Care Home: Warren Drive

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What the care home does well The service ensures staff are well supervised and trained. The Registered Manager has demonstrated the service deal with issues of safeguarding residents seriously and follow the service procedure in relation to disciplinary procedures for staff. Accidents are recorded and clear audit trail is available which links to risk assessments and care plans. The home is well maintained and set in beautiful gardens. What has improved since the last inspection? The service has continued to improve activities and consults with service users on a regular basis. What the care home could do better: No requirements or recommendations were made at this inspection. Key inspection report Care homes for older people Name: Address: Warren Drive Fielden Road Crowborough East Sussex TN6 1TP     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Alexis Reilly     Date: 0 8 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 23 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Warren Drive Fielden Road Crowborough East Sussex TN6 1TP 01892654586 01892611730 enquiries@warrendrive.com www.warrendrive.com Bluebell Care Homes Ltd care home 29 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 29 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category : old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Warren Drive provides care for up to 29 older people who require assistance with personal care. Service users are supported to be as independent as possible. However, assistance is available for all aspects of daily living as needed. Accommodation is provided on three levels, with access via shaft lift or stairs. The home has a modern extension that has been blended into the building and which provides the following accommodation, 4 suites and 2 bed sitting rooms with private balconies and terraces and a large well appointed garden lounge. The home is well maintained and furnished. Service users are encouraged to personalise their own Care Homes for Older People Page 4 of 23 Over 65 29 0 Brief description of the care home rooms. The building is surrounded by a two-acre garden and has a series of paths which provide access around the garden. Up to date fees are available from the service. Extra services, which include chiropody, hairdressing, outings, newspapers and magazines, are charged for separately. These charges are available from the home. Care Homes for Older People Page 5 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection began at 10am and finished at 2pm. The inspector spent time with service users in the home and individually with the three service users who were part of the case tracking, the inspector also had the opportunity to meet with one relative. The inspector enjoyed coffee in the lounge in the morning with twelve of the residents. Speaking in company with five. The inspector case tracked three service users, examining the care plans and the associated documents such as risk assessments and activity plans for these individuals. Other documents examined were copies of notifications, accidents and appointments, evidence of external reviews, the complaints procedure, copies of service users meetings, care plan meetings and staff meetings. Staff recruitment files and staff induction training sheets were also examined, as were a sample of the sheets which record the administration of medication and the duty rota. The plan of staff supervisions and the services Service user guide were also viewed. Care Homes for Older People Page 6 of 23 A partial environmental tour was carried out which included all communal areas, lounge, dining area, conservatory, kitchen and the three bedrooms of the service users case tracked. The inspector spent time with the Registered Manager, administrator, senior carer, and spoke briefly with the cook. The inspector also observed other staff interacting in a positive manner with service users during the inspection. In the report the inspector has included comments from people met on the day of the inspection. Information was also taken from the AQAA which was comprehensively filled in and returned by the due date. Care Homes for Older People Page 7 of 23 What the care home does well: What has improved since the last inspection? 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 23 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from receiving relevant and up to date information, which is made available to them prior to admission, allowing them to make an informed choice about the home prior to moving in. The processes in place for ensuring that suitable pre admission assessments are conducted is good, with services being offered to only those service users whose needs can be met. Evidence: As part of the inspection the inspector case tracked three service users in the home and spent time with these people individually. Other service users were seen during the course of the inspection and staff were observed interacting in a positive manner with service users. The inspector also had the opportunity to speak with relatives, the senior carer and the Registered Manager. As part of the case tracking the inspector examined the person centred care plans and the associated documents such as risk assessments and activity plans for these individuals; also evidenced were the external reviews from the placing team to ascertain if the needs identified in the assessment Care Homes for Older People Page 10 of 23 Evidence: are used as a basis for a comprehensive care plan. The inspector examined the service user guide and service users information pack and can confirm that they are clear document which contain relevant information. The home has had five new admissions since the last inspection, evidence was supporting to confirm that service users are involved in the admissions process and are given choice. The service had comprehensive assessment document in place which were used to assess someone referred to the service. Also available to view was collated information with regard to service users in the home, and their referring documents. This highlighted that the Registered Manager obtains background information and up to date CPA and mental health assessments if applicable prior to offering a place in the service. Intermediate care is not offered by this home. Care Homes for Older People Page 11 of 23 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans and procedures in place are sufficient to ensure that a good provision of health care and personal support is provided to service users by the home. Care is administered in way that protects residents privacy and dignity. Medication procedures are in order. Evidence: As part of the inspection the inspector case tracked three service users in the home and spent time with one of these individually, spending time with others in the home during the course of the inspection. Staff were observed interacting in a positive manner with service users. The inspector also had the opportunity to speak with one relative, the deputy, a carer and the Registered Manager. As part of the case tracking the inspector examined the person centred care plans and the associated documents such as risk assessments and activity plans for these individuals; also evidenced were the external reviews from the placing team to ascertain if the needs identified in the assessment are used as a basis for a comprehensive care plan. Care plans examined were clear and easy documents to follow. Evidence was supporting to confirm that service users are respected and personal care is delivered maintaining individuals Care Homes for Older People Page 12 of 23 Evidence: privacy and dignity. The inspector evidenced through out the care plans good practise examples in the way service users were to be encouraged and their independence promoted and maintained. The CQC sent surveys directly to the home, out of these seven surveys were returned directly to the CQC. In reply to the question do you receive the care and support you need out of the seven responses three said yes, two usually, one sometimes, and one did not reply. In reply to the question are staff always available when you need them three stated yes, three usually and one did not reply. Comments received directly from the CQC surveys included It couldnt be better, great collection of staff who look after me mentally and physically, very satisfied and happy. I am cared for very well and all staff are well trained. Care Homes for Older People Page 13 of 23 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Evidence was supporting to confirm that a range of social, cultural and recreational activities are on offer with the wishes of the service users being central to the provision. The menu is varied and specialist diets are provided for service users, with service users choice and wishes being respected. Evidence: As part of the inspection the inspector case tracked three service users in the home and spent time with these people individually, other service users were seen during the course of the inspection and staff were observed interacting in a positive manner with service users. The inspector also had the opportunity to speak with relatives, the senior carer and the Registered Manager. As part of the case tracking the inspector examined the person centred care plans and the associated documents such as risk assessments and activity plans for these individuals; also evidenced were the external reviews from the placing team to ascertain if the needs identified in the assessment are used as a basis for a comprehensive care plan. Evidence was supporting to confirm that relatives feel welcomed into the home. Menus are varied. Activities are on offer in the home, and evidence was supporting to confirm that individuals wishes with regard to activities are taken into consideration, and that Care Homes for Older People Page 14 of 23 Evidence: staff have a good understanding of individual service users likes and dislikes and indeed their history. Staff use this information to encourage service users to be involved in activities. Service users views are taken into consideration with regard to the activities and this was evident through minutes of the service users meetings and actions planned with regard to future activities in the home. The Registered Manager has also brought more outside activities into the home since the last inspection. Comments taken from the surveys were the home allows me to live my life as I want they leave me alone, some staff are excellent some are less so. Comments received about what the home does well were cares about its people, it is a very well run home very clean, very caring and helpful staff, always interesting activities, I am very settled and content in the home. I feel thoroughly at home at warren drive, they could do nothing better, they care for me well, keep me occupied, keep the home looking nice ie the garden, has a good variety of meals, no faults at all the home suits me down to the ground. Friends and family are welcome at any time and in accordance with service users wishes. Personal relationships and family relationships are encouraged if these are helpful and appropriate. Evidence was supporting to confirm that the service has updated their policies regarding Equality and Diversity. Care Homes for Older People Page 15 of 23 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from a robust and efficient complaints procedure, whilst the homes procedures and processes protect residents. Evidence: During the inspection the inspector examined copies of notifications, accidents and appointments, staff supervision records and the complaints procedure. Evidence was supporting to confirm that staff receive training in safeguarding vulnerable adults. Evidence was supporting to confirm that complaints are dealt with effectively and that the Registered Manager deals with any issues of safeguarding speedily and appropriately and follows the service procedures in relation to disciplinary procedures for staff. In addition evidence was supporting to confirm that residents and relatives felt able to raise concerns with the Registered Manger or staff and that these would be dealt with. All accidents and incidents are recorded by the carer involved or present at the time. The record is then checked by the senior carer. During the inspection the inspector and the deputy viewed all the accidents and recording for any incidents for the people case tracked. The inspector can confirm these were recorded correctly and there is system in place to case track these incidents. Risk assessments were updated accordingly. Care Homes for Older People Page 16 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Accommodation at the home is provided in such a manner that it is safe, hygienic and odour free. Appropriate infection control procedures are in place, in order to reduce or eliminate the risk of infection to staff and service users. Evidence: As part of the inspection the inspector carried out a partial environmental tour of the home, which included all communal areas, dining rooms, and lounges. The service users bedrooms who were involved in case tracking were also seen. The home is well maintained and all areas of the home, including the garden, and all areas are accessible to service users. The home has an ongoing plan of refurbishment in place. The size, location and layout of the home are suitable for its stated purpose. The home was clean and odour free throughout. There is a daily cleaning schedule in place. The home has an infection control policy in place and staff are trained in infection control procedures, staff training records viewed confirmed this. The home is set in lovely gardens which the residents have access to. Care Homes for Older People Page 17 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff recruitment procedures are effective and protect service users from potential harm or risk associated with poor recruitment practises. Evidence: As part of the inspection the inspector examined the recruitment files of three newly recruited staff to the service these were found to be in good order. The service uses the skills for care induction booklets, and a list of staff training was also seen as were copies of staff meetings. Evidence was supporting to confirm that staff are well trained, supervised and attend regular staff meetings. Staff complete NVQ qualifications and are also trained in areas relevant to the needs of service users such as challenging behaviour and dementia care. Members of staff were seen on the day of the inspection interacting positively with service users in an encouraging manner. Care Homes for Older People Page 18 of 23 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Registered Manger has ensured that service users live in a safe and well manager service which is run in their best interests. Evidence: Evidence through out the inspection was supporting to confirm that service users received a excellent level of service. Care plans and risk assessments were informative, activities are provided and service users dignity and independence is respected. Staff are well managed, supervised and trained. Service users are protected by the homes policy on recruitment and handling of finances and valuables. The inspector viewed copies of the internal monthly provider inspections, copies of residents meetings, news letters and quality assurance documents. The CQC sent surveys directly to the home out of these seven surveys were returned directly. In reply to the question do you receive the care and support you need out of the seven responses three said yes, two usually, one sometimes, and one did not reply. In reply to the question are staff always available when you need them three Care Homes for Older People Page 19 of 23 Evidence: stated yes, three usually and one did not reply. Comments taken from the surveys included they allow me to live my life as I want they leave me alone, employ more staff they are usually too busy to stop and listen and often requests for clean towels etc are missed, some are excellent some are less so, food is unimaginative. Comments received about what the home does well are cares about its people, it is a very well run home very clean, very caring and helpful staff. Always interesting activities, I am very settled and content in the home. I feel thoroughly at home at warren drive, they could do nothing better, they care for me well, keep me occupied, keep the home looking nice ie the garden. The home has a good variety of meals, no faults at all the home suits me down to the ground. Nothing it couldnt be better, great collection of staff who look after me mentally and physically, very satisfied and happy I am cared for very well and all staff are well trained. Evidence in the AQAA confirmed that policies and procedures are in place with regard to health and safety. Evidence found in the inspection highlighted the home ensures that its residents are well protected, taking the issues of safeguarding . The Registered Manager has demonstrated they act speedily and effectively and ensuring the services procedures with regard to staff disciplinary actions are followed effectively. Care Homes for Older People Page 20 of 23 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 21 of 23 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, Care Homes 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 22 of 23 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 23 of 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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