Care Home: Warren Park

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What the care home does well People`s needs were assessed before they moved into the home and their needs detailed in a plan of care. This made sure that staff had the information they needed to make a judgement about whether or not they could meet people`s needs. People`s health care needs were met and in the main the medication system was well managed. People told us they were treated with respect and dignity and we observed people being approached in a sensitive and reassuring manner. There was an activities programme and people were able to choose whether or not take part. People using the service and the staff acknowledged the value of recreation and stimulation in promoting a sense of well being. Contact with family and friends is encouraged and people are made welcome when they visit. A wholesome and balanced diet was offered. People told us in the main they were happy with the meals provided, We observed that people were offered the assistance they needed in a dignified manner. The home had a complaints procedure which was displayed and made available to people. Records of complaints showed they were taken seriously. There were procedures in place to protect people from harm and for taking appropriate action if allegations are made. In the main there are enough staff employed and their are satisfactory arrangements in place to cover absence and to provided support and care to people at peak times of the day. There was recruitment pending to maintain and further enhance the staff available. Staff receive training, support and supervision. This makes sure they have the skills to do their job. The recruitment procedure is robust and protects people from harm. The home is well managed by an experienced manager, who makes sure that the home is run in the best interest of the people using the service. People told us they are asked to comment on the service and there is evidence that comments and suggestions are acted upon. The procedures in place for the safekeeping of people`s money was adequate and records were kept along with receipts for income and expenditure. This made sure that people`s financial interests were safeguarded. There were safe working procedures, which promoted the health and welfare of people using the service and the staff. Staff were able to tell us the action they took on a daily basis to promote health and safety. What has improved since the last inspection? Since the last inspection the manager and the staff have worked hard to improve the service. we found an enthusiastic manager who communicated well with his staff and amotivated staff group who had benefited from management support from their direct manager and the organisation. Since the last inspection there has been some improvement to the quality of care plans, although there is acknowledgment that further development is necessary. There has been some improvements to the environment, pictures and memorabilia is now displayed. This offers stimulation and interest for people. Safe staffing levels are now being maintained, there are risk assessments in place and these are kept up to date. This makes sure staff have the information and equipment they need to move and handle people safely. The statement of purpose and the service user guide has been updated and people are offered a choice at mealtimes and staff are receiving the training they need to do their job. What the care home could do better: The environment was reasonable maintained however there were some areas in need of refurbishment , redecoration, replacement of floor coverings. The manager told us there are plans for this to be done. This will help to eliminate the offensive odour that was noted and provide a more comfortable environment for people using the service. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Warren Park White Lane Chapeltown Sheffield South Yorkshire S35 2YH     The quality rating for this care home is:   two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Shirley Samuels     Date: 1 7 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 26 Information about the care home Name of care home: Address: Warren Park White Lane Chapeltown Sheffield South Yorkshire S35 2YH 01142570595 01142570284 warrenpark@mimosahealthcare.com 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) : Mimosa Healthcare Ltd care home 60 Number of places (if applicable): Under 65 Over 65 0 0 60 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 60 60 0 The maximum number of service users who can be accommodated is: 60 The registered person may provide the following category of service only: Care home with nursing - Code N, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, Dementia - Code DE, Mental Disorder, excluding learning disability or dementia - Code MD. Date of last inspection Brief description of the care home Warren Park nursing home is a purpose built two-storey building overlooking fields, the motorway and a cricket pitch. The home caters for service users requiring general or DE/MD nursing care. Care Homes for Older People Page 4 of 26 1 8 1 1 2 0 0 8 Brief description of the care home The home is sited near a bus route and is close to Chapeltown, which has many amenities including shops, a supermarket and a railway station. A copy of the previous inspection report was on display and available for anyone visiting or using the home. Information about how to raise any issues of concern or make a complaint was on display in the entrance hall. The manager confirmed that the range of monthly fees from 1st April 2009 were 373 pounds - 481 pounds per week. Additional charges included newspapers, hairdressing and private chiropody. Care Homes for Older People Page 5 of 26 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: two star good 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: This was a key inspection carried out by Shirley Samuels on Wednesday 17/06/09 from 9:30am-6:30pm. The last inspection carried out on this service was completed on 02/07/08 We gathered evidence by talking to people using the service, talking to staff, making observations, checking records and comments from relatives on the day of the visit and from questionnaires handed out on the day. We checked a selection of documents regarding peoples care and support, staff records and records that showed evidence of compliance with regulations and standards. Care Homes for Older People Page 6 of 26 Before the inspection the manager completed a annual quality assurance assessment(AQAA). This information provided by the manager tells us how the service has developed since the last inspection and what is planned to further develop the service over the next 12 months. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into the report as recommendations- but only when it is considered that people using the service are not being put at significant risk of harm. In future if a requirement is repeated, it is likely that enforcement action will be taken. We would like to thank everyone for their help and co-operation. What the care home does well: What has improved since the last inspection? Since the last inspection the manager and the staff have worked hard to improve the service. we found an enthusiastic manager who communicated well with his staff and a Care Homes for Older People Page 8 of 26 motivated staff group who had benefited from management support from their direct manager and the organisation. Since the last inspection there has been some improvement to the quality of care plans, although there is acknowledgment that further development is necessary. There has been some improvements to the environment, pictures and memorabilia is now displayed. This offers stimulation and interest for people. Safe staffing levels are now being maintained, there are risk assessments in place and these are kept up to date. This makes sure staff have the information and equipment they need to move and handle people safely. The statement of purpose and the service user guide has been updated and people are offered a choice at mealtimes and staff are receiving the training they need to do their job. 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 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 9 of 26 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 10 of 26 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. People are provided with information about the home and do not move into the home without having their needs assessed. Evidence: In the AQAA the manager told us People are encouraged to visit the home they are given written information and notified of the need to carry out care assessments. In the last 12 months the manager told us that information about the home can be provide in different formats such as large print or braille Since the last inspection the service user guide and the statement of purpose have been updated and made available to all service users and their relatives. A copy of these documents are also available in the entrance to the home. This means that people have the information they need to make choices and to inform them about the standards they can expect. On each of the files checked there were assessments Care Homes for Older People Page 11 of 26 Evidence: carried out before people moved into the home. Staff told us they usually had enough information about people before they moved in and where there were gaps in the the information they endeavored to obtain it quickly. This means that staff had the information they needed to make a judgment about whether or not they are able to meet peoples needs. The home does not provide intermediate care. Care Homes for Older People Page 12 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are in place and peoples social and health care needs are met. In the main the medication system is well managed. People are treated with respect and their rights are upheld. Evidence: In the AQAA the manager told us feedback meetings and reviewers of care are held, care plans are audited, daily progress charts and records from professionals all inform staff of peoples needs and the action they need to take. Each person had a detailed plan of care that was developed from the initial assessment and developed further as staff became more familiar with peoples needs. Each care need was detailed on a separate sheet along with the action staff needed to take and the monthly evaluating and review. Daily observations were recorded on a separate sheet within the same file. Daily observation records were made by nursing and care staff. Care Homes for Older People Page 13 of 26 Evidence: The staff spoken to agreed that the recordings of observations and monthly evaluations were in some cases quite clinical and could be developed further to include more details of a social and emotional nature. The manager told us that staff were going to receive training on person centered planning and record keeping. People told us that they felt the staff took care of them well. They told us that if they were ill the staff always phoned the doctor. The records of needs show that people also have access to other health professionals and records of appointments and visits are kept. There was evidence of a service user who was admitted to the home with serious pressure ulcers. Photographic and written records show improvement. This is evidence of good nursing care and shows that peoples health care needs are met. Due to medication concerns following the last inspection in July 2008, we carried out a pharmacy inspection on the 11/08/08. Following this inspection two requirements and five recommendations were made. At this inspection only one recommendation remains outstanding which is carried forward in this report. Staff are trained to administer medication. observations were made of medication round. People using the service were approached sensitively. Some who were reluctant to take medication were gently encouraged for some this was successful for others it was not. Medication was never forced and efforts were made to make sure people were not distressed. Records of medication administered was appropriately recorded and there were codes used to indicate why medication had not been given. There were some minor shortfalls in recording details of medication brought forward from the previous month and two examples of medication previously being out of stock. Staff were observed talking to people in a friendly calm, reassuring and caring way. Staff were observed discreetly adjusting peoples clothing to make sure they were not exposed unnecessarily. People told us that staff treated them with respect and did not try to boss them about. Staff told us that on a daily bases they tried to respect peoples rights, privacy and dignity by, asking people what they wanted, encouraging people to make choices, knocking and waiting to be invited in, promoting dignity while carrying out personal care tasks. This means that people are treated with respect and their right to privacy is upheld. Care Homes for Older People Page 14 of 26 Evidence: Care Homes for Older People Page 15 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities are provided, people are encouraged to maintain contact with family and people are provided with a balanced diet. Evidence: The home employs an activities co-ordinator, who works 35 hours a week. Staff and people using the service told us activities are organised the enthusiasm and dedication had made a big difference to the quality of peoples lifes. A variety of activities took place during the week with activities split between the top and bottom floor. Activities included Craft, karaoke sessions, entertainers, hairdressing,reminiscing and pamper sessions. People told us about the fish and chip meal they had outside on the patio they said they really enjoyed it and wanted to do it again. Staff told us that they tried to make sure that people who spent a lot of time in their bedroom also had the opportunity for recreational activities and stimulation. Some people told us in the questionnaires that they would like to go out more. People told us they were able to keep in contact with family and friends. The records Care Homes for Older People Page 16 of 26 Evidence: show that there are many visitors to the home. People are able to see visitors in private and staff told us they always try to make themselves available to communicate with relatives and to answer any questions and offer reassurance where necessary. People using the service and their next of kin are notified of their rights at the time of admission and staff told us they try to promote independence and encourage people to make choices for themselves. Where people are less able to make choices staff told us they made choices for people based on what they knew about people and what they had learned about them while caring for them. Friends and family were encouraged to contribute information to support staff in helping people make choices. This shows that people are helped to exercise choice and control over their lives. care plans included peoples dietary needs and some of their preferences. There is a choice offered at all meals and snacks are provided between meals. Since the last inspection additional mealtime assistants have been initiated specifically to assist people with eating their meal and to ensure that all people using the service have a pleasant mealtime experience and to make sure their nutritional needs are met. Care Homes for Older People Page 17 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are taken seriously and there are procedures in place to protect people from harm and to investigate any allegations. Evidence: The home has a complaints procedure. People told us they knew how to make a complaint and had someone to talk to if they were not happy. The records show that since the last inspection the home has received eight complaints. The records details the content of the complaint, the outcome of the investigation and what action will be taken to improve practice where complaints have been upheld. The complaints procedure was detailed in the information given to people on admission and was displayed in the entrance to the home. In the AQAA the manager told us there had been four safeguarding referrals in the last 12 months. At the time of this visit there were two safeguarding outcomes still pending. There was evidence to show that appropriate action had been taken to protect people and other agencies notified. Care Homes for Older People Page 18 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is reasonably maintained clean and hygienic however there is an offensive odour. Evidence: In the main the layout of the home is suitable for the people using the service. There are plans (which the manager told us have now been passed) to make some structural changes to the dining and lounge areas. The home is reasonable maintained, there is a maintenance person employed who is able to respond to maintenance issues promptly. There is an offensive odour in the home however this is permeated into floor coverings, furniture and furnishings and is difficult to eradicate without replacement. There is a rigorous cleaning routine and staff are committed to creating and maintaining a clean and hygienic home that is free from offensive odour. The manager told us there is a plan to carry out refurbishment following completion of the planned structural changes. Care Homes for Older People Page 19 of 26 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. There is enough staff to meet peoples needs they are trained and competent and the recruitment procedure protects people from harm. Evidence: In the AQAA the manager told us the required staffing levels are maintained, recruitment checks are carried out and staff receive training. People told us that staff usually come quickly when they call for assistance. Staff were observed providing appropriate levels of supervision to people. Staff told us in the main they worked well together, communication between staff was good and staff encouraged each other to maintain good standards of care and shared good practice with each other. Ancillary staff were diverted at busy times of the day to provided direct assistance to people,helping with feeding and providing drinks. The manager told us that there are some vacancies which they are in the process of filling this will enhance the service to people and provided flexibility. Since the last inspection staff had received training which included induction, health and safety, moving and handling, first aid food hygiene,safe handling of medicines Protection of vulnerable adults, infection control and dementia awareness. This makes sure that staff are trained and competent to do their jobs. The manager told us about further training that was planned for staff. The home worked well with outside training agencies to make sure staff received the Care Homes for Older People Page 20 of 26 Evidence: training they needed. Staff spoke positively about the training they received, they were enthusiastic and gave us examples of how they transfered what they learned into practice. This made sure that people were supported and cared for by staff who understand their needs and approach their job with competence and confidence. This in tern promotes a sense of wellbeing for people. Three staff files were checked they included all the information required and showed that staff were throughly checked before commencing work at the home. Records on file included, evidence of criminal records check, application forms, interviews, references and proof of identification. This shows that the recruitment procedures protects and supports people using the service. Care Homes for Older People Page 21 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and peoples health safety and welfare is promoted. Evidence: Since the last inspection there has been a new manager appointed. The staff told us that the manager was approachable, knowledgeable about the people using the service and that he led by example. The staff told us the home was well managed and that they felt valued within the organisation. The manager is not yet registered with us but has started the process. People told us they were asked to comment on the service. There was evidence to show that the home responded to comments received from people and implemented changes wherever possible. The conduct of the service was monitored by the director of quality and the operations manager. Staff told us that representatives of the organisation visit the home and talk to them about the work they do and check out with them how they feel things are going. Care Homes for Older People Page 22 of 26 Evidence: The records show that staff meetings are held information is shared openly with them and they are able to comment on the service. Meetings are also held with people using the service. This shows that people are able to comment on the service and contribute to how the service is run. Questionnaires are also sent to people using the service and relatives. The manager is in the process of collating the information and looking at ways of responding to some of the comments and implementing suggestions were possible. People told us they were happy with the procedures in place for managing their financial arrangements. Three peoples files were checked and they detailed income expenditure and the balance of monies corresponded with the records. This shows that peoples financial interests is safeguarded. Staff told us they had received training on safe moving and handling. We observed good practice staff explained to people what they were going to do, wheelchairs were used safely, staff used equipment and aids in a confident manner and maintained peoples dignity and ensured their safety. Staff were able to give us some examples of how they promoted health and safety on a daily basis, they told us hazards were reported and sorted quickly, they had reviewed health and safety training and understood their responsibility for their own safety and that of the people they supported. The records showed and the manager confirmed in the AQAA that safety checks had been made on equipment, appliances and services such as fire systems, hoist, lift, gas and electric appliances. The records showed that some staff had not received fire instruction in the last six months this was brought to the attention of the manager who was required to provide instruction to staff as soon as possible. Care Homes for Older People Page 23 of 26 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 24 of 26 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 1 9 A system should be in place to record medication carried forward from the previous month and to trigger reordering of medication. This will make sure medication is not out of stock and will ease the process of checking stock levels. This recommendation is carried forward from the inspection carried out by the pharmacy inspection on the 11/08/08. All parts of The home must be kept clean, reasonably, decorated, furnished and free from offensive odour. To make sure people live in a safe well maintained environment. All staff must receive fire instruction twice yearly. To make sure staff know what action to take in the event of a fire. 2 19 3 38 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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