reviews – both of care plans (monthly) and the overall care package (six monthly). The staff team demonstrated a clear understanding of the needs of elderly service users with a past/present mental illness. The home is able to meet the assessed needs of its residents in a variety of ways such as keyworking, individual plans and contracts. Health records were being kept pertaining to, for example, visits by members of the community health services, and monthly weight checks. The home has a long established good relationship with the local mental health team, and service users are encouraged to take responsibility for their health as much as they can. The medication administration records were all in order. It was noted that for some residents the home had (in the medication administration file) a photograph and a detailed client profile alongside a medication profile. It is recommended that this good practice be extended to cover all service users. The Inspector was pleased to be able to meet with a number of service users. All spoke highly of the service they received and the care shown for them by the staff team. Almost all of the residents have some ability to look after their own personal care. For them, staff will offer advice, guidance and support as necessary. There was good documentation regarding each service users’ personal care needs within their individual care plan. Warren The DS0000025856.V327031.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12 – 15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users are provided with a variety of appropriate activities, and they are encouraged to take an active part in the local community. Dietary needs are satisfactorily catered for. Visitors are made welcome. Collectively this means that the lifestyle in the home, in general, matches the expectations and preferences of the service users. EVIDENCE: Residents are encouraged to join in a number of in-house activities such as baking, table top games, quizzes, bingo, soft ball exercises, current affairs discussions and art. One service user attends a day centre each week. Contact with friends and family is encouraged, as is participation in the local community. Some service users are perfectly able to go out on their own, and staff support them to do so. Warren The DS0000025856.V327031.R01.S.doc Version 5.2 Page 12 The home benefits from having a long-standing cook, who has a good rapport with residents and staff alike. On this visit the kitchen was in the midst of a refurbishment. Most of the work has been arranged to take place during the afternoon/evening, so as not to disrupt the main, lunchtime meal. On the day of the inspection this was not possible so the service users were consulted and happily agreed to a take away meal. It was clear that all of the staff were working together to minimise the disruption to the residents. Warren The DS0000025856.V327031.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There is an acceptable complaints procedure in place, and both the Statement of Purpose and the Service User Guide contain a copy. This means that the service users can be reassured that should they raise any complaints they will be listened to, taken seriously and their concerns acted upon. There is also an adequate adult protection procedure in place, along with a whistleblowing procedure. The manager has a copy of the Croydon POVA procedure to hand. This means that service users are protected, as much as is possible, from abuse. EVIDENCE: There have not been any complaints since the last inspection. Neither have there have been any POVA referrals in the intervening period. Warren The DS0000025856.V327031.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. This is a relatively small establishment and thus benefits from being able to create a homely, relaxed and comfortable atmosphere. A tour of the building evidenced that it was in a good state of repair, and it was felt that the home provided a safe and well-maintained environment. The communal areas were clean, pleasant and hygienic, as were most of the bedrooms inspected. EVIDENCE: As already mentioned, a tour was made of the communal areas and some of the bedrooms, which were found to be generally clean, and in an acceptable state of decoration and furnishing. Service users are able to bring in their own Warren The DS0000025856.V327031.R01.S.doc Version 5.2 Page 15 personal possessions, and it was nice to see rooms outfitted with furniture brought in by the residents. The premises continue to be generally fit for purpose. Mention has been made in the summary of the improvements made in the home since the last inspection. The conservatory dining room is much improved by having had a new roof, while the refurbishment of the smoking room has transformed it into a comfortable, attractive lounge, which is proving popular with residents – both smokers and non-smokers alike. The very pleasant garden can now be accessed by wheelchair users through the smoking room. The bedrooms were, in the main, well maintained, clean and acceptably furnished. It was nice to see fridges and kettles being provided where service users wished it and where it had been risk assessed as safe. There was a notable odour in one of the bedrooms, however the manager had already discussed this with the Inspector, and outlined the measures she was taking to resolve the problem. As this work is in hand, no requirement has been made to this effect. Warren The DS0000025856.V327031.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 – 30 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. For a home of this size, there should be 15 care hours allocated per service user each week. The rota provided indicated that this level was being met. At night there are always 2 waking staff on duty. This means that service users should have their needs attended to promptly. The manager confirmed that all senior care staff had achieved an NVQ level III award, while junior staff either had a level II NVQ, were working towards one, or were about to commence the level II course. Staff are also able to access a number of other training courses. This means that the residents are cared for by experienced and trained staff. The staff files inspected evidenced that the recruitment practice in the home was generally sufficiently robust enough to protect and support service users, albeit some minor improvement was needed in two areas. EVIDENCE: As mentioned above, the home was maintaining the staffing levels previously agreed with the Commission. This means that there are usually three carers on each day shift, with the aforementioned 2 staff on waking night duty. Warren The DS0000025856.V327031.R01.S.doc Version 5.2 Page 17 The home is to be commended for enabling all of its senior carers to obtain an NVQ level III award, and the carers themselves are to be congratulated. The manager explained that at the recruitment stage for new staff, she insists that they either have an NVQ II award, or agree to commence the course once their probationary period is over. Other training courses already planned for this year include First Aid, Moving and Handling and Food Hygiene. The home has recruited four new staff since the last inspection. Examination of their files indicated that in most respects they had provided the required information. The manager was informed, however, that she must establish, and record, the reason for any gaps in the employment history of new employees, and also determine why a new carer had left a previous job working with vulnerable people. Warren The DS0000025856.V327031.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users are enabled to live in a home which is managed well, and run in the best interests of the service users. Service users finances are safeguarded by the accounting and financial procedures in place in the home. It was felt, from examination of the relevant documentation, that the health, safety and welfare of services users and staff was being promoted and protected. Warren The DS0000025856.V327031.R01.S.doc Version 5.2 Page 19 EVIDENCE: The home manager has now been in post for many years, and can draw upon a wealth of experience in caring for older persons with past or present mental illness. The home benefits from a low staff turnover, and this has a positive impact on the care provided. A number of quality assurance systems are in use in the home. As well biannually sending out surveys to service users and their families and any other relevant stakeholders, quality checks are carried out in each bedroom and all communal areas every 1-2 months. The home’s management looks after the pocket money for a number of service users. Where items are purchased on behalf of a resident this is clearly documented and receipts obtained. The records were available for inspection. Some of the service users also prefer to pay their contribution to the fees directly to the manager. Again, this is documented and the service user asked to sign all records. Examination of health and safety documentation indicated that all of the periodic maintenance checks were up to date. These included maintenance of the lift, fire detection and fighting systems; hoists; gas and electrical installation and appliances and the water system. There was only one concern, which related to the fire alarms. The record indicated that tests were usually (and appropriately) carried out every week, however for some reason there had been a two week gap leading up to this inspection. This was drawn to the attention of the manager. Warren The DS0000025856.V327031.R01.S.doc Version 5.2 Page 20 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Warren The DS0000025856.V327031.R01.S.doc Version 5.2 Page 21 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 OP29 Regulation 19 Requirement Timescale for action 22/01/07 2 OP38 23 The registered person must ensure that new staff provide all of the information required in the Regulations. The registered person must 15/01/07 ensure that fire alarms are tested on a weekly basis and that this is recorded. 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 OP9 Good Practice Recommendations It is recommended that the home obtain a photograph and a detailed client profile for all service users. Warren The DS0000025856.V327031.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 The DS0000025856.V327031.R01.S.doc Version 5.2 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!