Warrengate is a nursing home for up to 40 people some of whom have dementia. At the time of our visit 39 people lived here. People who live here are all over the age of 65, and many receive care and support for a physical disability, or a sensory impairment.The home is arranged on three levels, with the care being given on the ground and first floor at the time of our inspection. Communal areas include a large dining area, lounge and secure gardens.
There was 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.
The inspection took place on 01 November 2016 and was unannounced. At our last inspection in February 2015 we identified five breaches in the regulations, and areas of the home that required improvement. The registered manager and provider gave us an action plan on how they would address these issues. At this inspection we found that all the areas of concern had been addressed, and people had a positive experience living at Warrengate.
Staff managed the medicines in a safe way and were trained in the safe administration of medicines. However guidelines for ‘As required’ medicines needed to be further developed, to minimise the risk of these medicines being given incorrectly. People received their medicines when they needed them.
There was positive feedback about the home and caring nature of staff from people who live here. A relative said, ““The staff are kind and caring here.”
People were safe at Warrengate because there were sufficient numbers of staff who were appropriately trained to meet the needs of the people. The registered manager regularly reviewed staffing levels to ensure they matched with the needs of people. Staff understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified, such as the local authority safeguarding team or the police.
Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks. In the event of an emergency people were protected because there were clear procedures in place to evacuate the building. Each person had a plan which detailed the support they needed to get safely out of the building in an emergency.
The provider had carried out appropriate recruitment checks before staff commenced employment, to ensure they were safe to work with people who may be at risk.
Staff received a comprehensive induction and ongoing training, to ensure they could meet and understand the care needs of the people they supported. Staff received regular support in the form of annual appraisals and formal supervision to ensure they gave a good standard of safe care and support.
Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). An appropriate assessment of people’s ability to make decisions for themselves had been completed. Where people’s liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.
People had enough to eat and drink, and received support from staff where a need had been identified. People’s individual dietary requirements where met.
People were supported to maintain good health as they had access to relevant healthcare professionals when they needed them. Positive feedback was given by a visiting healthcare professional about the knowledge and skills of the nursing and care staff. People’s health was seen to improve due to the care and support staff gave.
The staff were kind and caring and treated people with dignity and respect. The staff knew the people they cared for as individuals, and were attentive to people’s needs.
People received the care and support as detailed in their care plans. Care plans were based around the individual preferences of people as well as their medical needs. People and relatives were involved in reviews of care to ensure it was of a good standard and meeting the person’s needs.
People had access to a wide range of activities that met their needs. Activities were varied and based on people’s interests and life history.
People knew how to make a complaint. When complaints had been received these had been dealt with quickly and to the satisfaction of the person who made the complaint. Staff knew how to respond to a complaint should one be received.
The provider had effective systems in place to monitor the quality of care and support that people received. Quality assurance records were kept up to date to show that the provider had checked on important aspects of the management of the home. People and relatives were encouraged to give feedback about the home, via surveys and regular meetings. The registered manager and provider listened and took action where required. The registered manager had ensured that accurate records relating to the care and treatment of people and the overall management of the service were maintained.
People benefitted from living in a home with good leadership and a stable staff team, so they knew the people who looked after them. A relative said, “I am very happy with this care home; It’s the human interaction they give.”