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Inspection carried out on 26 September 2017

During a routine inspection

This inspection took place on 26 September 2017 and was unannounced.

Warwick House was last inspected in August 2015 and was rated Good. At this inspection, the service remained Good.

The provider is registered to provide accommodation in the service for up to 22 older people and 5 people with a learning disability.

The service is divided into two units. Warwick House offers short term care for older adults whilst Bonsall View offers short term care for younger people with profound multiple complex learning disabilities and autism.

The part of the home used to provide care for older people was not being used at the time of our inspection. The part of the home used to provide respite care for people with a learning disability, Bonsall View, was being used at the time of our inspection. There were three people using this service at the time of our inspection.

A registered manager was in post and was available throughout the inspection. 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.

Staff knew how to keep people safe and understood their duty to protect people from the risk of abuse. Risks were managed so that people were protected from avoidable harm.

Sufficient staff were on duty to meet people’s needs and staff were recruited through safe recruitment practices. Medicines were managed safely.

Staff received induction, supervision and appraisal. Training figures could be improved, though staff felt that they received sufficient training and plans were in place to address this issue. Capacity issues were being considered by staff and further work was being completed in this area, specifically, around Deprivation of Liberty Safeguards (DoLS) in conjunction with advice provided by the local authority.

People received sufficient to eat and drink and external professionals were involved in people’s care as appropriate.

Staff were kind and knew people well. People and their relatives were involved in decisions about their care. Advocacy information was available.

People received care that respected their privacy and dignity and promoted their independence.

People received personalised care that was responsive to their needs. Care records contained sufficient information to support staff to meet people’s individual needs. A complaints process was in place and staff knew how to respond to complaints.

People and their relatives were involved or had opportunities to be involved in the development of the service. Staff told us they would be confident raising concerns with the management team and that appropriate action would be taken.

The registered manager and provider were meeting their regulatory responsibilities. There were effective systems in place to monitor and improve the quality of the service provided.

Inspection carried out on 4 August 2015

During a routine inspection

This inspection took place on 4 August 2015 and was unannounced.

Warwick House is registered to provide residential care and support for 22 older people and five people with a learning disability.

The service is divided into two – Warwick House offers short term care for older adults whilst Bonsall View offers short term care for younger people with profound multiple complex learning disabilities and autism. At the time of our visit there were 11 people using the service at Warwick House and one person using the service at Bonsall View, with two more expected that day.

Warwick House has 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 registered manager is based primarily in Warwick House whilst the assistant manager is based at Bonsall View, however they share information and work closely as a management team.

We saw that people using the service felt safe. Staff had a good awareness of abuse and were confident about what action they would take if they had any concerns, this would include reporting concerns to the registered manager. Staff had received training which reflected the needs of the people who used the service and enabled them to provide support in a safe manner. We saw there were sufficient staff to support people’s individual needs.

We saw people using the service were well cared for. People who used the service complimented the staff who supported them.

We saw that people received their medication in a timely and safe manner, administered by staff who were trained in the administration of medication. We saw risk assessments in place in people’s plans of care to promote their safety.

Care records were personalised and accurately reflected peoples care and support needs, the care plans included information about people’s life histories, interests and likes and dislikes which provided staff with sufficient information to enable them to provide care effectively.

People’s health and welfare was promoted and they were referred to relevant health professionals in a timely manner to meet their health needs.

The service had an atmosphere which was warm, friendly and supportive, we saw staff engaged with people who used the service and staff also encouraged people to participate in activities and entertainment.

Audits and checks were effectively used to ensure peoples safety and the building and equipment were well maintained .

The registered manager ensured the service was involved with the local community.

The provider and the management team provided effective leadership to the service and sought regular feedback from people using the service. They encouraged staff and visitors to attend meetings to share their views in order for the managers and provider to review and develop the service.

Inspection carried out on 10 April 2014

During a routine inspection

Is the service safe?

On arrival we saw extensive building work was taking place externally and the bedrooms were being decorated. However, this was being well managed to ensure that people were cared for in a clean, hygienic and safe environment.

People who used the service were protected from the risk of abuse, because appropriate risk assessments were in place that raised staff awareness each time they completed a minor injuries or body mapping form.

We saw people were supported to receive their medicines safely and in the way they preferred.

Is the service caring?

We looked at four people’s care records and spoke with five staff including two managers. We spoke with one person and observed people at the home as they continued with their daily activities.

We observed people's routines at different times of the day. We saw they were given choices with their meals and took part in the activities provided. On the younger adults respite unit they were out for the day taking part in activities. At Warwick House for older people we spoke with one person and observed the care of another person who could not make a choice due to their condition. We saw staff sat with them, spoke with them and made them feel comfortable during their day.

Is the service responsive?

There was an effective complaints system available. We saw comments and complaints people made were responded to appropriately.

Is it effective?

We saw that effective recruitment processes were in place to ensure people received care from staff who were safe to be with them and received sufficient training to meet their needs. We saw risks were managed through effective consent procedures.

Is the service well led?

We saw the provider made regular health and safety checks including fire safety, hoist checks and electrical safety checks as examples to ensure they provided a safe environment for people to use. The manager was in daily charge of both services supported by a full complement of staff.

Inspection carried out on 20 August 2013

During a routine inspection

At the time of this inspection visit there were 16 people using the older persons unit and four people were using the younger adults unit. We spoke with three people at the service, two staff, one visiting health professional and two visitors. We carried out telephone interviews with one family member and two staff following the inspection visit.

We were unable to communicate with the people using the younger adults respite care service, due to their limited verbal communication. We observed people being supported by staff in a caring manner.

People using the older person’s service told us they were happy with the care they received from the staff team. Comments included “the staff are wonderful, which makes me feel safe here,” “I am happy at Warwick House, the staff understand your needs” and “I have no concerns, the staff are very good.”

Family members we spoke with were complimentary about the service provided and the staff.

Risk assessments were not robust, measures were not always fully in place to minimise identified risks and keep people safe.

The provider did not have effective procedures in place to manage medicines safely, which did not ensure people received medicines in a safe way.

Staff worked well together as a team, and felt supported by the management team.

Inspection carried out on 31 October 2012

During a routine inspection

We spoke with four people using the service about their care and support. Comments about the care provided included, "I like it here, and it is a good home,” “I get all the support I need” and “my confidence has increased due to the support provided by staff I can now do something’s for myself.”

People we spoke with told us they liked the staff working in the service. One person said “I like them, they are good to us." They also told us that they felt staff respected their privacy and dignity.

People told us knew what to do if they had any concerns. Comments included “the manager would sort things out," I have had no reason to complain” and “I am confident the manager would listen and deal with any concerns.”

People told us they enjoyed the meals. They told us that the food was “very good,” “We always get a choice and if you don’t want what’s on the menu, you are given an alternative” and “there is always a choice at meal times, we are given refreshments through the day.”

A relative told us that staff were very good and always kept them informed with any changes in their relative’s care needs. They also told us that staff will contact the GP if their relative was unwell. People using the service also confirmed this one person told us “if I am not well, staff will contact the GP.”

Staff spoken with told us they felt supported by the manager, and have regular training opportunities.

Reports under our old system of regulation (including those from before CQC was created)