The Warren

Updated 14 November 2020

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.

This was a targeted inspection looking at the infection control and prevention measures the provider has in place. As part of CQC’s response to the coronavirus pandemic we are conducting a thematic review of infection control and prevention measures in care homes.

The inspection took place on 27 October 2020 and was announced.

Updated 14 November 2020

About the service

The Warren is a nursing home providing personal and nursing care to 25 people aged 65 and over at the time of the inspection. The service can support up to 27 people.

People’s experience of using this service and what we found

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Since our last inspection improvements had been made. Extensive and detailed personalised care plans and risk assessments were in place. Staffing levels had been increased and protective care time overlap shifts were in place to enable meaningful time with people. An extensive activities programme had been implemented which provided people with physical and emotional stimulation.

Robust audits had been implemented in consultation with Local Authority Quality Assurance Improvement Team (QAIT), at the request of the registered manager. The QAIT team offers advice and support to providers to meet the quality standards and requirements of regulators and local authority. Audits reviewed people’s care plans and risk assessments, incidents and accidents, staffing needs, infection control and health and safety. This enabled any trends to be spotted to ensure the service was meeting the requirements and needs of people being supported. Where actions were needed, these had been followed up. For example, care plans and risk assessments had extensively been updated, an activities programme implemented, and new policies and procedures put in place to guide staff.

Staff spoke positively about communication as a staff team. Several voiced difficulties adjusting to all the changes which had been implemented by the registered manager. Staff did however recognise that changes had to be made in order for the service to meet health and social care regulations.

The service provided safe care to people. People felt safe and supported by staff. One person commented, “The staff are brilliant. I feel safe here and well cared for." A relative commented, “My husband is very safe here.” Medicines were safely managed on people’s behalf.

People were supported to maintain a balanced diet. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them.

Staff relationships with people were caring and supportive. Staff treated people with dignity and respect when helping them with daily living tasks. The service ensured people led meaningful and fulfilled lives.

Some improvements were needed with the recruitment and selection process in place. There were certain issues with three staff members recruitment procedure, with regards to start dates and receipt of paperwork prior to starting. We fed this back to the registered manager and established there appeared to be some communication issues. The registered manager immediately agreed to carry out an audit of all staff files. The second day of our inspection found that the registered manager had already started auditing the staff files of all new starters and these had followed the recruitment procedure correctly. People received effective care and support from staff who were well trained and competent.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 22 January 2019) and there were four breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Warren on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.