Inspection on 26/09/06 for Warrengate Nursing Home

This inspection was carried out on 26th September 2006.

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

Warrengate Nursing Home 08/11/05

Warrengate Nursing Home 28/06/05

Warrengate Nursing Home 11/10/04

Warrengate Nursing Home 12/05/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Warrengate Nursing Home 2 The Warren Kingswood Surrey KT20 6PQ Lead Inspector Lesley Garrett Key Unannounced Inspection 26th September 2006 09:00 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 Warrengate Nursing Home DS0000013367.V313565.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. Warrengate Nursing Home DS0000013367.V313565.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Warrengate Nursing Home Address 2 The Warren Kingswood Surrey KT20 6PQ 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) 01737 833359 01737 830331 Claremont Care Services Limited Mrs Catherine Mary Blatcher Care Home 36 Category(ies) of Dementia - over 65 years of age (9), Old age, registration, with number not falling within any other category (36) of places Warrengate Nursing Home DS0000013367.V313565.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Of the 36 (thirty-six) service users accommodated in the home up to 9 (nine) persons may fall within the category of Dementia (Older People) DE(E) 8th November 2005 Date of last inspection Brief Description of the Service: Warrengate is a large detached home standing in its own grounds in a residential area on the edge of a private estate in Kingswood just off the A217, some three and a half miles north of the M25. The grounds to the front of the house provide good parking for visitors and the large gardens are secluded. There is a railway station at the local village about a mile away, where amenities include shops, post office and banking facilities, these can be reached by car or using the homes private mini-bus. The home provides accommodation with nursing for up to thirty-six older people and has provision within this number to support up to nine people with dementia. The range of fees for the rooms are £550-755 Warrengate Nursing Home DS0000013367.V313565.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit was held over seven hours and commenced at 0920 and ending at 1630. Lesley Garrett lead inspector for the service carried out the site visit and the registered manager and the provider/owner represented the establishment. The inspector carried out a tour of the premises and spoke with some service users and staff. She looked at some policies and procedures, care plans and employment records for some staff. The inspector would like to thank the service users, staff, manager and provider of the home for their hospitality during this site visit. What the service does well: What has improved since the last inspection? The registered manager has now completed her registered managers award and is just waiting for her certificate. The provider has converted one of the downstairs bathroom into a wet room, which now allows service users to take an assisted shower who previously could not use the shower room that was in place. Several staff has been recruited from Poland who has settled in well and are all having English lessons at a local college. An activities organiser has been recruited and it was her first week when the inspector visited. A programme of activities has been provided by the home, which includes all the Christmas arrangements that have been planned. Warrengate Nursing Home DS0000013367.V313565.R01.S.doc Version 5.2 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. Warrengate Nursing Home DS0000013367.V313565.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 Warrengate Nursing Home DS0000013367.V313565.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. No service user moves into the home without having their needs assessed and assured that these will be met. The home does not provide intermediate care beds. EVIDENCE: The manager stated that she carries out all pre-admission assessments and in her absence another suitably qualified registered nurse. The inspector sampled some assessments and found them comprehensive and they were kept in the individual service user folders and care plans were then generated form this assessment. The home does not provide intermediate care. Warrengate Nursing Home DS0000013367.V313565.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 &10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users individual plans of care are comprehensive and demonstrate that their health and personal care needs are met. The home has policies and procedures in place for the safe handling of medications and no issues around privacy and dignity were raised. EVIDENCE: The home has recently changed their documentation and care plans and risk assessments are now contained in a book. The inspector sampled some folders and found them to be comprehensive and contained care plans, risk assessments and daily notes. There was evidence of consultation with service users and their relative/representative and this will be further developed. The manager stated this is still a new system and some consultations have still to take place. The general practitioner (G.P.) visits every week to see any service user that requires a doctor, they also visit in between if necessary. The manager stated that they are a good support to the home. The home also has a chiropodist, Warrengate Nursing Home DS0000013367.V313565.R01.S.doc Version 5.2 Page 10 optician and dentist that all visit on a regular basis. The home also has access to the community dietician who has visited to do assessments on those service users who require supplements. The tissue viability nurse is also available and the home can contact her direct. The manager told the inspector that no service user self medicates. The home receives their medications from a local pharmacy and they use bottles on a twenty-eight day cycle. The inspector sampled some medication administration charts and found that they contained no gaps. The homes medication policy was also sampled. It was a recommendation that two registered nurses sign all handwritten entries but the manager phoned the inspector later that week to say this had now been implemented. The staff respects the privacy and dignity and the inspector observed staff knocking on the bedroom doors prior to entering. Shared rooms have curtains in place and staff were seen to be addressing service users by their preferred name and this is also documented in their individual folder. Warrengate Nursing Home DS0000013367.V313565.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users will now have activities that will match their expectations and they maintain contact with family and friends. Contacts with the local community could be expanded. Service users are encouraged to exercise control and choice over their lives and the choice of menu and quality of the food is a good standard. EVIDENCE: Since the last inspection in November 2005 the home has employed an activities co-ordinator. The post had previously been filled with the chef who found it increasingly difficult to provide both activities. The manager stated that the activies co-ordinator had only started this that week but has started to meet the service users on a one to one to allow her then formulate an activities programme. Since the inspection the provider has provided the inspector with the activity programme until the end of the year. Visitors are welcomed to the home at all times and the inspector saw this on the day of inspection. They all spoke with the manager who was knowledgeable and able to answer their questions. A church service is available every month in the home but service users also have access to their Warrengate Nursing Home DS0000013367.V313565.R01.S.doc Version 5.2 Page 12 local church, which is next door for weekly church services on a Wednesday. Different entertainers visit the home every month and local schools visit mainly at Christmas time. Community contact is the area that the activities coordinator plans to expand if possible in the New Year. The inspector met the chef who is now able to concentrate fully on the kitchen and provision of meals. The chef told the inspector that she works on a sixweek cycle of menus and the inspector saw samples of these. The chef told the inspector that she works in the mornings and is helped by a kitchen assistant and that the home then has supper assistants who come in to do the evening meal. All food in the fridge was labelled and dated and a recent environmental health visit highlighted only two minor concerns, which the provider stated would be addressed soon. Warrengate Nursing Home DS0000013367.V313565.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that their complaints will be listened to and taken seriously. Service users are protected from abuse. EVIDENCE: The home has a complaints policy which the inspector sampled this is available to every service user and is also displayed in the reception. A complaints log is kept by the manager to show the nature of the complaint and the investigations that take place and the outcome of the complaint. The manager told the inspector that she has not received any complaints this year. Service users at the home are protected from abuse. The manager told the inspector that the home has had two referrals under the local authorities safeguarding adult’s procedures. The inspector sampled the home’s safeguarding adults policy which was in line with Surrey Multi Agency Procedures. The manager had a good knowledge of the procedures and told the inspector has had training in this subject and that her and the provider/owner are attending Surrey’s training soon specifically designed for managers and providers. Warrengate Nursing Home DS0000013367.V313565.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a safe and well-maintained environment, which is clean with no offensive odours. EVIDENCE: The manager and provider/owner told the inspector that there is a planned maintenance schedule but all jobs will be actioned when they are necessary. The provider/owner told the inspector that earlier this year there was a problem with the downstairs bathroom and this has now been converted into a wet room. The manger told the inspector that the service users seemed to enjoy having a shower. Rooms have been decorated and have matching curtains and bedspreads and all have been personalised by the service users. There is a programme of renewing beds in the home from divan into the hi-lo beds for the safety and comfort of the service users and staff. The provider/owner told the inspector that this is already underway. Warrengate Nursing Home DS0000013367.V313565.R01.S.doc Version 5.2 Page 15 The inspector viewed the gardens and spoke with the provider/owner and manager as there was as unprotected slope from the patio onto the grass. The inspector was told that no service user has access to the outside unless they are with a member of staff. A recommendation was left at the end of the inspection for the registered persons to risk assess the gardens so that service users have safe access. The provider/owner phoned the inspector later that week to say that the home has now had a quote from their landscape gardeners and work will begin to install a sensory garden and to ensure that the slope will be safe and anticipates that the work will be completed by the spring of 2007. The manager told the inspector that the laundry assistant had recently left the home. The staff was consulted and they stated that they would prefer to do the laundry between them so the provider/owner has arranger for an extra member of staff to be on duty every morning to accommodate this. Infection control training takes place for all staff and the manager stated she will make sure that procedures for the laundry is now given to all staff working in the laundry. During this site visit the inspector detected no offensive odours in the home. Warrengate Nursing Home DS0000013367.V313565.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The number of staff on duty and the skill mix meets the service users needs. NVQ training for the care staff needs to continue so that at least 50 hold this qualification. Service users are protected by the homes recruitment policy and practice. The home has regular training for all staff making them competent to do their job. EVIDENCE: The inspector sampled the staff rotas sent with the pre-inspection questionnaire and on the day of the site visit. The home usually has three registered nurses in the morning and one in the afternoon and at night. The care staff supports the registered nurses. The manager told the inspector that a particularly busy time was the afternoons until 1700 therefore there is always an extra member of staff on during this period. The manager also stated that staffing levels could always be changed in consultation with the provider/owner if the dependency levels change. The manager stated that not all of the care staff has level 2 National vocational qualification (NVQ). This is due to staff leaving that have gained this Warrengate Nursing Home DS0000013367.V313565.R01.S.doc Version 5.2 Page 17 qualification and new staff that have not gained it yet. More staff has been enrolled and are due to start early next year once their English classes have been completed. The registered provider informed the inspector that NVQ training is always available and that they use an outside training company. The provider told the inspector following the site visit that the number of NVQ trained staff varies due to staff turnover but seven carers have now been registered. . The number of NVQ trained staff varies due to staff turnover the provider told the inspector following the site visit. The inspector sampled some recruitment folders and found that they contained the information required. The old style application forms did not contain space to give a full employment history with explanation for gaps. The manager showed the new application forms, which and now has the room to give these explanations and is more comprehensive. The manager told the inspector that training takes place on a regular basis. This training is given by an outside training provider and covers all the mandatory training for example, abuse awareness, moving and handling, food hygiene and fire awareness which takes place twice a year. The home can take some service users with dementia and dementia awareness training has also taken place. Warrengate Nursing Home DS0000013367.V313565.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed by a person fit to do so and discharges their responsibilities fully. The home has some quality audits in place and the views of the service users are sought. The financial interests of the service users are safeguarded and the health and safety of all service users are promoted and protected by the various checks that take place on a regular basis. EVIDENCE: The registered manager has been in place for six years and told the inspector that in July this year she obtained her Registered Managers Award but is still awaiting her certificate. She told the inspector that she undergoes periodic Warrengate Nursing Home DS0000013367.V313565.R01.S.doc Version 5.2 Page 19 training to ensure that her knowledge is current and regularly updated. The provider/owner is in the home most days and therefore there are clears lines of accountability. The manager told the inspector that they do a satisfaction survey twice a year, which seeks the views of the service users. The results of these questionnaires were then fed back in a newsletter. It is a recommendation at the end of the report that these surveys should include other stakeholders for example G.P., chiropodist and opticians and to also include families or representatives. The policies and procedures that the inspector sampled had been updated and the manager said they are always being updated and changed whenever necessary. The provider/owner told the inspector that no money is kept in the home for the service users. He will settle any invoices on their behalf and then invoices the relatives or representatives every month. The inspector used the pre-inspection questionnaire to check the health and safety records. All checks had been carried out this year and the gas system was not due for checking until November 2006. The home has a maintenance person who checks the water temperatures regularly and the fire alarms every week and these are documented. Warrengate Nursing Home DS0000013367.V313565.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 X 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 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Warrengate Nursing Home DS0000013367.V313565.R01.S.doc Version 5.2 Page 21 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 Timescale for action 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 OP33 Good Practice Recommendations It is strongly recommended that the home seek the views of visiting professionals to the home and family or friends of the service users. Warrengate Nursing Home DS0000013367.V313565.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Warrengate Nursing Home DS0000013367.V313565.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. 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