The Warren

Updated 24 August 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 18 June 2018 and was unannounced. The inspection was carried out by two inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before our inspection we reviewed the information we held about the service. We reviewed notifications the registered provider had sent us. A notification is important information about particular events that occur at the service that the provider is required by law to tell us about.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During our inspection we spoke with eight people who lived at the service, one relative, the operations manager, the deputy manager, the operational director, the daily activities coordinator, a kitchen assistant and hostess, the head housekeeper, one care assistant and two senior care assistants.

We looked at the care records for four people and records that related to health and safety and quality monitoring. We looked at medication administration records (MARs). We observed how people were cared for in the communal areas.

Updated 24 August 2018

The Warren is a ‘care home’. People in care homes receive accommodation and personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The Warren is registered to provide personal care and accommodation for up to 44 people. At the time of the inspection there 42 people living in the home. The home is purpose built and accommodation is on one floor. Communal areas include a number of lounges, a dining room, a conservatory and a hairdressing salon.

This unannounced inspection was carried out on 18 June 2018.

At the time of the inspection there was not a registered manager in place. However, a new manager had been appointed and planned to apply to become registered with the Commission when they commenced working in the home. 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.

At the last inspection in February 2017 the service was rated requires improvement. We asked the provider to make improvements to reducing risks to people, safe administration of medicines, ensuring people receive the support they required in a timely manner. We also asked them to ensure that there was effective monitoring of the quality of the service being provided.

At this inspection we found the provider had made the required improvements and the service is now rated as Good.

Staff were aware of how to keep people safe from harm and what procedures they should follow to report any harm. Action had been taken to minimise the risks to people. Risk assessments identified hazards and provided staff with the information they needed to reduce risks where possible.

Medicines were managed safely. Staff received training and competency checks before administering medicines unsupervised. Medicines were stored securely. The records were an accurate reflection of medicines people had received.

Care plans gave staff the information they required to meet people’s basic care and support needs. People received support in the way that they preferred and met their individual needs.

There was an effective quality assurance process in place which included obtaining the views of people that lived in the home, their relatives and the staff. Where needed action had been taken to make improvements to the service being offered.

Staff were only employed after they had completed a thorough recruitment procedure. Staff received the training they required to meet people's needs and were supported in their roles.

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 service supported this practice and worked within the guidance of the Mental Capacity Act 2005.

Staff were motivated to provide care that was kind and compassionate. They knew people well and were aware of their history, preferences, likes and dislikes. People's privacy and dignity were respected.

People were supported to maintain good health as staff had the knowledge and skills to support them. There was prompt access to external healthcare professionals when needed.

People were provided with a choice of food and drink that they enjoyed. When needed staff supported people to eat and drink.

There was a varied programme of activities including activities held in the service, trips out and entertainers that came into the home.

There was a complaints procedure in place. People and their relatives felt confident to raise any concerns either with the staff or manager.