We carried out a review of the data available to us about Warnford Close on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Warnford Close, you can give feedback on this service.
A registered manager was in place. 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.
Warnford Close has 12 rooms and offers support for people from the age of 18 who need support with their mental well-being. There were 11 people living at the service, however one was in hospital and one was on home leave on the day of the inspection.
At our last inspection carried out on 26 August 2015, we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations. The concerns were: The registered person had not maintained an accurate, complete and contemporaneous record in respect of each service user, including a record of decisions taken in relation to the care and treatment provided. The registered person had not notified the Commission of incidents which had occurred.
The provider sent us an action plan in telling us they would be compliant with all the regulations by the end of November 2015.
At this inspection we found that the provider had made improvements and progress had been made since our last inspection. The provider was meeting the requirements of the regulations, in all areas.
People told us they were very happy with the care and support they received and if not they were happy to tell staff of any issues.
People were well supported and encouraged to make choices about what they ate and drank and could help themselves at any time.
The care staff we spoke with demonstrated a good knowledge of people’s care needs, significant people and events in their lives, and their daily routines and preferences. Staff also understood the provider’s safeguarding procedures and could explain how they would protect people if they had any concerns.
Staff told us they enjoyed working in the home and were a close, long standing group of staff.
Staff described management as supportive. Staff confirmed they were able to raise issues and make suggestions about the way the service was provided.
The service was safe and there were appropriate safeguards in place to help protect the people who lived there.
People were able to make choices about the way in which they were cared for and staff listened to them and knew their needs well. Staff had the training and support they needed.
There was evidence that people and staff had been involved in reviewing support plans.
Recruitment practices were safe and relevant checks had been completed before staff worked at the home.
People’s medicines were managed appropriately so they received them safely
The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Appropriate mental capacity assessments and best interest’s decisions had been undertaken by relevant professionals. This ensured that any decisions were made in accordance with the Mental Capacity Act, DoLS and associated Codes of Practice.
The service was also meeting the requirements of the Mental Health Act 1987 (2007) (MHA) as some people were being cared for under the MHA.
People accessed the local community on their own and they were free to come and go from Warnford Close with the caveat that they told staff when they were leaving and an expected time of return. They also participated in shopping for their own food needs.
There was a quality assurance system in place which meant that the service was able to monitor, review and adapt any area that needed improvement.
This inspection took place on 26 August 2015 and was unannounced.
Warnford Close is registered to provide accommodation and personal care services for up to 12 people who have mental health needs. At the time of our inspection there were 11 people living at the home. Some had lived at the home for a number of years. Others were in the process of making the transition to more independent living. They were accommodated in a purpose built house with single rooms. Toilet and bathroom facilities were shared and included a wet room on the ground floor. There were two lounges, one of which had recently been decorated, a shared kitchen and dining area, and a laundry room for people to use. There was an enclosed garden with a sheltered outside sitting area which was used by people who chose to smoke. People were encouraged and supported to clean their rooms and the shared areas of the home, and to do their own laundry.
There was a registered manager in place. 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.
Assessments, plans and risk assessment records for people’s care and support were not always accurate, complete and up to date. The service had arrangements in place to learn lessons from incidents and accidents, but notifications about relevant events were not always sent to the Care Quality Commission.
The service took steps to protect people from risks, including the risks of abuse and avoidable harm, while allowing them to make choices and exercise their independence. Staff were aware of what they needed to do to keep people and themselves safe. There were enough staff to support people safely and the provider’s recruitment process was designed to make sure staff were suitable to work in a care setting. Staff followed appropriate procedures to store, handle and administer people’s medication safely. Where people managed their own medication, staff prompted, reminded and checked them as appropriate.
Staff received training and support by means of supervision and appraisal meetings to maintain their skills and knowledge. People consented to their care and support. People were encouraged to choose and prepare their own meals and to maintain a healthy diet. The service supported people to maintain their health and wellbeing by access to other healthcare providers when they needed them.
There were positive, caring relationships between people and staff supporting them. People were able to express their views and take part in decisions about their care and support, and about the service in general. People’s privacy and dignity were respected.
People’s care and support reflected their needs, preferences and choices. Staff reviewed people’s care on a regular basis and supported people in a way which promoted their independence. Staff supported people to take part in activities in the community where they needed help. There was a complaints procedure in place, people were aware of it and had used it. Complaints were dealt with and followed up to people’s satisfaction.
The registered manager had systems in place to manage the service. There were regular checks to monitor and improve the quality of service provided, although these had not identified the areas for improvement we found. People had open and trusting relationships with the staff who supported them. There was a homely and professional atmosphere.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the Care Quality Commission (Registration) Regulations 2009. You can see the action we told the provider to take at the end of the full version of this report.
The provider was required to submit a plan detailing the action they were taking to ensure compliance with both of these standards and the date at which they would be compliant. The provider told us in their plan that they would be compliant with this standard by 31 December 2013.
At this inspection we found that the provider had taken appropriate measures to achieve compliance with this standard.
People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.
We spoke to four people who lived at the service. We also spoke to the two care staff on duty and to the registered manager.
Three of the four people we spoke to said they liked living at the home. Staff were said by people to be helpful and that they received the support they needed. Each person had a designated staff member (a keyworker) who took a lead role in making arrangements for care and support. One person said how helpful their keyworker was. One person said they did not like living at the home and wanted to live in more independent accommodation.
Each person we spoke to said they were consulted about the arrangements for their care and were involved in care reviews. People also said they attended regular house meetings where they were able to discuss issues about life at the home.
We saw records to show staff completed a number of training courses and had regular supervision.
We found people were supported to take their medicines and that there were different arrangements for each person so they could develop independence in this. Medicines records were not always accurate and we saw one person was not being supported as set in the person's care plan.
The home had a number of ways to monitor and check its own performance. These included surveys of service user's, service user's families and health and social care professional's views about the home.
At this inspection we identified that the registered persons had achieved compliance with the regulation that we inspected. The service maintained appropriate systems to control the spread of infection. However, checks on these systems had not been recorded as being carried out. The manager told us they would start to record these immediately.
People told us they liked living at the home. One person said, 'It's lovely. I like it. It's peaceful.' Another person said how helpful the staff were, saying they received help with everything they needed help with. People said they were supported to maintain and develop their independence.
We saw that each person's needs were assessed and there were comprehensive details about how each person was supported. People said they were consulted about their health and social care needs and had seen their own care plan.
Health and social care professionals told us the home generally provided a good standard of care and that the home worked in conjunction with other hospital and community mental health services.
The home provided at least two members of staff on duty between the hours of 9am and 9pm each day. People living at the service, staff, and health and social care professionals, commented that the home had sufficient staff to meet people's needs. Staff told us they had access to a range of training courses.
One person commented on some aspects of cleanliness such as urine on the floor of toilets. We found toilets and bathrooms were in need of cleaning.
People told us they felt safe in the home and said they would speak to staff or the manager if they had any concerns. People were confident that any concerns would be addressed.