Inspection on 06/07/05 for Anchorage House

This inspection was carried out on 6th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Anchorage House 30/06/08

Anchorage House 07/06/06

Anchorage House 05/09/05

Anchorage House 28/10/04

Anchorage House 01/06/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

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33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Anchorage House 12 Margaret Street Folkestone Kent CT20 1LJ Lead Inspector Wendy Mills Announced 6 July 2005 9:30 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Anchorage House H56-H05 S28362 Anchorage House V228049 060705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Anchorage House Address 12 Margaret Street, Folkestone, Kent, CT20 1LJ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01303 211180 Mrs Tina Dennison Care Home only 5 Category(ies) of Learning Disability x 5 registration, with number of places Anchorage House H56-H05 S28362 Anchorage House V228049 060705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Anchorage house is a small home for up to five adults with learning disabilities. It is situated in a residential area of Folkestone and is close to the harbour and all local amenities. The building is an end of terrace large Victorian house which offers single accommodation for each service user. The communal space comprises of a large lounge, smaller dining room, kitchen and conservatory. There is a small, safe and enclosed garden at the rear of the property. There have been some recent changes in the home to provide better officed accommodation and a grounf-floor, sleep-in room. The service users participate in a wide range of educational and leisure activities for which the Home provides transport. the home is owned by Mrs Tina Dennison. Mrs Denison also owns and manages a sister home close by. Anchorage House H56-H05 S28362 Anchorage House V228049 060705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was conducted by Wendy Mills, regulatory inspector for the home and Julian Graham, regulatory inspector for Harbour House, the sister home of Anchorage House. Harbour House is very close by and both homes were jointly inspected. The inspection began at 09.30 hours and consisted of discussion with the registered manager/provider; a tour of the home; in-depth interviews with staff that were conducted in private, and interviews, in private, with all of the residents. Key documentation, such as care plans, risk assessments, staff rotas, staff files and activity schedules, was inspected. Both direct and indirect observations were made throughout the inspection. The residents, staff and the registered manager are thanked for the welcome they gave the inspectors and for the assistance they gave during the inspection. Over the past year, three of the residents from Anchorage House have moved to Harbour House and a new resident has moved into Anchorage House. At present there are only three residents at Anchorage House. All the residents were in good health and spirits on the day of inspection. They continue to lead very full and active lives. What the service does well: The home helps the residents to maximise their independence in a supportive and proactive way. The residents make very good use of local amenities and facilities. They participate well in local community activities and help their neighbours. There is a very relaxed, welcoming and friendly atmosphere in the home. The residents participate well in the running of the home and lead busy and active lives. The home liaises well with health care professionals, care managers and specialists to ensure the health of the residents is maintained and promoted. The home has a positive and proactive approach to staff training. Anchorage House H56-H05 S28362 Anchorage House V228049 060705 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: 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. Anchorage House H56-H05 S28362 Anchorage House V228049 060705 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Anchorage House H56-H05 S28362 Anchorage House V228049 060705 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,&4 Prospective residents and current residents and their relatives and supporters are clear about what to expect from the home. Residents understand their rights and responsibilities whilst living at the home. EVIDENCE: The home has a statement of purpose, a service user guide and written assessment and admissions policies and procedures. Previous inspections have confirmed that these are sound and give appropriate information to the residents and their relatives and supporters. Responses to the relatives questionnaires were all positive. They indicated that they understand what they can expect from the home. The residents told the inspector that they invite prospective residents to visit and have a meal with them at the home. They said that they can always talk to Tina or any of the staff about any concerns they may have. Anchorage House H56-H05 S28362 Anchorage House V228049 060705 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) There is a clear care planning system in place however, some more detail is required to identify specific needs. Residents are supported to make decisions and to participate in the life of the home. EVIDENCE: Care plans were examined. They were found to contain good information about the care the residents require, however, some risk assessments were missing. All care plans need to reflect more clearly all the assessed needs of the residents and to detail how best these can be managed. The residents said that they enjoy living in the home and can talk easily to the manager and staff. They are supported to take part in household chores such as cleaning their rooms and washing up. Some were more enthusiastic than others about helping with housework. There are regular house meetings and the residents can air their views at these meetings. However, the residents were seen to be very confident and happy to air their views at any time. Anchorage House H56-H05 S28362 Anchorage House V228049 060705 Stage 4.doc Version 1.30 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12,13,14,15 16&17 The home supports the residents to maximise their independence and achieve their goals The residents lead busy and fulfilling lives and participate well in their local community. The home supports links with familiy and friends very well. It should, however, be more diligent about recording the way in which it supports the residents to meet some of their more specific needs, such as sex education. The way the home manages nutrition is good and residents are actively involved in the planning and preparation of meals. EVIDENCE: Inspection of the activities schedules and conversation with both staff and residents confirmed that they attend colleges, work placements and participate in a wide variety of leisure activities both during the day and in the evenings. The residents said that they can choose which activities they want to do. The registered manager said that she is always looking for new activities to offer Anchorage House H56-H05 S28362 Anchorage House V228049 060705 Stage 4.doc Version 1.30 Page 11 the residents. Their goals are recorded in the care plans and risk assessments are in place for most activities. The residents were happy to talk about their familiy and friends and showed the inspectors their family photographs. The home makes all visitors very welcome. The staff advocate positively on behalf of the residents in order to help them maintain positive friendships outside the home. Transport is provided for activities and home visits but independent use of public transport is also encouraged. The home positively supports appropriate sexual relationships. However, risk assessments and the necessary education and support in respect of sexual needs should be more clearly recorded in the care plans. The residents are supported to participate in the planning, shopping for, and preparation of meals. They said that they can choose what they like to eat and that they enjoys meals out and visits to the local pub. Anchorage House H56-H05 S28362 Anchorage House V228049 060705 Stage 4.doc Version 1.30 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19&20 The residents receive sensitive personal support and their healthcare is promoted. Medication policies are sound but the home’s procedures in respect of medication would benefit from review. EVIDENCE: It is evident that staff strive to ensure that personal support and prompting to encourage independence in personal care is given in a sensitive way. Medication policies are sound and medication practices at this home were not inspected at this visit. However, inspection at the sister home revealed some concerns about the way in which hand written entries are made on the MAR sheets, the storage of internal and external medicines in the same place and inadequate assessment of staff competence to administer medicines. Although the registered manger said that procedures are different in Anchorage house, these procedures require review and updating to ensure that they are common to both homes. This is particularly important and several staff work in both homes and different procedures could prove very confusing. Anchorage House H56-H05 S28362 Anchorage House V228049 060705 Stage 4.doc Version 1.30 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22&23 The home deals with complaints in a satisfactory way. Staff have a good understanding about Adult Protection issues and know how to protect the residents from all forms of abuse. However, some of the home’s policies and procedures are not sufficiently robust or clear to protect the residents. EVIDENCE: The residents said that they can talk easily, and at any time, to the manager or other staff if they have any concerns. Conversation with staff confirmed that they are very aware of the varying needs of the residents and they will complain on their behalf if necessary. Responses to the relatives’ questionnaires all indicated that they know how to complain if necessary. However, additional comments stated that they were pleased with the care their relative is receiving and that they have not had cause to complain. Although risk assessments are contained in the care plans, some activities involving risk for example, visits to the bank by individual residents, do not have written procedures of risk assessments. The home must review the care plans to ensure that all activities involving risk, and particularly those where there is potential for abuse, are risk assessed and clear procedures put in place. Unfortunately, a theft by a member of staff at the home revealed a flaw in the way the home was supporting the residents to manage their money. This resulted in an Adult Protection Alert. The home acted immediately to reimburse those who had suffered loss and to change policies and procedures to ensure further safeguards are in place. Anchorage House H56-H05 S28362 Anchorage House V228049 060705 Stage 4.doc Version 1.30 Page 14 Conversation with staff showed that they have a very good understanding of adult protection issues but were less clear about when they could guarantee a resident confidentiality and when they would have to pass on information to appropriate authorities even if a resident or a colleague had asked them not to. Anchorage House H56-H05 S28362 Anchorage House V228049 060705 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28&30 The standard of the environment within the home is good and provides the residents with a homely and welcoming place in which to live. There is plenty of communual space and toilet and bathing facilities. Investment has recently been made to make further improvements to the home. EVIDENCE: There is a spacious lounge and smaller dining room. Both have been recently re-decorated. The home has two bathrooms and four toilets. Work is currently underway to provide a larger office and downstairs sleep-in room. The residents were very confident in their conversations with the inspectors.. There is a pleasant and friendly ambience in the home and the residents said they can choose what to do with the time they spend in the home. They gave the inspectors permission to see their rooms. All the rooms were clean and comfortable. Each room has been personalised and reflects the interests, family and personality of each resident. They all said that they like their rooms and have all their personal things around them. Anchorage House H56-H05 S28362 Anchorage House V228049 060705 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35&36 The residents benefit from a settled staff team who are well trained and supported. However, care staff and team leaders require more frequent oneto-one formal supervision. Staffing levels are satisfactory, although rotas do not always reflect who is on duty and in which of the two homes. Recruitment practices are sound. EVIDENCE: There are generally two staff on duty when all residents are at home. These numbers are sufficient to enable residents to go out and to undertake activities they want to do. Staffing rotas, however, must always reflect which staff are on duty in the home, including when the manager works a shift. Two staff were interviewed in private and demonstrated very good awareness of their role and responsibility. They presented as kindly people who are working hard to support the residents in being as independent as they can be and to enable them to lead interesting lives. Staff turnover is low, which provides consistency and continuity of care, which is of benefit to the residents. Including the manager, seven of the thirteen staff employed have a NVQ which is Anchorage House H56-H05 S28362 Anchorage House V228049 060705 Stage 4.doc Version 1.30 Page 17 commended. Staff also have regular access to other training which enables them to gain new skills and understanding to help them work more effectively with the residents. Both staff members who were interviewed, for example, said they understand the behaviours of one of the residents much better since attending a course on autism. Whilst some one-to-one formal supervision is being undertaken with staff, this should be more consistent. The team leaders for each of the homes, both of whom are new to the role, need more input, training and assistance from the manager. This will enable them to carry out their responsibilities with greater confidence and effect, for example, in the developing of detailed care plans, keeping accurate financial records of residents’ monies. A sample of staff files were examined which revealed sound recruitment practice. The manager is reminded that CRB checks are not transferable unless within companies. Anchorage House H56-H05 S28362 Anchorage House V228049 060705 Stage 4.doc Version 1.30 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,40,41&42 The management of the home is mostly satisfactory. There is an open management culture and the independence, health, safety and welfare of the residents is promoted. However, more attention is needed to ensure key documentation is kept up to standard and that CSCI requirements are met. EVIDENCE: The manager for the home has maintained her continuing professional development. She attends training sessions with staff and actively seeks out new opportunities both on behalf of the residents and for staff training. She has an open and honest management style and the residents are clear confident in talking to her about anything that might worry them. Staff say that they are very happy working in the home and believe that the residents have a very good quality of life. Inspection of documentation showed that there are still some procedures that require review and some activities that require risk assessments. No health and safety hazards were noted on the day of inspection. Anchorage House H56-H05 S28362 Anchorage House V228049 060705 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Anchorage House Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 x H56-H05 S28362 Anchorage House V228049 060705 Stage 4.doc Version 1.30 Page 20 no Are there any outstanding requirements from the last inspection? 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. 2. 3. Standard 6 9 20 Regulation 15 15 13 Requirement care plans to be reviewed and to reflect all assessed needs Risk assessments to be reviewed and to include all activities and behaviours that involve risks a review of medication procedures, including storage to be undertaken at same time as the requirements are met fro thie standard at the sister home, Harbour House. auditable financial records to bemaintained with regards to residents monies Adult abuse policy to ibe clear about when information given in confidence should be shared Staff rotas to accurately reflect staff on duty at any given time staff to receive formal supervision at least six times each year Timescale for action 06/09/05 06/09/05 06.08/05 4. 5. 6. 7. 23 23 33 36 17 Schedule 4.7 13 17 Schedule 4.9 18 06/08/05 06/08/05 06/07/05 06/09/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Anchorage House H56-H05 S28362 Anchorage House V228049 060705 Stage 4.doc Version 1.30 Page 21 No. 1. Refer to Standard Good Practice Recommendations Anchorage House H56-H05 S28362 Anchorage House V228049 060705 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford, Kent TN23 1HU 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 Anchorage House H56-H05 S28362 Anchorage House V228049 060705 Stage 4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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