Inspection on 12/10/05 for The Anchorage

This inspection was carried out on 12th 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Anchorage 27/06/07

The Anchorage 12/10/06

The Anchorage 06/07/05

The Anchorage 09/12/04

The Anchorage 17/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 The Anchorage 47 Abbotsham Road Bideford Devon EX39 3AF Lead Inspector Andy Towse Unannounced Inspection 12th October 2005 12:30p The Anchorage DS0000022116.V253419.R01.S.doc Version 5.0 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 The Anchorage DS0000022116.V253419.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 Adults 18-65. 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. The Anchorage DS0000022116.V253419.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Anchorage Address 47 Abbotsham Road Bideford Devon EX39 3AF 01237 421002 01237 421002 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) Jedd International Ltd. Donna May Thirkell Care Home 9 Category(ies) of Learning disability (9) registration, with number of places The Anchorage DS0000022116.V253419.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th July 2005 Brief Description of the Service: The Anchorage is a large, older type property situated within easy access of the facilities available at Bideford. It is registered to accommodate up to 9 people who have a learning disability. All residents are accommodated in single occupancy bedrooms. All communal facilities, such as the lounge, kitchen and dining area are situated on the ground floor, enabling them to be accessed by residents with restricted mobility. The home has garden areas which are accessible to all residents The Anchorage DS0000022116.V253419.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection which took place over a timespan of four and a half hours. Information contained in this report was obtained from discussion with the manager, members of staff and residents combined with inspection of documentation and records, including resident’s care plans. What the service does well: 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. The Anchorage DS0000022116.V253419.R01.S.doc Version 5.0 Page 6 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 Outcomes Statutory Requirements Identified During the Inspection The Anchorage DS0000022116.V253419.R01.S.doc Version 5.0 Page 7 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 the following standard(s): 4 The home has an admissions process which involves both existing residents and prospective residents and ensures that those being admitted to the home can make an informed choice about whether or not to reside there. EVIDENCE: The manager is currently considering the admission of a new resident. Records showed that this ongoing process had involved several visits to the home by the prospective new resident and also her carers. Existing residents were also involved, having met the prospective resident, and they had been asked about their feelings concerning the prospective resident. Records were seen to have been kept regarding the visits and in discussion the registered manager confirmed that this prospective resident’s introduction was being undertaken at a pace which was suited to her specific needs. The Anchorage DS0000022116.V253419.R01.S.doc Version 5.0 Page 8 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 the following standard(s): 6 Service users know their assessed and changing needs and personal goals are reflected in their individual plan. EVIDENCE: This was an unannounced inspection. On arrival at the home a review meeting was taking place. This was being chaired by the registered manager. The resident whose plan was being reviewed was present and was fully involved in the discussion about her personal aspirations and the contents of her care plan. The registered manager was questioned about why certain other people were present at the review and her response confirmed that it was appropriate for all attending to be there. The resident herself was seen to be confident in addressing issues raised in the discussion and, was very specific about her chosen holiday destination and who should accompany her. At the end of the inspection another review was seen to be taking place in which a resident and also his relatives were present. The Anchorage DS0000022116.V253419.R01.S.doc Version 5.0 Page 9 Three other residents were spoken to. All confirmed that they were involved in the compilation of their care plans and this was further substantiated by their signatures on these plans. The residents have individual files. As well as containing care plans, these also contained risk assessments and information regarding the complaints system. All this information was written in both bold, large print and widget in an attempt to make it more easily understood by residents. The home has an active key worker system. This was substantiated by these staff attending reviews and in their assisting with the compilation of their care plans. Residents knew who their key worker was and in discussion, showed that they knew what the key workers’ role was. Their descriptions however seemed to concentrate on key workers buying them toiletries and clothes rather than perceiving them as enablers working alongside them to achieve maximum independence. The Anchorage DS0000022116.V253419.R01.S.doc Version 5.0 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 the following standard(s): 16, 17 Whilst residents are encouraged to take responsibility in their daily lives their perception of the role of key worker needs to evolve to encompass that of an enabler towards independence. EVIDENCE: The home encourages residents to be independent. Residents take responsibility for keeping their rooms tidy and carrying out other domestic tasks. All files contained risk assessments which related to medication, money and keys. These were also written in widget to make them more easily understood by residents. Residents were seen to be called by their chosen term of address and this was recorded in their care plans. Residents could choose when to be alone or when to be in company. On the day of the inspection two residents spent most of their time in their rooms, another two were sat in one bedroom watching a television programme and The Anchorage DS0000022116.V253419.R01.S.doc Version 5.0 Page 11 another spent intermittent time, either in the lounge or in her room where she demonstrated her skills at using her computer. Those residents who were assessed as capable had keys to their bedrooms. The home has a relaxed attitude towards pets and there are two pet cats at the home. Whilst residents were aware of who their key workers were their perceptions of the role seemed to be that they were there to do tasks for them rather than work towards enabling them to achieve more independence. These perceptions will hopefully change as staff put into practice the ethics behind the recent training arranged by the proprietor. Residents’ rooms were seen to be personalised and they clearly regarded these areas as their own personal spaces. The registered manager has recently produced a ‘winter menu’. The home operates a ‘winter’ and ‘summer’ menu. Residents choices for menu were ascertained during residents’ meetings and then translated onto the menu. This was confirmed by reference to the minutes of residents’ meetings, which, were also written in widget and available to residents. In instances where residents had limited communication skills their choices were ascertained by using thyeir key workers’ knowledge of their preferences obtained through experience, observation and individual knowledge of the resident. There is always a roast dinner on Sundays. Residents could choose where to eat. Residents make their own breakfasts All residents’ files contained weight charts. The Anchorage DS0000022116.V253419.R01.S.doc Version 5.0 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 the following standard(s): Standards 18, 19 and 20 were inspected during the announced inspection of 6th. July 2005. EVIDENCE: The Anchorage DS0000022116.V253419.R01.S.doc Version 5.0 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 the following standard(s): Whilst the home has ensured that staff have received appropriate training regarding the protection of vulnerable adults, policies need to be extended to more fully safeguard residents’ financial welfare. EVIDENCE: The registered manager is aware of the POVA register and the need to refer staff deemed as unsuitable to work with vulnerable adults for possible inclusion on that register. Since the last inspection there have been no allegations of abuse or poor practice within this home. Inspection of staff files and records held at the home confirmed that all staff have attended POVA training courses. At the time of the inspection, Policies and Procedures were inspected. Although there were policies regarding the acceptance of gifts there was no mention of staff being precluded from involvement in making or benefiting from residents’ wills. Staff spoken to were also unaware of the existence of such policies. The Anchorage DS0000022116.V253419.R01.S.doc Version 5.0 Page 14 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 the following standard(s): Standards 24 and 30 were inspected during the announced inspection of 6th. July 2005. EVIDENCE: The Anchorage DS0000022116.V253419.R01.S.doc Version 5.0 Page 15 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 Residents are protected by the registered manager’s rigorous recruitment procedure. EVIDENCE: This home received a complaint regarding poor care practices. This was prior to the last inspection. Since that time the registered manager and proprietor have been pro active in addressing the issues raised. The proprietor has recently completed the sixth and final workshop which explored the values required to work with people with learning disability. These workshops were attended by all staff and examined power relationships between staff and residents and aspects of the five accomplishments such as choice, dignity, independence, rights and fulfilment. This training did not just entail attendance, but also the submission of assignments and group work to complement the learning process. In order that staff are able to communicate more easily with residents all staff have attended ‘Total communication’ training. All staff complete the Learning Disability Award Framework training. There are currently eight staff, of which two have completed NVQ 2, however another is participating on the course and two more are due to commence training. Whilst the home will not achieve the required number of NVQ trained staff by the end of 2005, 50 of the staff should have achieved this by the middle of 2006. The Anchorage DS0000022116.V253419.R01.S.doc Version 5.0 Page 16 The registered manager is currently recruiting two new care staff. It was seen that neither were to commence work prior to receipt of CRB clearance. Both prospective new staff members had files containing references and documents confirming their identity. The home has set questions used to interview staff. Mandatory training was seen to have been booked for the new members of staff and an thorough induction which involved shadowing more experienced staff. Records were kept of interviews and new staff are subject to a probationary period during which time their development is evaluated and recorded at set times. Staff files were seen to be very well maintained and were easy to access. The Anchorage DS0000022116.V253419.R01.S.doc Version 5.0 Page 17 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 42 The registered manager has completed additional modules in her qualifying training in order to increase her knowledge and competence. Residents’ safety should not be compromised by fire doors being wedged open. EVIDENCE: The registered manager is completing her NVQ 4 and Registered Manager’s Award. Following a complaint last year, she extended her NVQ training to include a module on normalisation. This was to increase her knowledge regarding working with people with a learning disability. The registered manager has instituted a clear system of record keeping relating to staff and resident files. Whilst Standard 42 was inspected during the previous inspection, at this inspection it was seen that the fire door leading to the laundry, which opens onto a main landing, had been wedged open and thereby compromising the safety of residents. Training records showed that staff at this home receive fire The Anchorage DS0000022116.V253419.R01.S.doc Version 5.0 Page 18 safety training twice a year and that this training is given by a professional bought in by the proprietor. The Anchorage DS0000022116.V253419.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 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 X x Standard No 22 23 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X X x Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 x 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Anchorage Score X X X x Standard No 37 38 39 40 41 42 43 Score 3 X X X X 1 X DS0000022116.V253419.R01.S.doc Version 5.0 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 Standard YA42 Regulation 23(4) (a) Requirement That the practice of wedging open fire doors ceases. Timescale for action 12/10/05 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 YA26 Good Practice Recommendations That the home’s policies are extended to include financial policies which preclude staff from assisting with the compilation of residents’ wills or from benefiting from them. 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