Inspection on 26/09/06 for Anchorage Nursing Home

This inspection was carried out on 26th September 2006.

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

Other inspections for this house

Anchorage Nursing Home 14/05/09

Anchorage Nursing Home 22/05/08

Anchorage Nursing Home 31/05/07

Anchorage Nursing Home 18/03/06

Anchorage Nursing Home 29/11/04

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

CARE HOMES FOR OLDER PEOPLE Anchorage Nursing Home 17 Queens Road Hoylake Wirral CH47 2AQ Lead Inspector Natalie Charnley Unannounced Inspection 26th September 2006 10:00 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.V299650.R01.S.doc Version 5.2 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.V299650.R01.S.doc Version 5.2 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.V299650.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 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 of the home. 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. The home have a sister home located in the local area. It costs £480.00 per week to live at the home Anchorage Nursing Home DS0000065659.V299650.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over one day. The inspector arrived at the home at 10am and left at 3pm. Informal and formal discussions took place with the manager, the administrator, 7 staff and 5 residents. No visitors were available at the home for comment. A number of staff and residents were sent questionnaires to ask for their opinion on the home. Comments from these documents are also contained in this report. The inspector completed the inspection by looking at the homes records, a tour of the building, formal and informal interviews and information from previous inspection reports. The inspector followed an inspection plan written before the start of the inspection to ensure that all areas that needed covering were done so. Feedback was given to the manager during and at the end of the inspection. The arrangements for equality and diversity were discussed throughout the visit and are detailed throughout this report. Particular emphasis was placed on the methods that the home used to determine individual needs and the practices that they put into place into meeting those needs. What the service does well: What has improved since the last inspection? A comprehensive quality assurance system has been put in place. The home has been awarded the ISO 901/2000, which is a quality assurance check. Some staff training has been completed, however this needs further work to meet the required standard. Anchorage Nursing Home DS0000065659.V299650.R01.S.doc Version 5.2 Page 6 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 Nursing Home DS0000065659.V299650.R01.S.doc Version 5.2 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 Anchorage Nursing Home DS0000065659.V299650.R01.S.doc Version 5.2 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): 2 Quality outcomes in this area are good. This judgement has been made using all available evidence, including a visit to the service. No residents moves into the home unless a pre-admission assessment has taken place. This ensures the safety of the residents. EVIDENCE: 5 residents care files were sampled, including the 2 most recent admissions to the home. Evidence was available to show that detailed assessments are carried out prior to admission by the home. These look at what a resident can and cannot do for themselves. Details are also included regarding medical history, likes and dislikes and any risks that a resident may take when living at the home. This is to ensure they live in a safe environment. Anchorage Nursing Home DS0000065659.V299650.R01.S.doc Version 5.2 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 and 10 Quality outcomes in this area are adequate. This judgement has been made using all available evidence, including a visit to the service Care plans need improving to ensure they all contain enough detail. Medication is well managed and needs minimal improvement. Residents feel their dignity is respected at all times. EVIDENCE: Care plans sampled showed that the home try and provide individualised care. Plans are developed and signed, where possible by the residents. Where a resident unable to do this, family members sign on their behalf. Some care plans were better quality than others. Some were very detailed, however others were very basic and contained information such as ‘difficult with medication’ and ‘allow time’. These instructions are not clear enough for staff to follow, and must be improved. Risk assessments cover a variety of areas such as manual handling and pressure area care. One residents file showed that she had a pressure ulcer. The home had liaised with a tissue viability nurse, who is a specialist in this area. Expert advice was then given and the home records showed that the wound was healing. Anchorage Nursing Home DS0000065659.V299650.R01.S.doc Version 5.2 Page 10 Another residents care plan stated that they needed their blood pressure taking 3 times per week. The home had been doing this and monitoring any changes. Medication administration records (MAR charts) and the treatment room were checked during the inspection. The home currently does an extra count of drugs that could potentially be abused. It is recommended that this practice be stopped as it can often cause confusion with the official CD (controlled drug) counts. A check on all CD’s at the home was carried out and found to be accurate. 17 residents had handwritten MAR charts that had not been double signed by staff. This practice must be carried out to ensure that the correct drug and dose are given. It is recommended that the manager carry out a monthly audit of the MAR charts as part of quality assurance checks. Residents spoken to stated that they felt treated well by staff. One resident commented, “ staff here are lovely, they are so nice”. Staff were observed to address residents in a polite way and knock on bedroom doors before entering. Anchorage Nursing Home DS0000065659.V299650.R01.S.doc Version 5.2 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 and 15 Quality outcomes in this area are good. This judgement has been made using all available evidence, including a visit to the service Activities are varied and enjoyed by residents. Residents are encouraged to make personal choices on a daily basis. Meals are healthy, nutritious and are enjoyed by residents. EVIDENCE: The home has an activity organiser that works 18 hours per week. Residents and staff stated that they felt that more activity hours were needed at the home, especially for those residents “ who cant really join in”. Staff stated that they felt under pressure to do activities along with their general care duties. Types of activities offered vary from trips out, craft sessions and massage. A weekly plan is available that sets out the activities on offer and a recent survey was carried out for residents to suggest what they would like to do. Residents spoken to stated that they enjoyed joining in with activities at the home. Links are kept with the sister nursing home, and on occasions, joint activities are done. Anchorage Nursing Home DS0000065659.V299650.R01.S.doc Version 5.2 Page 12 Residents confirmed that they could have visitors at the home at any time. Staff commented that visitors could meet residents in the bedrooms or in the communal areas, such as the lounge. Residents were able to list choices that they are encouraged to make on a daily basis, such as what time they get up and go to bed, what meals they eat and what they wear. Comments were made such as “ We can do most things when we want to here” and “I can go to bed when I want to, staff don’t mind”. The home has a rotating menu that changes seasonally. Daily menus are written on a blackboard and are available to residents, enabling them to make a choice. Residents were observed at lunchtime, which was a social and unhurried occasion. Meals were well presented and hot. Good stock levels were available in the kitchen, including fresh foods. The chef confirmed and evidenced that he has a system in place for monitoring and recording the quality and temperature of foods. Anchorage Nursing Home DS0000065659.V299650.R01.S.doc Version 5.2 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): 16 and 18 Quality outcomes in this area are good. This judgement has been made using all available evidence, including a visit to the service The home has a clear complaints policy and ensure staff are appropriately checked before they start work at the home. EVIDENCE: The home have no recorded complaints logged since the last inspection. A policy is in place for handling complaints and is easily accessible for residents. Residents confirmed they knew how to make a complaint if needed. The home has a copy of the local authority adult protection procedures. Staff files showed that appropriate police checks had been carried out on all staff before they start work at the home. Policies and procedures are in place to ensure residents are kept safe from abuse. Anchorage Nursing Home DS0000065659.V299650.R01.S.doc Version 5.2 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): 21 and 26 Quality outcomes in this area are adequate. This judgement has been made using all available evidence, including a visit to the service Areas of the home are in need some replacement carpets, however is otherwise well maintained. Infection control policies are in place, but staff training must back this up. EVIDENCE: A full tour of the home was carried out as part of the inspection. All areas were found to be clean and tidy. Residents stated that cleaners “worked hard” at the home and came to clean their room daily. The dining room, staff room and corridor area carpets were noted to be badly stained and need of replacement. There is currently no maintenance and decoration plan in place, however the manager was able to point out areas that had improved. Policies and procedures are in place around infection control, however staff training records show this training has not been given to staff. Anchorage Nursing Home DS0000065659.V299650.R01.S.doc Version 5.2 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): 27,28,29 and 30 Quality outcomes in this area are good. This judgement has been made using all available evidence, including a visit to the service Staffing numbers are suitable for the size of the home, however some training needs to be updated. Staff recruitment checks protect the residents from harm. EVIDENCE: The home staffing rota shows that the following staffing levels are followed: 2 Nurses and 6 care assistants (am shift) 2 Nurses and 4 care assistants (pm shift) 1 Nurse and 3 care assistants (night shift) Cleaners, cooks, an administrator and kitchen porter are also employed to ensure the home runs smoothly. Staff and residents stated that they felt that staffing numbers were good and that this allowed good standard of care to be given. Residents commented, “ Staff are great, they are always here to help” and “The girls are lovely, so helpful and kind”. The home has no deputy manager in place, which would assist the manager greatly. The manager currently works some office hours, but also works as a direct member of the care team. 31 of care staff at the home currently holds an NVQ (national vocational qualification) in care. Anchorage Nursing Home DS0000065659.V299650.R01.S.doc Version 5.2 Page 16 This falls short of the 50 needed to achieve the national minimum standard. 3 staff are currently studying towards this qualification, and the manager is aware of the shortfall in this area. Staff training is recorded in a matrix, so it is clear to view the needs of staff. Not all staff are up to date with mandatory training, however there are plans in place to address this. Staff were able to talk about the training they had been given and gave examples such as embalmment, abuse awareness, fire awareness and manual handling. It was identified that in particular the chef does not have an up to date food hygiene certificate. 4 staff files were checked. These contained references, police checks and information about previous employment. Files were well organised and kept up to date. PIN (personal identification numbers) checks to confirm the nurses were suitably qualified had been undertaken in August 2006. Anchorage Nursing Home DS0000065659.V299650.R01.S.doc Version 5.2 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): 31,33,35 and 38. Quality outcomes in this area are good. This judgement has been made using all available evidence, including a visit to the service The quality of the service provided at the home is monitored. The manager is competent and well regarded and health and safety checks are in place to safeguard residents and staff. EVIDENCE: The manager at the home has been in post for 12 months. She is a registered general nurse and has 26 years experience in caring for older people. She also holds a specialist management qualification. Staff and residents stated that she was “ supportive” and “very approachable”. Anchorage Nursing Home DS0000065659.V299650.R01.S.doc Version 5.2 Page 18 The home has just achieved an external quality assurance award. This has meant a lot of new policies and procedures have been introduced such as surveys and a suggestion box. The home has worked hard to achieve this award and are staff morale has improved as a result. Staff meetings are held on a regular basis and staff felt that the comprehensive morning ‘handover’ was particularly useful for monitoring what is going on at the home. The home holds very little money on behalf of residents. Receipts are kept and records are well recorded. Families are encouraged to manage finances on behalf of residents if they are unable to do so themselves. Accident records and health and safety certificates were checked and found to be satisfactory. Fire checks are carried out on a regular basis and one member of staff is the designated fire marshal. Risk assessment regarding the home environment are in place to ensure the safety of the residents. Anchorage Nursing Home DS0000065659.V299650.R01.S.doc Version 5.2 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 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Anchorage Nursing Home DS0000065659.V299650.R01.S.doc Version 5.2 Page 20 YES 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 OP7 Regulation 15(1) Requirement The registered person must ensure all care plans are detailed and provide the basis of which care can be given The registered person must ensure that all handwritten medications are double signed. The registered person must produce a maintenance and decoration plan, to include provision for replacement of the carpets identified in the report All staff must have undertaken the mandatory training programmes. Remains outstanding from previous inspection report. Due 1.7.06 Timescale for action 01/12/06 2 3 OP9 OP19 13(2) 23(1)(2) 01/10/06 01/12/06 4 OP30 18 01/12/06 Anchorage Nursing Home DS0000065659.V299650.R01.S.doc Version 5.2 Page 21 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 4 Refer to Standard OP9 OP12 OP27 OP28 Good Practice Recommendations It is recommended that the manager audits medication charts on a monthly basis and removes the 2nd registered for monitoring controlled drugs. It is recommended that the number of hours designated to activities be increased. It is recommended that the registered provider give consideration to employing a deputy manager. It is recommended that the home follow through their plans to put more staff onto NVQ training. Anchorage Nursing Home DS0000065659.V299650.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 Nursing Home DS0000065659.V299650.R01.S.doc Version 5.2 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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