Inspection on 05/11/08 for The Anchorage

This inspection was carried out on 5th November 2008.

CSCI found this care home to be providing an Good service.

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 07/03/07

The Anchorage 09/08/05

The Anchorage 04/05/05

The Anchorage 15/10/04

The Anchorage 19/04/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Anchorage 78 Wootton Road Kings Lynn Norfolk PE30 4BS two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Brenda Pears Date: 0 5 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: The Anchorage 78 Wootton Road Kings Lynn Norfolk PE30 4BS 01553765378 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): lyn.james@daybreaksupport.com Ms Lynda Yvonne James Name of registered manager (if applicable) Ms Lynda Yvonne James Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 6 0 care home 6 learning disability Additional conditions: Date of last inspection A bit about the care home The Anchorage is a care home providing personal care and accommodation for six younger adults who have a learning difficulty. The home is privately owned by Ms Lynda Yvonne James and is situated in Kings Lynn on a busy road within walking distance from the town centre. There are also local shops and community services within the immediate local area of the home. The home has its own transport and undertakes regular trips with service users. An off road car parking area is available at the front of the home.The Anchorage is a converted house and the accommodation consists of single rooms, two of which have en-suite facilities. There are two lounges (one used as a games room) a kitchen/diner, and bathrooms on the ground and first floors. The gardens consist of paved and lawn areas with established borders and shrubbery. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is 2 stars. This means that the people who use this service experience good quality outcomes. This was an unannounced inspection undertaken on the 5th November 2008 and was undertaken from 4pm. An earlier visit had been made but resdidents were not at home, so this inspection was carried out when all residents were in the home. Information was provided to us by the home on an assessment form known as an Annual Quality Assurance Assessment (AQAA). This inspection also considers information received from the service since the last key inspection. In order to complete the inspection a site visit was conducted and we spoke to the manager, the provider, to residents and to the staff on duty at the time. We also undertook a site visit and residents invited us to see their rooms. What the care home does well Residents are treated with respect and it was clear from discussions and observations at this time, that staff do support independence and treat the home as belonging to the residents. Choices are supported and residents played a major role in this inspection by making decisions and discussing their experiences with us. Staff are inducted into their role and are given regular supervision sessions and undertake training at regular intervals. What has got better from the last inspection What the care home could do better The service does undertake risk assessments and these were seen on care plans, however, there was no risk assessment in place for toiletries that are left out and are easily accessed. This was discussed with the manager who stated that a risk assessment would be completed and kept on file. A review of all risk assessments must also be undertaken when there is any change in the behaviours of a resident in the home. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Brenda Pears 33 Greycoat Street London SW1P 2QF 02079792000 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The manager does assess the needs of any new resident to make sure individuals can be fully supported before any agreement is made. Evidence: Previous reviews of care plans have shown that pre admission assessments are undertaken for any new admission. Three care plans were seen at this time and assessments are kept on file. The manager confirmed that new residents are able to visit the home and stay overnight as many times as is necessary before any decision is made to move into the home. It was explained that other residents are also involved with the decision of a new admission as they have to live with the person, they are consulted at all stages. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Care pans contained clear information and guidance for staff to meet the needs of residents and to support their well being. Evidence: Two care plans were read at this inspection and both contained full information about the needs of the individual and also likes and dislikes. Information was clear and provided staff with sufficient details for them to meet the needs of the resident. Care pans were clearly set out and orderly with regular reviews being undertaken. Information on records included the choices of the person, for example, where they preferred to eat meals and also about how to speak to the person and provide appropriate support where necessary. Observations at this time and discussions with residents confirm that staff do consider the dignity and well being of residents. The home is run as residents choose and has a welcoming atmosphere. Risk assessments are on records and these again were comprehensive and provided staff with information to assist with the well being of residents. However, a risk assessment must be completed for toiletries that can be accessed by residents. While this may not pose a risk at this time, risk assessments must support this fact and be reviewed in the event of any changes in behaviours. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Residents are supported to take part in a range of activities and maintain contact with family and friends and a variety of meals are chosen by residents Evidence: Records show how people are supported to choose activities and live their lives as independently as they wish. There is a clear record of all positive achievements, no matter how small, to show what people are achieving. For instance if a person helps with dinner or clears their room, this is positively recorded and recognised as a personal accomplishment. Records and discussions with residents and staff show that residents enjoy activities outside the home and are part of the local community. These include shopping, day centre, visits to the pub and to family and friends. Residents were happy to talk about their activities and show pictures in their rooms and around the home of various outings and special events. Diaries are kept to record meals and foods that are enjoyed. Residents said that they like the food and everyone gets to choose. Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Healthcare needs are met and medication is stored and recorded appropriately to support the health and well being of residents. Evidence: Care plans contained evidence that healthcare professionals are contacted when necessary, regular checkups are undertaken and hygiene and health records were up to date. There were clear instructions for staff when any risk is assessed and how to maintain the well being of residents. A communication book is also used to transfer details of any new information and to confirm appointments that have to be arranged or attended. Medication is recorded appropriately, records were orderly and up to date at this inspection. While medication is refrigerated where necessary, there is no independent fridge that can be locked and used only for medicines. This is specified in guidelines and discussions were undertaken with the manager regarding this storage. Medication is audited at each handover of staff teams and staff sign to agree this. Staff also have an induction and the local pharmacy carry out regular training and provide support to the home. Records and discussions with staff confirmed this is undertaken before any medication is dispensed by a member of staff. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Residents know who to complain to and routines and practices in the home support open discussions. This enables residents to feel they can talk to staff about any matter or problem they may have. Evidence: An incident regarding the handling of money has highlighted areas that required a review of procedures in the home. This has now been undertaken and the handling and recording of money, while previously robust, has now be strengthened. Additional adjustments have also been made to risk assessments to provide additional protection for residents and staff. The amount of money held has been reduced to also minimise risk. Any complaints are copied to the provider and daily diaries are kept for all residents and complaints are recorded in these. Previous complaints had been received regarding the behaviours of one person in the home. With such comments and the changing behaviours of the individual, this led to a review of needs. This matter has now been concluded and this clearly shows that those living in the home were considered and their complaints and opinions listened to and acted on. Residents said that they knew who to speak to if they had a complaint or were unhappy and that they can always talk to staff members. Staff also expressed a thorough knowledge of the needs of each resident and how they would recognise certain behaviours that may indicate there was a problem. Any transactions regarding money is itemised to each resident on a monthly basis and a copy also goes to any social workers. These are reviewed on request and also at care plan reviews. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home does provide a comfortable and safe environment for people to live in that supports their needs and choices. Evidence: The home has a welcoming and relaxed atmosphere and residents move about the home freely. Staff provide support where necessary but also show that they are aware the individual resident makes their own decisions about routines. Rooms are individual and residents were happy for us to see their own rooms at this time. The kitchen now has new flooring and blinds, the hallway has new wallpaper and a utility area has been developed with a new laundry. The side lounge has been plastered and redecorated. A wet room has been installed as residents did not use the bath and prefer to have showers. There has been some rewiring in the home and a new external pathway with ramp and hand rail has been added to a patio area, providing a comfortable outside space. The home was found to be clean, tidy, comfortable and hygienic in all areas. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living in the home have their needs met by a consistent staff team who are trained and supervised, providing continuity of care. Evidence: There are always two members of staff on duty and one person known as a befriender is also provided to give one to one time to residents and provide a male presence in the home. This person undertakes training along with other members of the staff team. Appropriate recruitment procedures have been followed including a criminal record check and references are also obtained. Staff stated that they feel competent to undertake their role and have good support from both the provider and the manager. Discussions also show that staff do know the residents and how they wish to be supported. The manager monitors care plans and risk assessments with reviews being undertaken on a regular basis. Training that has been undertaken during this year includes a refresher course on handling medication, understanding learning difficulties and Autism, managing challenging behaviour, fire training, first aid, moving and handling and food hygiene. Staff were seen to be undertaking their work with due consideration for the dignity of individuals and also respecting privacy and choice at all times during this inspection. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Residents live in a home that is comfortable and is run in their best interests. Evidence: Health and safety measures are undertaken regarding regular fire drills that are recorded and it is ensured that new staff do undertake a fire drill in the home. Policies and procedures are regularly reviewed to incorporate any changes in legislation. The manager confirmed that certificates for insurance, electrical testing generally and for all equipment (PAT) and fire certification are all up to date. Regular quality monitoring is undertaken and questionnaires have recently been sent out to family, friends, professionals, day centre staff, residents, care staff and any other key person in the lives of the residents. The manager explained that regular contact with visitors also helps to deal quickly with any problems that may arise. Information, observations and discussions undertaken at this time do show that the home operates in a competent way and that the needs and wishes of residents are at the centre of the care provided. Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action 1 36 19 The Registered Person must ensure all care staff receive formal supervision sessions at least six times per year. 30/06/2007 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 9 13 31/01/2009 To provide a safe environment for residents at all times A risk assessment to be completed regarding all toiletries to minimize risk and hazard. To also avoid limiting the activities and choices of residents. 2 20 13 That medicines are handled in line with guidelines set by the Royal Pharmaceutical Society and requirements of the Misuse of Drugs Act. 02/03/2009 Any medicines requiring cold storage are to be kept in an independent, lockable fridge at all times. In line with legislation and to protect the well being of service users. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!