Inspection on 31/10/05 for Anchor Lodge

This inspection was carried out on 31st October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Anchor Lodge 02/01/08

Anchor Lodge 31/01/07

Anchor Lodge 15/05/06

Anchor Lodge 06/03/06

Anchor Lodge 02/03/05

Anchor Lodge 28/09/04

Anchor Lodge 28/04/04

Anchor Lodge 12/01/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Anchor Lodge Cliff Parade Walton-on-Naze Essex CO14 8HB Lead Inspector Sara Naylor-Wild Unannounced Inspection 31st October 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Anchor Lodge DS0000036541.V262984.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Anchor Lodge DS0000036541.V262984.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Anchor Lodge Address Cliff Parade Walton-on-Naze Essex CO14 8HB Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01255 850710 01255 850710 www.anchor-lodge.co.uk Mr Farooq Mohammed Mrs Uzaira Farooq Care Home 14 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (2), Old age, not falling within any other of places category (14) Anchor Lodge DS0000036541.V262984.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Two persons, aged 65 years and over, who require care by reason of dementia, whose names were provided to the Commission in April 2005 Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 14 persons) One person, under the age of 65 years, who requires care by reason of Korsakoff Syndrome (dementia) whose name was provided to the Commission in March 2004 2nd March 2005 Date of last inspection Brief Description of the Service: Anchor Lodge is an established care home situated in a residential area of Walton on Naze. Local shops, post office, library, churches and leisure facilities are all found in the town. The detached property overlooks the seafront with views of the beach and the sea from the home. There is a front garden in which service users can sit. There is off road parking to the rear and side of the home. Accommodation is in twelve single rooms and one double room, over three floors. Access is via a staircase or passenger lift. In recent years alterations and additions have been made to the bedroom accommodation, all now having en suite facilities of wash hand basin and toilet. Communal areas are found on the ground and second floor and comprise of a lounge, sun lounge, dining room and a small first floor lounge with sea views. Anchor Lodge DS0000036541.V262984.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place in one day on 31st October 2005. The inspection took 3 hours in total and during this time the inspector undertook a tour of the premises, held discussions with service users and staff and read records such as care plans. In the absence of the registered person, the staff on duty at the time of the inspection did not have access to other records such as staff recruitment, training and supervision, financial records, etc. Therefore these standards were not assessed at this visit and will be addressed at subsequent inspections. What the service does well: What has improved since the last inspection? What they could do better: Overall the consistent management input is required to ensure that the development of all areas of the service is proactively followed on a daily basis. This includes ensuring that serious concerns raised about staff conduct are reacted to and taken up with the individual(s) and/or a Protection of Anchor Lodge DS0000036541.V262984.R01.S.doc Version 5.0 Page 6 Vulnerable Adults Procedure is set in motion. Also that the maintenance and upkeep of the home must be regularly attended to and any repairs made in a timely manner. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Anchor Lodge DS0000036541.V262984.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Anchor Lodge DS0000036541.V262984.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 6. The home carries out an assessment of prospective service users’ needs. The home does not provide intermediate care. EVIDENCE: The service users’ files sampled at the inspection contained assessments of need that included the items required by NMS and Regulation 5. However some assessments seen appeared to contradict information contained in other elements of the assessment format. For example a service user had three separated assessments of mental health and cognitive awareness ranging from early stages of dementia, to alert and aware. Anchor Lodge DS0000036541.V262984.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Care plans did not contain person centred information, but did refer to some identified needs. Health needs were recorded in daily records. Medication is administered according to the home’s policy and procedures. EVIDENCE: Care plans of three service users sampled demonstrated some efforts to set out the action required to meet identified needs. However these require concentrated development to address both the person centred plans for each individual and to ensure updated information given in daily records are recorded and actioned in care plans. At the previous inspection the proprietor had outlined the intention to introduce the Alzheimer’s Society person centred planning documents. Disappointingly this has not materialised and can only be assumed that this is attributed to the lack of consistent managerial time spent in the home. Anchor Lodge DS0000036541.V262984.R01.S.doc Version 5.0 Page 10 Daily records identify when service users’ health and wellbeing requires attention and the steps taken to address this through health professional support. However care plans were not updated regularly enough to establish changes in health care and how these affected the overall care required. Observations of the medication system and dispensing on the day of inspection supported the expectations of the NMS. Anchor Lodge DS0000036541.V262984.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. There is no provision for activities and individual preferences within the home. Family and friends are welcomed by the home as service users wish. There is limited evidence of how service users are supported in making choices. Service users are provided with varieties of meals. EVIDENCE: There was no evidence on the day of inspection of service users being engaged in any type of activity and staff interactions with them was limited to task orientated duties. The rota did not identify an activities coordinator’s role as outlined at the previous inspection and service users spoken with were unaware of any significant provision for activities. Family and friends of service users visit the home without any difficulty and staff were welcoming in their interaction with them. The meal provision was again considered at the inspection. The meals recorded as consumed did not match the planned menu, although there was a variety of Anchor Lodge DS0000036541.V262984.R01.S.doc Version 5.0 Page 12 meals provided. The cook explained that night staff did not always get the correct meat out of the freezer for the planned menu meal. Food stocks were sufficient and a reasonable mixture of quality. There were fresh stocks of fruit and vegetables. Anchor Lodge DS0000036541.V262984.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18. There was evidence to suggest the home does not adhere to the POVA guidance. EVIDENCE: Records held on the daily log appeared to indicate that a staff member had accepted gifts from service users in direct opposition to the home’s stated policy. The proprietor had left messages relating to the return of the items by the anonymous staff member and cited that further action would be taken if this was not done. Such an indirect means of dealing with the issue taken by the proprietor did not support the home’s stated procedure in relation to staff conduct or Protection of Vulnerable Adults. Anchor Lodge DS0000036541.V262984.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. There were issues with the maintenance of the building. EVIDENCE: During a tour of the premises the inspector noted some serious issues in relation to the fabric of the building. These included unstable flooring to the ground floor bathroom and toilet, and uncovered wires protruding from the wall on the first staircase. The most significant issue in relation to these items was the fact that there was awareness of the issue but no action taken to address these. Immediate Requirement Notices for both issues were left with the person in charge. The proprietor addressed this with information about what action had been taken to address the items in a timely fashion. However this should not have necessitated the attention of the Commission to prompt this action. Overall the refurbishment of the home seems not to have progressed and items remain unfinished in some rooms. Anchor Lodge DS0000036541.V262984.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 28. The home does not employ housekeeping staff, which continues to impact on the care levels provided. Staff files were not available for inspection. EVIDENCE: There has been an ongoing concern voiced by the Commission in relation to the staffing arrangements in the home. In particular the domestic duties included in care staff daily routine, and how this detracted from the staff interaction with service users outside of key care tasks. The proprietors have continuously stated that they did not believe the arrangement detracted from the care provision, and at the last inspection had sought to address issues such as activities through the appointment of an activities co-ordinator. During this inspection the staffing levels remained at two care staff and a cook for the am shift, and care staff duties continued to include housekeeping tasks. The staff on duty did not feel they were able to provide the level of care input required to ensure service users received anything but the basic attention to their care needs, due to non care elements of their job. The inspector noted that areas of the home did not appear to be of a high level of cleanliness. One service user’s room was very dusty and the carpet was dirty and stained. There were also soiled continence pads left around the room until late in the day. Anchor Lodge DS0000036541.V262984.R01.S.doc Version 5.0 Page 16 During the inspection day staff were not observed spending time with service users other than in direct care tasks. Anchor Lodge DS0000036541.V262984.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32 & 33. The home does not benefit from consistent levels of management and leadership. The atmosphere of the home was low in mood and negative in response to the care provided. The person in charge did not have access to any records other than care planning. EVIDENCE: There was a poor atmosphere on the day of inspection that was shared by staff and service users. Staff were disenchanted with the manner in which the home was managed and gave examples of issues including accessing minor equipment and working arrangements not supporting anything above basic provision. Service users spoken with did not feel the home had changed and Anchor Lodge DS0000036541.V262984.R01.S.doc Version 5.0 Page 18 that staff did not spend time with them, they were aware of the low morale amongst the staff team and in general were depressed about the home’s operation. Staff reported that they did not attend staff meetings and the minutes of meetings are not posted in the home. Anchor Lodge DS0000036541.V262984.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 2 2 x x x x x x 2 STAFFING Standard No Score 27 2 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 2 x x x x x Anchor Lodge DS0000036541.V262984.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation 4, 5 & 6 Requirement The registered person must ensure that the Statement of Purpose and Service Users Guide are representative of the actual service delivery and that these documents are kept under review and made available to service user. This standard was not assessed at this inspection and therefore is carried over to the next visit. 2 OP2 17(1)(a) Schedule 3 The registered person must ensure that each service user has a written contract/terms and conditions with the home. This standard was not assessed at this inspection and therefore is carried over to the next visit. 3 OP4 14 31/03/06 The registered person must ensure that they can demonstrate the home’s capacity to meet the assessed needs (including specialist needs) of individuals admitted to the home. This standard was not assessed at this inspection and therefore Anchor Lodge DS0000036541.V262984.R01.S.doc Version 5.0 Page 21 Timescale for action 31/03/06 31/03/06 is carried over to the next visit. 4 OP8OP7 15 The registered person must develop and review the service users’ plans of care, as detailed in National Minimum Standards for Care Homes for Older People This is a repeat requirement. 5 OP10 15 The registered person must ensure that service users’ rights to be treated with dignity and respect are upheld. Specifically that continence aids are appropriately managed. 31/03/06 31/03/06 6 OP12 16(n) 31/03/06 The registered person must ensure that service users’ expectations and preferences are noted and considered when planning leisure and social activities in the home. This is a repeat requirement. 31/03/06 7 OP14 12 The registered person must ensure that the home is conducted so as to maximise service users’ capacity to exercise autonomy and choice. This is a repeat requirement. 8 OP18 13(6) The registered person must ensure that reporting of abusive practice is responded to in accordance with the home’s POVA policy and the local POVA guidelines. The registered person must ensure that the home is maintained appropriately and protects service users’ safety. The registered person must ensure that facilities are suitable to meet the assessed needs of all service users, including communication and signage, DS0000036541.V262984.R01.S.doc 31/03/06 9 OP19 13(4)(a) 31/03/06 10 OP22 23 31/03/06 Anchor Lodge Version 5.0 Page 22 which assists service users with dementia. This is a repeat requirement. 11 OP25 23,13 The registered person must ensure that pipework and radiators are guarded or have guaranteed low temperature surfaces. This standard was not assessed at this inspection and therefore is carried over to the next visit. 12 OP26 16(j) The registered person must ensure that satisfactory standards of cleanliness and hygiene are maintained in the home. The registered person must ensure that the number and skill mix of staff meets service users’ needs. This is a repeat requirement. 14 OP30 18,19 The registered person must ensure that there is a staff training and development programme, which meets the National Training Organisation (NTO) workforce training targets and ensures staff fulfil the aims and objectives of the home and meet the changing needs of service users, with particular regard to meeting the needs of service users with dementia. This standard was not assessed at this inspection and therefore is carried forward to the next visit. 15 OP31OP32 8,9 The registered person must ensure that the home has a registered manager who is qualified, competent and experienced to run a home. DS0000036541.V262984.R01.S.doc 31/03/06 31/03/06 13 OP27 18 31/03/06 31/03/06 31/03/06 Anchor Lodge Version 5.0 Page 23 This is a repeat requirement. 16 OP33 24 31/03/06 The registered person must consider the introduction of quality assurance and monitoring systems to ensure the home is running in the best interests of the service users. This standard was not assessed at this inspection and therefore is carried over to the next visit. 1 OP34 7 The registered person must provide a business and financial plan for the establishment, open to inspection and reviewed annually. This is a repeat requirement. 16 OP36 18 The registered person must ensure staff receive appropriate induction, supervision and training. This standard was not assessed at this inspection and therefore is carried over to the next visit. 17 OP37 17 The registered person must revise and update records as detailed in Care Homes Regulations, Regulation 17 and Schedule 4. This standard was not assessed at this inspection and therefore is carried over to the next visit. 18 OP38 12,13 The registered person must ensure so far as is reasonably practicable the health, safety and welfare of service users and staff. This standard was not assessed at this inspection and therefore is carried over to the next visit. 31/03/06 31/03/06 31/03/06 31/03/06 Anchor Lodge DS0000036541.V262984.R01.S.doc Version 5.0 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP16 Good Practice Recommendations The registered person should ensure that a complaints log is maintained of all complaints received by the home, including informal complaints. This standard was not assessed at this inspection and therefore is carried over to the next visit. The registered person should maintain a record of service users’ choices to exercise their right to participate in the civic process and how this is supported. This standard was not assessed at this inspection and therefore is carried over to the next visit. The registered person should consider whether the dining room facilities are suitable for the purpose of achieving the aims and objectives set out in the Statement of Purpose and the needs of service users. This standard was not assessed at this inspection and therefore is carried over to the next visit. 2 OP17 3 OP20 Anchor Lodge DS0000036541.V262984.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Anchor Lodge DS0000036541.V262984.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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