Warren Court

Warren Court is a residential care home providing personal care and accommodation to up to 19 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 17 people using the service.

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

We found that people’s privacy and dignity was not always upheld in relation to toilet facilities. We have issued a breach related to this.

Care plans were not always person-centred. Plans did not include information about people’s preferences about their daily care. Protected characteristics and support required around this was not included. This was discussed with the registered manager who said plans would be reviewed and revised.

We received mixed feedback about the caring attitude of care workers. We received the following comments, “They were a bit cross when I had an accident once, but I have not seen any sign that this is normal or of physical harm,” and “They are absolutely lovely, they are wonderful.” We discussed the mixed feedback with the registered manager who said a meeting would be held with care workers.

We have made a recommendation in relation to safe care and treatment of people.

People were supported by enough staff who had the relevant experience and training to support people. A person said, “Yes, they know what they are doing, they are very capable as well as kind.”

Managers had not identified the issues we found in the quality of care, people, relatives, and staff felt comfortable raising concerns and giving feedback. Staff felt supported by their managers and colleagues. The provider had systems in place to monitor the quality and safety of the service and staff worked effectively with other health professionals to support people .

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 good (report published 11th September 2017)

Why we inspected

The inspection was prompted by a review of information we held about the service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We have identified a breach in relation to people not always being treated with dignity and respect.

We have made a recommendation in relation to safeguarding people from the risk of abuse, assessing risk safely, monitoring and management, safeguarding people from the risk of abuse, preventing and controlling infection and maintaining social relationships

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice:

The provider had a robust system in place to ensure that visitors and external staff entering the premises had their vaccination status and lateral flow tests (LFT) checked. The provider had additional spare LFTs available for those who were unable to obtain and complete a test prior to visiting (which would be required to be negative prior to entering the home). A separate outbuilding near to the entrance was used to check visitor temperatures, negative LFT results and vaccination status (if appropriate). In addition, face masks and alcohol gel were in plentiful supply and temperatures of anyone visiting were recorded by a staff member. The provider had a contact-free thermometer for such checks to be conducted.

The provider had implemented appropriate social distancing in all communal areas. For example, the dining area and living room had appropriately spaced chairs to ensure a distance of 1-2 metres between residents could be maintained.

The provider had an admissions process in place. The provider told us that new admissions were nursed in their room until a 14 day period had passed, and three negative LFTs had been obtained over consecutive days.

Our observations during the inspection confirmed staff were adhering to personal protective equipment (PPE) and social distancing guidance.

The provider had ensured staff who were more vulnerable to COVID-19 had been assessed and plans were in place to minimise the risk to their health and wellbeing.

This inspection took place on 20 and 21 April 2017, the first day was unannounced. At the last inspection in February 2015, the service was rated Good. At this inspection we found the service remained Good overall. The service demonstrated they continued to meet the regulations although we found improvements were needed in relation to meeting people’s social needs and choices. In the key question 'Is it responsive?' we have therefore rated the service 'requires improvement'.

Although there were organised social activities, these were not always arranged according to people’s preferences and individual needs. We have made a recommendation about improving the activities to provide more engagement and stimulation for people, particularly those living with dementia.

People using the service and their relatives told us they felt safe and well cared for. Staff knew how to recognise and report any concerns they had about the care and welfare of people and how to protect them from abuse and harm. Where risks were identified, there was guidance on the ways to keep people safe in their home and in the local community.

Warren Court continued to be safely maintained and people had the equipment they needed to meet their assessed needs.

Staff received an induction and relevant training to support people with their care needs. This was followed by ongoing refresher training to update and develop their knowledge and skills. Staff also undertook training courses specific to people’s needs such as dementia awareness. They were supported though an appraisal and supervision system to check they remained skilled in their roles.

There were positive and caring relationships between staff and people who lived in the home and this extended to relatives and other visitors. People who used the service and their guests were treated with respect and courtesy. Staff were caring, patient and maintained people’s privacy and dignity.

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

People received care and support which was based on individual assessments of their care needs and took into account each person's ability, need and preferences. People's wishes, choices and beliefs were reflected in their care plans. There was information about people’s social links and relationships with family and friends. Staff were responsive when people's support needs or circumstances changed and care records were updated appropriately.

People were encouraged and supported to eat and drink well. When people were at risk of poor nutrition or dehydration, staff involved other professionals such as the GP or dietician.

Medicines were managed safely and people received their medicines as prescribed. The service worked closely with external professionals to promote people's health and wellbeing and meet their needs. Appropriate referrals were made when people became unwell or required additional services.

People and their relatives felt involved in the way the home was run and were encouraged to express their views and opinions. They knew how to complain and make suggestions, and were confident their views would be acted upon.

The registered manager continued to provide effective leadership and staff felt supported. The provider had systems in place that continued to be effective in assessing and monitoring the quality of the service. Where improvements were needed or lessons learnt, action was taken.