Warren Farm Lodge

We found the following examples of good practice.

¿ Visitors accessed the home via a back door to minimise the risk of infection. A screen had been used in the conservatory during relative visits to keep them and people safe from any potential infection spread.

¿All bedrooms were single occupancy and contained a hand wash basin and toilet. The facilities decreased the need for people to use communal areas which minimised a risk of infection spread.

¿The registered manager was fully aware of the actions that must be taken if a new person was to be admitted to the home. This included the need for negative COVID-19 test results and for the person to self-isolate.

¿ Tests were readily available and were carried out as required to identify and reduce the incidence and spread of COVID-19. A number of staff had been trained to complete testing.

¿ Adequate stocks of Personal Protective Equipment (PPE) were available within the home. Staff were seen wearing the required PPE.

¿ The layout of communal areas had been changed to promote social distancing. Staff were aware that good ventilation was important and this was enabled.

¿ Staff had received(Infection Prevention and Control) IPC training including hand washing and PPE donning and doffing. The management regularly monitored staff to ensure they were adhering to safe IPC practices.

¿The provider’s IPC policy was up to date and had been implemented within home.

Warren Farm Lodge is a residential care home providing personal care and accommodation for 25 people aged 65 and over at the time of the inspection. The service can support up to 30 people in a purpose-built building.

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

People were relaxed and comfortable at Warren Farm Lodge and were complimentary of the care they received. Staff knew how to protect people from abuse or avoidable harm and were confident any issue they reported to managers would be addressed. Risks were managed appropriately and equipment had been regularly serviced to ensure it was safe to use. Staffing levels had been recently reduced in response to a reduction in the number of people using the service.

Staff were recruited safely and were sufficiently skilled to meet people’s needs. Training was regularly refreshed and staff received regular supervision and support from their managers. The service was well maintained and all rooms had en-suite facilities and kitchenette areas. An extension of the service’s lounge was planned to provide additional communal space.

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.

Staff provided compassionate support and people’s privacy and dignity was respected. Staff spent time chatting with people throughout the day and responded promptly to people’s request for help.

Care plans were accurate and up to date. They provided staff with sufficient guidance to ensure people’s needs were met. Care plans also included details of people’s life histories to help staff understand how the person’s experiences could impact on their current support needs. People were supported to engage with a range of activities and relatives were encouraged to visit.

The staff team were well motivated. They told us their managers were supportive, approachable and fair. There was registered manager in post and appropriate systems in place to support staff outside of office hours.

Quality assurance processes were appropriate, and people’s feedback was valued and acted upon. All incidents were investigated to identify areas of learning or where improvements could be made.

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

Rating at last inspection

At our previous inspection the service was rated Good. (Published 23 December 2016)

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 Warren Farm Lodge on our website at www.cqc.org.uk.

The manager was registered with us as is required by law. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

Medicines were given appropriately and the recording of their administration was clear and concise. They were kept and disposed of as they should be. People’s long term health needs were addressed and people saw medical professionals when they needed to. People received adequate food and drink.

There were a suitable amount of staff on duty with the skills, experience and training in order to meet people’s needs. People felt safe and they were able to raise any concerns they had and felt confident they would be acted upon.

Staff were well trained and knowledgeable regarding people’s needs. Staff felt well supported by management and felt able to speak with senior staff at any time.

People’s ability to make important decisions was considered in line with the requirements of the Mental Capacity Act 2005. Staff interacted with people in a positive manner and their consent was sought before any care was carried out. Staff maintained people’s privacy and dignity whilst encouraging them to remain as independent as possible.

People’s preferences were acknowledged and staff understood people’s likes and dislikes. People were encouraged to participate in activities where they chose to and friendships were maintained.

People, their relatives and staff spoke positively about the approachable nature and leadership skills of the registered manager. Structures for supervision, allowing staff to understand their roles, and responsibilities were in place. Systems for updating and reviewing risk assessments and care plans to reflect people’s level of support needs were effective. Quality assurance audits were undertaken regularly and the provider gave the registered manager support.

Notifications were sent to us as required, so that we could be aware of how any incidents had been responded to.

Is the service safe?

We saw that people were cared for in an environment that was maintained and suitable to meet their needs. One person told us, 'I love my bedroom and the home is great.' All part of the communal areas were clean and well maintained. Staff spoken with and records seen showed training was provide so that people's needs were met safely. We saw that risk assessments and equipment was available to ensure that people had the right equipment to meet their needs. All the people spoken with told us that they felt safe living there.

All the people spoken with told us that staff responded quickly when they needed assistance. We observed good interactions between the staff and the people who lived there. One person told us, 'You only have to ask once and it's done.'

We saw that a recent external audit had been undertaken by the provider and improvement in some records was required. For example more information in risk assessments to ensure staff had the information to provide safe care at all times. However the manager had begun to take action to address this.

The care manager told us that one application under the Deprivation of Liberty Safeguards had been made. Records showed that this had not been reviewed. We asked the provider to establish if this was still current and take the necessary action if required. The manager commenced this process during our visit. This meant the service had procedures in place to protect people when required and make decisions on their behalf to keep them safe.

Is the care effective?

All the people that we spoke with who used the service and their relatives told us they were happy with the care and that their needs were being met. One person told us, 'It's the best home. I looked at a few before I came here, and it was the best then and it is the best now'. We saw that people were provided with information about the service, for example an advice line was displayed in the entrance to the home, so people could contact them in confidence if they had concerns, details of the resident association and how to make a complaint. All the people spoken with told us there were involved in decision about their care.

We saw that staff knew people well and were attentive to their needs whilst supporting them to be independent. One person told us,' I could not ask for better staff to help me they are all lovely.' People were encouraged to do the things they liked. This meant staff responded to individual needs.

Is the service caring?

All the people we spoke with and their relatives told us that the staff were caring. One person told us, 'They (staff) help me when I need help but they always ask if they can do anything.'

People told us and we saw that staff respected their privacy and dignity and that they were given choices about their care. One person told us, 'I have been here for two years, I cannot praise the staff enough, kind considerate and very helpful'. This meant people were happy with their care.

We saw that staff were attentive to people needs and spoke with people respectfully. We saw that staff asked people if they wanted drinks and encouraged them to make choices. A relative told us, 'There is always a pleasant and comfortable atmosphere and I see staff caring for people.' A visiting healthcare professional told us, 'Any instructions given to staff are always followed and they always seek advice.' This showed that staff cared for people and ensured that people's needs were met.

Is the service responsive?

All of the people that we spoke with told us that staff asked them if they would like to be supported with personal care tasks such as bathing. One person told us, 'The staff always ask and wait for me to give them an answer. I have never been made to do anything that I have not agreed to.' One staff member told us, 'I always ask people, 'do you want a bath or shower today and what time would you prefer'.' This meant that staff were able to provide care that met people's needs according to what they wanted on a daily basis. During our inspection, we observed staff members responding to people's needs. For example, we observed a staff member discreetly ask a person if they could assist them to the bathroom. We also observed staff at lunchtime give people time to decide whether they wanted to be supported to the dining area or have their lunch in the lounge. This meant that staff responded to people in a personalised way taking into account how people felt.

We saw that care plans were reviewed so peoples' changing care needs were updated to ensure that staff had the current information so they could support them. However, daily records needed to show what people do on a daily basis and contain more details about how people spend their time. There were no restrictions on family members visiting the home showing that the service was responsive to people's needs and enabled them to maintain relationships with people important to them.

Is the service well led?

There is a registered manager in post who has day to day responsibility of the service provided. This meant staff should have the guidance and support to meet people's needs.

We saw that meetings with people who used the service were held to gain their views about the service and make suggestions for improvement. All the people we spoke with told us that the manager and staff always listen. This meant the provider monitored the service and took people's views into consideration when making improvements.

All staff told us that they were able to put forward ideas and the provider would listen and try and accommodate where possible to improve the service provided to people. All staff spoken with told us they felt supported by the manager, and had regular training opportunities. This meant staff had the skills to care for people safely.

People were supported in a way that enables their privacy, dignity and independence to be respected. One person told us, 'Staff ask my permission before they do anything'. They treat me as an individual and my wished are respected. All of the people spoken with commented that they were happy with the service provided. This meant people preferences were respected.

Staff spoken to was able to tell us about people's care needs so that they were cared for appropriately. One person told us 'I am pleased with the service I have, the staff look after me well'. All of the people spoken with commented that they were happy with the service provided. This meant people received the care they wanted

We saw that systems were in place to keep people safe from harm.

Staff received a range of training so that they had up to date knowledge and skills in order to support people safely.

There were systems in place to monitor and seek feedback from the people using the service to ensure people received a quality service.

We visited the service to follow up improvements from our inspection in February 2011.

Six people using the service told us they they were fully involved in their care. One person told us "I know about my care plan and what it says, and I know it changes as I do'.

All three relatives told us they were consulted about their relative's care and kept informed about their relative's health so they felt involved in their care.

Staff spoken to was able to tell us about people's needs so that they received care in a way that the they preferred. This meant staff had the information about people using the service so they could discuss people care with the individual.

People were complimentary about quality of the food and told us the cook consulted with them about their meals. This meant people preferences and choices were known.

Staff received a range of training so that they had up to date knowledge and skills in order to support people using the service with their medication. This meant people received their medication with support and as prescribed.

We saw people's personal information being held securely. This meant peoples personal information was kept confidential and accessed only by staff.