Care Home: The Warren Nursing Home

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What the care home does well The Warren is managed well and managerial structures are clear giving peopleaccountability for areas of work. Staff are supervised and communication about the needs of people living at the Warren is effectively made available to staff. The environment is suitable for people`s assessed needs and the accommodation is exceptionally clean, maintained to a high standard and is a homely place for people to live in. Staff are dedicated and knowledgeable about the roles they are employed to perform. Robust staff recruitment processes ensure that vulnerable people receive protection from employment of unsuitable staff. What the care home could do better: We have not made any statutory requirements or recommendations as a result of this visit. Random inspection report Care homes for older people Name: Address: The Warren Nursing Home Cluden Road Northam Bideford North Devon EX39 3QF three star excellent service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Susan Taylor Date: 1 5 0 6 2 0 1 0 Information about the care home Name of care home: Address: The Warren Nursing Home Cluden Road Northam Bideford North Devon EX39 3QF 01237476932 01237421214 mail@riverbankcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Laura Jane Hobbs Type of registration: Number of places registered: Conditions of registration: Category(ies) : Riverbank Care Limited care home 32 Number of places (if applicable): Under 65 Over 65 32 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is 32 The registered person may provide the following category of service only: Care home with nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home The Warren provides 24-hour nursing care to older people. The home is a detached property situated within easy reach of the facilities of Northam, Westward Ho! and Bideford. Originally an older type property it has been converted and also extended. Care Homes for Older People Page 2 of 9 Brief description of the care home Recent upgrading has meant that nearly all of the accommodation available is single rooms. There is 1 double bedroom that is used for couples. A passenger lift enables service users to access all areas of the home. There is a car parking area. To the front is a lawn area that is pleasant and easily accessed. Riverbank Care Limited is a member of the Registered Nursing Homes Association, and has achieved the Investors in People Award. Current fee levels can be obtained from the provider or manager of the home. Extra charges are made for Hairdressing, Chiropody, Personal toiletries, Personal taxis all of which vary. Care Homes for Older People Page 3 of 9 What we found: This was an unannounced routine inspection. We focused our inspection on case tracking 2 people by talking to them about their experiences at The Warren and looked at their records in relation to assessment and admission, on-going and changing care needs, risk assessment and medication management. We looked at staff recruitment records, the homes environment, management and health and safety measures. We also met 3 relatives who were visiting their relation at the home during the day. We looked at assessment and care records of 2 people, one of whom who had recently been admitted to The Warren. Our inspection found there were comprehensive, detailed and full records assessing peoples needs prior to admission to the unit. One person who we were case tracking said they were asked a lot of questions so that the staff can get to know me. There was also clear evidence of peoples changing needs being assessed and action of plans of care being adapted to ensure that current needs will be met. For example, a persons pain relief had been constantly reviewed as part of their palliative care and they told us that they were comfortable. We asked some duty staff about peoples care needs and staff were knowledgeable about how to provide care in order to meet peoples needs. For example, they explained what observations they would be concerned about in respect of potential skin breakdown and described measures such as regular turning or moving a person as well as using pressure relieving devices to prevent this. Therefore, peoples healthcare needs are well known and are being met. Prior to the inspection we sent surveys to 10 people who live at the service. We received 5 replies. These tell us that they were asked if they wanted to move into the service and that they received enough information about the service for them to make an informed decision about moving in to the home. By examining care records and in talking with duty staff we saw that there are good systems in the home to ensure that peoples needs are regularly reassessed and monitored. Prior to the inspection we received survey returns from 8 staff who work at The Warren. Staff told us that they are always kept up to date with changes made in care plans. We saw that staff maintain good daily records of care people receive and that handovers take place at staff shift changes. We inspected how medicines are managed at the service. We saw that systems are in pace to monitor completion of medication records and to ensure that peoples medicines are reviewed. Medicines were stored safely and securely. We saw that the storage of medicines was safe. One of the people who we case tracked told us Theyre always asking me if Im okay. Nurses look after my tablets and I get them on time when I need them. Survey returns from people living at the service (8) indicated that 100 percent of people know how to make a complaint if they are unhappy with the service they receive. No formal complaints have been received by the service in the last 12 months. Relatives that we met told us that they were confident that the service would take concerns and complaints seriously. They remarked this is excellent home. This is the only place I know where we can come in and have a meal with Mum, whenever we want to and Shes always immaculately clean and well cared for. Care Homes for Older People Page 4 of 9 Staff we spoke with during the inspection gave us credible accounts of process to follow should they have concerns about the safety of people living at the service. All staff survey respondents (8) told us that they knew what to do if someone had concerns about the home. We looked at communal rooms and a selection of bedrooms, focussing on the accommodation of the 2 people we case tracked. The home was exceptionally clean and provides good wide spaces for wheelchair users, both indoor and outside in the unit grounds. Rooms were personalised and people were able to move freely around the unit to socialise with other people. There is a large conservatory, which most people were enjoying sitting in talking to friends and family. Staff surveys received prior to the inspection told us that staff underwent preemployment checks before they started work at The Warren. We examined staff recruitment records for 2 staff employed since the last inspection. We saw that appropriate checks were carried out prior to employment to ensure that people unsuitable for working with vulnerable adults did not gain a post at the home. These checks included exploring gaps in employment history at interview. We saw that 2 references were received prior to people starting work at the home, and asks the referee to comment on the persons suitability for work with vulnerable people. Our surveys to staff asked if their induction covered everything they needed to know to do the job when they started. All 8 staff that responded verified that their induction covered this very well. Similarly, when we spoke to 2 new staff they told us that the induction is tailored to their needs and ensures that they have the confidence, skills and support to look after people properly. Therefore, the induction for staff at the Warren is comprehensive, person centred and in line with national guidance. The service is managed well and there are clear lines of accountability. We looked at accident and incident records and saw that reporting was appropriately logged. Incidents and accidents were monitored monthly by management with statistical analysis available for trends and patterns. We have been appropriately notified of significant events in the home via the required reporting process. We checked equipment that is used by one of the two people who we case tracked. The hoist that is used to move the individual had been examined by an external contractor within the last six months and was deemed safe to use. The manager told us that automatically done every six months. Therefore, peoples health and safety is maintained by procedures in the home. The Annual Quality Assurance Assessment (AQAA) that was submitted to us prior to the inspection gave us the information we asked for and demonstrated that the service was able to take a self-critical approach to its business operations. The Warren continues to provide excellent outcomes for people living at the home. What the care home does well: The Warren is managed well and managerial structures are clear giving people Care Homes for Older People Page 5 of 9 accountability for areas of work. Staff are supervised and communication about the needs of people living at the Warren is effectively made available to staff. The environment is suitable for peoples assessed needs and the accommodation is exceptionally clean, maintained to a high standard and is a homely place for people to live in. Staff are dedicated and knowledgeable about the roles they are employed to perform. Robust staff recruitment processes ensure that vulnerable people receive protection from employment of unsuitable staff. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 9 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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