Archived: The Warren Residential Lodge

Updated 26 January 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We undertook this unannounced comprehensive inspection of The Warren Residential Lodge on 14 December 2015. At the last comprehensive inspection in June 2015 this provider was placed into special measures by CQC.

The inspection team consisted of an inspector and an expert by experience in the care of older people. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before our inspection we reviewed the information we held about the home, including previous inspection reports and notifications of incidents the manager had sent to us since the last inspection. A notification is information about important events which the service is required to send us by law.

During our inspection we spoke with a newly appointed manager who was not registered with the Commission, a deputy manager and seven members of staff including; two head of care staff, care staff, senior care staff and a newly appointed director for the service. We spoke with 12 people who lived at the home and seven relatives and visitors. Following our inspection we received feedback from two health and social care professionals.

We looked at the care plans and associated records for five people and the medicines administration records for 23 people. We looked at records relating to the management of the service including four staff recruitment records, quality assurance documents, policies and procedures, the staff handbook, incident and accident logs, staff training information and information regarding complaints and safeguarding concerns.

Updated 26 January 2016

We carried out a comprehensive inspection of this service on 30 June and 1 July 2015 and found the provider was not meeting the legal requirements in relation to standards of care and welfare for people who use the service. Care and treatment was not designed to meet people’s needs or preferences. There was a failure to ensure systems and processes were in place to assess, monitor and mitigate the risks relating to the health, safety and welfare of people, or to improve the quality and safety of services provided. After this comprehensive inspection the service was placed into special measures.

We undertook this unannounced comprehensive inspection on the 14 December 2015 to check the service had made improvements and met legal requirements. The service had taken sufficient steps to be taken out of special measures.

The home provides accommodation and nursing care for up to 31 older people. At the time of our inspection 23 people lived at the home.

The registered provider of this service was an individual provider and therefore was not required to appoint a manager. They had appointed a nominated individual to manage this service on their behalf. This person was not registered for the service and as such did not have the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The legal responsibility for this service was with the registered provider. Following our inspection in June 2015, the registered provider informed us of their plans to change the registration of the service to a Limited Company and appoint a Registered Manager for the service.

At this inspection we found the registered provider had met all of the requirements of the Regulations to meet the fundamental standards, although further work was required to embed practices in the home.

Risk assessments in place informed plans of care for people to ensure their safety and welfare, and staff had a good awareness of these. Health and social care professionals were involved in the care of people, especially those with enhanced needs; care plans reflected this. Medicines were stored and administered safely.

There were sufficient staff to meet the needs of people who lived at the home and the provider had implemented a system of review to ensure adequate staffing levels would be available if people’s needs changed. Staff had a good understanding of how to keep people safe, identify signs of abuse and report these appropriately. Processes to recruit staff were in place which ensured people were cared for by staff who had the appropriate checks and skills to meet their needs.

People consented to their care and had opportunities to be involved in planning and reviewing their care however further work was required to embed this practice in the home.

People received food and drink in line with their needs; the provider had discussed people’s dietary likes and preferences recently and was planning to introduce a new range of food choices for people. People who required specific dietary requirements for a health need were supported to manage these.

Care plans in place for people reflected their identified needs and the associated risks; a system of review for care plans had been implemented but was in its infancy. Key workers had been identified to support people in ensuring these care plans remained up to date and in line with their needs. Staff were aware of people’s needs and understood their role in supporting these. Staff were caring and compassionate and knew people in the home well.

There was a wide variety of activities available for people, however some people were not aware of these. People were able to move independently around the home and access communal areas where groups of people enjoyed social interactions and activities together.

Complaints had been responded to in line with the registered provider’s policy and this work needed to be sustained. Incidents and accidents had been reported and investigated; there was a robust system in place to monitor and review the incidents of falls in the home and ensure staff learned from these incidents.

A new management structure in the home had greatly improved the support available for staff and staff spoke openly of working together to improve the lives of people who lived at the home. The management team had introduced robust quality assurance systems in the home. Whilst in their infancy, these audits were monitored by the management team to ensure the safety and welfare of people at the home. People, their relatives and staff felt positive in the recent changes in the service; however these needed to be sustained.