CARE HOMES FOR OLDER PEOPLE
Anchorage Nursing Home 17 Queens Road Hoylake Wirral CH47 2AQ Lead Inspector
Mrs Christine Marshall Announced Inspection 18th March 2006 13:00 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 Anchorage Nursing Home DS0000065659.V284310.R01.S.doc Version 5.1 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. Anchorage Nursing Home DS0000065659.V284310.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Anchorage Nursing Home Address 17 Queens Road Hoylake Wirral CH47 2AQ 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) 0151 638 4391 Rolfields Limited Helen Radcliffe Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Anchorage Nursing Home DS0000065659.V284310.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 29th November 2004 Brief Description of the Service: The Anchorage Nursing Home is a three storey building situated in Hoylake. The home is registered to provide nursing care for up to thirty-five service users over the age of 65 years of age. There are bedrooms on all three floors. There are two dining rooms, lounge and conservatory situated on the ground floor, as is the kitchen and laundry room. There is a passenger lift to all floors and a stair/chair lift from ground to first floor. There are two care parks, providing ample space for visitors. Rolfields Ltd owns the home and the registered manager is Helen Radcliffe. Anchorage Nursing Home DS0000065659.V284310.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This is the second of two inspection visits, scheduled from 1st April 2005 to 31st March 2006. The people living at The Anchorage will be referred to as residents. This announced inspection took place during the afternoon. A full tour of the home was undertaken, including bedrooms, lounge and dining areas and bathrooms. All areas were clean and hygienic. Staff recruitment, training and supervision files were looked at and comments in respect of these are to be found in the body of this report. A large number of the residents were spoken to. Each resident appeared to be well cared for and said that hey were happy with the care at the home. Visiting relatives readily praised the home and the staff for their care. The owners, nurses and care staff spoke with the inspector and showed that there is a very good team approach to the care given to the residents. What the service does well:
The Anchorage provides a homely environment for the people who live there. There is a friendly atmosphere within the home. There is good communal space with lounges, dining areas and a conservatory. The fabric and furnishings of the home are of a good standard and the home is kept clean and hygienic. Daily routines for the people living Anchorage are flexible residents said that they were happy and content. Anchorage Nursing Home DS0000065659.V284310.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better:
The new owners and manager have worked very hard to refurbish the home’s environment and a programme for this is underway; some corridor areas remain in need of decoration and re-carpeting. One bathroom remains in need of new panelling to make sure that it is safe to be used. A recognised quality system would improve the monitoring of the home and the care that is given; the provider is currently seeking assessment for this. The medication room temperature should be recorded daily to make sure that medications, creams and lotions are stored at the right temperature. Anchorage Nursing Home DS0000065659.V284310.R01.S.doc Version 5.1 Page 7 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 Nursing Home DS0000065659.V284310.R01.S.doc Version 5.1 Page 8 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 Anchorage Nursing Home DS0000065659.V284310.R01.S.doc Version 5.1 Page 9 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 Pre-admission assessments are done before any resident moves into the home, making sure that all the relevant information is gained so that the right care can be provided. EVIDENCE: Individual personal assessments are done before any person is admitted to the home, so that a clear picture of the care that is needed by each individual is prepared. Four residents’ files were looked at and each contained a pre-admission assessment. These included physical, mental, social and nursing assessments of care; each was completed in a satisfactory way. The residents were able to confirm that they had been assessed before going to live at the home. Anchorage Nursing Home DS0000065659.V284310.R01.S.doc Version 5.1 Page 10 Anchorage Nursing Home DS0000065659.V284310.R01.S.doc Version 5.1 Page 11 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 Residents’ health care needs are fully supported and their wellbeing is protected by safe medication systems. EVIDENCE: Care plans are written records of the care that are given to each person that lives at the home and two care plans were looked at; each of these was satisfactory. A number of residents and their relatives said that they knew about their care plans and that they were happy with these. Residents said that they had the GP of their choice and that they had regular visits to the chiropodist, dentist, optician and also hearing aid services. Medication systems are safe and monitored by the manager. It was recommended that the medication room have the temperature recorded daily to make sure that all medicines, creams and lotions are stored at the right temperature.
Anchorage Nursing Home DS0000065659.V284310.R01.S.doc Version 5.1 Page 12 There were two oxygen cylinders in the medication room that need to be chained to the wall for safe storage. The manager is attending to this as a matter priority. The manager said that the residents are now offered a lock for their bedroom doors and any new resident to the home will have a lock fitted prior to taking up the accommodation. This will make sure that residents have privacy in their bedrooms. Anchorage Nursing Home DS0000065659.V284310.R01.S.doc Version 5.1 Page 13 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): 15 Residents are given wholesome and nourishing food, with plenty of choice. Mealtimes are flexible if needed and drinks and snacks are available 24 hours a day. EVIDENCE: There are varied menus for the residents, who all said that they liked the food. There is a full choice of breakfast, a set lunchtime meal, with options if needed, a set teatime meal, again with options and suppers are served from about 8pm ton9pm. The records of the meals given to the residents are being reviewed to make sure that each resident has a record of what they have eaten. The teatime meal looked appetising and nourishing and discussions with the chef confirmed that the residents’ preferences and special diets are catered for. Anchorage Nursing Home DS0000065659.V284310.R01.S.doc Version 5.1 Page 14 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): 16 Residents and their relatives are able to voice their complaints and know who to speak to if they have any concerns. EVIDENCE: There is a written complaints procedure in place and a copy of this is displayed in the entrance of the home. There have been no complaints either to the manager of the home or to the Commission for Social Care Inspection. Residents and their relatives said that they had no complaints whatsoever. Anchorage Nursing Home DS0000065659.V284310.R01.S.doc Version 5.1 Page 15 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): 21 & 26 The home offers a comfortable environment in that it is kept clean and hygienic. EVIDENCE: Standard 21 was assessed on the previous inspection visit when three bathrooms were found to be in need of repair to the bath panels and pipes. Two of the bathrooms have been fitted with new panels and the pipes have been boxed in; however the ground floor bathroom still needs to be fitted with new bath panels. The manager said that this was being attended to within the next two weeks or so. The laundry area is lean and contains new laundry equipment that has sluicing programmes for soiled items. The entrance to the laundry area remains in need of new flooring/carpeting. Anchorage Nursing Home DS0000065659.V284310.R01.S.doc Version 5.1 Page 16 There are policies and procedures for the Control of Substances Hazardous to Health (COSHH) guidelines for the safe use of laundry solutions and substances. All areas of the home are kept clean and hygienic. The residents who were able and visiting relatives said that they were happy the laundry, and with the standard of cleanliness at the home. Anchorage Nursing Home DS0000065659.V284310.R01.S.doc Version 5.1 Page 17 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): 29 & 30 Staff have the appropriate training, qualifications and experience necessary to give a good care service to the residents. Robust employment checks make sure that residents’ are in safe hands. EVIDENCE: Inspection of the staff recruitment files showed that the staff who have been recruited by the new owners and who are working at the home have the required pre-employment checks. The manager is currently going through all of the files of that staff who were employed by the previous owner, to make sure that they contain all of the records that are required under Schedule 2 of the Care Homes Regulations. Staff training is in progress and most of the staff have undertaken mandatory courses in moving and handling, health and safety, fire and abuse awareness. Those who have not yet completed the training programme are scheduled to complete within three months. Anchorage Nursing Home DS0000065659.V284310.R01.S.doc Version 5.1 Page 18 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): 33 & 35 The home is going to make sure that the best interests of the residents are protected in that a quality monitoring system is being sought; financial records are designed to protect the residents’ interests. EVIDENCE: The home does hold some personal monies for residents. These were checked and found to be accurately recorded. Residents were able to confirm that they, or their relatives looked after their money. The owners are currently in the process of being assessed for the British Standards Institute (BSI) quality mark. This will make sure that residents, relatives, staff and visiting professional are surveyed on a regular basis and the outcomes of these surveys will be fed back to those taking part.
Anchorage Nursing Home DS0000065659.V284310.R01.S.doc Version 5.1 Page 19 Anchorage Nursing Home DS0000065659.V284310.R01.S.doc Version 5.1 Page 20 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 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X X 2 X X X X 3 STAFFING Standard No Score 27 X 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 X X X Anchorage Nursing Home DS0000065659.V284310.R01.S.doc Version 5.1 Page 21 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. Standard OP29 Regulation 19 Requirement All staff files must contain the required records according to Schedule 2 of the care Homes regulations. All staff must have undertaken the mandatory training programmes. A quality monitoring system must be developed. Timescale for action 01/05/06 1 2 OP30 OP33 18 24 01/07/06 01/06/06 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. 2. 3. Refer to Standard OP9 OP15 OP19 Good Practice Recommendations Oxygen cylinders should be chained to the wall for safe storage. Records of the food that is served to the residents should be reviewed. Some of the corridors remain in need of redecorating and carpeting. Anchorage Nursing Home DS0000065659.V284310.R01.S.doc Version 5.1 Page 22 4 OP21 The ground floor bathroom should have the bath panel fitted properly. Anchorage Nursing Home DS0000065659.V284310.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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