Archived: Warneford House

Updated 18 June 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 is 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.

The inspection took place on 26 April 2016. The inspection was unannounced and was carried out by an adult social care inspector. Before the inspection we reviewed the evidence we had about the service. This included any notifications of significant events, such as serious injuries or safeguarding referrals. Notifications are information about important events which the provider is required to send us by law. We had not asked the provider to complete a Provider Information Return (PIR) as this inspection was to establish if improvements had been made since our last inspection in September 2015. The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we spoke with three people who lived at the service. If people were unable to express themselves verbally, we observed the care they received and the interactions they had with staff. We spoke with eight staff, including the registered manager, registered nurse, care, domestic and catering staff. We looked at the care records of six people, including their assessments, care plans and risk assessments. We looked at how medicines were managed and the records relating to this. We looked at five staff recruitment files and other records relating to staff support and training. We also looked at records used to monitor the quality of the service, such as the provider's own audits of different aspects of the service. We also received feedback from two relatives.

The last inspection of the service took place on 30 September and 1 October 2015 when concerns were identified regarding medication, record keeping, staff supervision and governance.

Updated 18 June 2016

This inspection took place on 26 April 2016 and was unannounced. At our previous inspection in September 2015, we found the provider was not meeting all the regulations we inspected. This was because care and support needs were not always clearly identified in care records. Care records were not always reviewed with the expected frequency. The provider was not always responsive to the changing needs of people, in particular weight loss and dietary needs. Care plans did not always accurately reflect people’s current needs. Call bells were not always in situ or within reach of people.

After the last comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. We carried out this comprehensive inspection to check that they had followed their plan and to confirm that they were meeting all of the legal requirements.

Warneford House provides accommodation, nursing and residential care for up to 40 older people including those who are living with dementia. At the time of our inspection the home was providing support to 30 people. The home had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There were systems in place to protect people from abuse, staff had received appropriate support and training which enabled them to identify the possibility of abuse and take appropriate actions to report and escalate concerns. Risks were assessed and managed appropriately through the appropriate use of risk assessments.

There were systems in place to monitor the safety of the environment and equipment used within the home minimising risks to people. There were arrangements in place to deal with emergencies.

There were safe staff recruitment practices in place and appropriate checks were conducted before staff started work ensuring people were supported by staff that were suitable for their role. There was enough staff on duty to meet the needs of the people living at the home.

Medicines were managed, stored and administered safely by trained and competent staff.

There were processes in place to ensure new staff were trained appropriately and staff received regular training, supervision and annual appraisals. Staff gained consent for the support they offered people. The registered manager and staff were able to demonstrate their understanding of the Mental Capacity Act 2005

and Deprivation of Liberty Safeguards legislation.

Staff had a good understanding of the needs of the people and how they liked to be supported. Staff spoke with and treated people in a respectful and caring manner and interactions between people, their relatives and staff were relaxed and friendly. Staff respected people's privacy and dignity. People and their relatives told us they were made welcome in the home.

People received care and treatment in accordance with their identified needs and wishes. Care plans documented information about people's personal history, choices and preferences and preferred activities.

There was information on how to make a complaint displayed on the notice board for people living at the home. People knew how to complain and felt that when they did that their concern was taken seriously.

There were systems and processes in place to monitor and evaluate the quality of the service provided.