Archived: Warwick Park Care Home

Updated 23 November 2023

The Inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by four inspectors and an Operational Performance Development manager.

Service and service type

Warwick Park Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and we looked at both during this inspection.

Registered manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We also reviewed information that we held about the service such as notifications. We used information sent to us by the provider in their PIR. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We used all of this information to plan our inspection.

During the inspection

We reviewed 10 people's care plans and risk assessments. We reviewed staff training and supervision. We also reviewed other records relating to the management of the service. We spoke with 4 people who lived at Warwick Park, 9 staff, the registered manager and two deputy managers. Following the inspection visit we spoke with the provider, the nominated individual and the local authority.

Updated 23 November 2023

About the service

Warwick Park Care Home is a residential care home providing personal care to up to 50 people with care and support needs. The service provides support to younger people, older people, people with a physical disability and people living with dementia. At the time of our inspection there were 40 people living at the service.

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

Risks were assessed and recorded. However, when changes in people’s needs occurred, or when guidance was provided from healthcare professionals, this did not always trigger a review of the risks.

Care plans did not always contain accurate and current guidance and direction for staff on how to meet people’s needs and was sometimes contradictory.

Some people had been assessed as being at risk of pressure damage to their skin. Pressure relieving mattresses had been provided. Some mattresses were not correctly set. There was no process in place to ensure mattresses were always set correctly for the people using them.

People received their oral medicines as prescribed. The service had recently moved to an electronic medicines management system. However, there were no protocols for medicines that were prescribed ‘when required’, or when people required their medicines to be given covertly or when people were self-administering their own prescribed medicines.

People had been prescribed creams and lotions. There were many gaps in these records. We were not able to evidence that people were having these applied as prescribed.

Care plans provided some guidance for staff on how to meet people’s needs. However, we found gaps in the records where care had not been recorded as required. We judged this was a recording issue and we found no impact on people as a result of this recording concern.

There was an audit programme in place to help identify any areas of the service that may require improvement. However, some audits were not effective as they were not accurate.

There had been a serious event which had taken place at the service prior to the current registered manager taking up their post. This event had not been notified to CQC as required.

We had received concerns from visiting healthcare professionals regarding the service being cold. They told us, “It is often cold in Warwick Park.” A new boiler had been installed a few weeks prior to this inspection. During the first few hours of our inspection the service was not warm throughout. Inspectors found that most of the radiators had been turned off. This was addressed by the registered manager.

There were malodours throughout the service. The carpets throughout the service were worn and marked. The passenger lift was out of use and had been for several months. A stair lift had been installed to ensure people were not impacted by this.

Some staff training needed updating and not all staff had received supervision since the registered manager took up their post in January 2023. However, registered manager and the nominated individual were working through a service improvement plan which was addressing this issue.

The recruitment processes were satisfactory. The service had sufficient numbers of staff to meet people’s needs.

The registered manager was supported by two deputy managers, the provider and the nominated individual. Regular meetings took place to review the actions in the service improvement plan and there was evidence of improvements being made.

There were effective safeguarding systems in place and staff knew what actions to take to help ensure people were protected from harm or abuse.

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; however, the policies and systems in the service did not support this practice as the records held by the registered manager for people, who required restrictions to be placed upon them, were inaccurate.

Staff worked within the principles of the MCA and sought people's consent before providing personal care and assistance. Staff were observed providing kind and caring support.

People, staff and relatives had recently been asked for their views and experiences by the manager and the provider. Responses had not yet been received. A residents meeting and a staff meeting had been held since the registered manager took up their post.

The registered manager understood their responsibilities under the duty of candour.

Staff had been trained in the effective use of Personal Protective Equipment (PPE). We observed some staff wearing PPE to help protect people from the risk of infections.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection:

The last rating for this service was good (6 October 2022).

Why we inspected

The Care Quality Commission (CQC) had received concerns in relation to people’s care needs not always being met and poor governance. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Warwick Park on our website at www.cqc.org.uk

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.

Enforcement

We have found breaches in relation to safe care and treatment, good governance and failure to notify CQC as required at this inspection.

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.