Inspection on 06/07/05 for The Anchorage

This inspection was carried out on 6th July 2005.

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

Other inspections for this house

The Anchorage 27/06/07

The Anchorage 12/10/06

The Anchorage 12/10/05

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 Andrew Towse Announced 06 July 2005 10:00hrs The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Anchorage D54 D06_s22116_anchorage_v230399 060705 stage 4.doc Version 1.30 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 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 LD Learning disability (9) registration, with number of places The Anchorage D54 D06_s22116_anchorage_v230399 060705 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 9 December 2004 Brief Description of the Service: The Anchorage is a large semi-detached property indistinguishable from other properties in this residential area of Bideford. Its situation gives its residents easy access to Bidefords facilities. All residents occupy single bedrooms with access to all floors being by stairs. The home has garden areas which are being improved and which are accessible to residents. Internally, the communal areas comprise a lounge and dining room, both of which are on the ground floor which ensures they are accessible to anyone with restricted mobility who resides on that floor. The Anchorage D54 D06_s22116_anchorage_v230399 060705 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection which took place over a period of 7 hours. The information contained in this report was obtained through discussion with residents, the manager, staff and from the examination of records, including care plans. This was complemented by information supplied by the manager on a pre inspection questionnaire circulated by the CSCI and from comments made by residents on comment cards. What the service does well: What has improved since the last inspection? What they could do better: The home has a complaints procedure and has produced this in widget to make it more user friendly. Although copies are kept on residents’ files it could be made more accessible to them if it was displayed more prominently within the home. The Anchorage D54 D06_s22116_anchorage_v230399 060705 stage 4.doc Version 1.30 Page 6 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 D54 D06_s22116_anchorage_v230399 060705 stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection The Anchorage D54 D06_s22116_anchorage_v230399 060705 stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 4, 2 The home operates an admissions process which ensures that both the home and the prospective resident have sufficient knowledge upon which to base their decisions regarding admittance. EVIDENCE: There has been no new resident admitted since August 2003, so for this section of the report evidence was obtained from looking at records relating to the last admission and a discussion with the registered manager. Records showed that this service user came to ‘The Anchorage’ on several occasions as part of the introduction process which also assisted her, and her relative, in making an informed choice about moving to the home. An assessment was carried out by staff from ‘The Anchorage’ at the prospective resident’s place of residence. Although this service user had restricted levels of communication, information regarding her abilities, needs and aspirations were obtained through interaction with the resident, discussion with her mother and information supplied at her previous place of residence and also from a psychiatric assessment. The Anchorage D54 D06_s22116_anchorage_v230399 060705 stage 4.doc Version 1.30 Page 9 With regard to the resident’s aspirations, the registered manager said that these were obtained through discussion with the resident’s mother and also through ‘trial and error’ in interaction with the resident. Records confirmed that it was still the policy of the home to let prospective service users visit the home as part of the admissions process, as a recent prospective resident had spent time at the home, before it was decided not to continue with the admissions process in this instance. The Anchorage D54 D06_s22116_anchorage_v230399 060705 stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9 Residents are involved in the compiling of their care plans and are given opportunities to participate in the day-to-day running of the home. EVIDENCE: Care Plans were seen to have been signed by service users, or, in instances where service users were unable to sign, they had left a mark to confirm that the plan had been involved in the compilation of the plan and agreed with its contents. Service users and, if they wish, their relatives, attend the reviewing of their care plans. Minutes of residents meetings are written in ‘widget’ to make them more easily understandable by residents. The minutes show that residents are able to make choices regarding their lives. Such instances were reflected in individual choices of food being incorporated into the menu and decisions regarding activities and outing taking into account resident’s individual preferences. The minutes also show that residents were involved in selecting the colour scheme for areas of the home and one resident said that she had chosen the colour scheme for her bedroom. The Anchorage D54 D06_s22116_anchorage_v230399 060705 stage 4.doc Version 1.30 Page 11 Within the home, residents are responsible for tidying their rooms and taking responsibility for various areas of the home. This is all written on a rota of which, in discussion, residents confirmed they were aware of. The Anchorage D54 D06_s22116_anchorage_v230399 060705 stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15 The home is pro-active in supporting residents’ relationships with family and friends. EVIDENCE: Residents are encouraged to maintain contact with friends and relatives. Residents’ next of kin are invited to reviews. Discussion with residents and the manager combined with examination of records showed that the majority of residents have regular contact with family and relatives and that key workers and the manager take responsibility for encouraging this contact and keeping relatives well informed of issues relating to residents. The home has a written policy on personal relationships. Minutes of service user meetings showed that residents’ choices about food are sought and then incorporated into the home’s menu. On the day of the inspection service users were seen to have a simple lunch of comprising a choice of sandwiches. They were seen to be able to choose where they ate and those spoken to said that they enjoyed their food. The Anchorage D54 D06_s22116_anchorage_v230399 060705 stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20 The well being of residents is ensured by access the relevant healthcare professionals and recent training of staff in the administration of medication. EVIDENCE: The home has a written policy regarding the handling, storage and administration of medication. Copies of this policy have been signed by the staff designated the responsibility of administering medication. These staff have received training in the administration of medication by the registered manager and the deputy manager and also by Boots who supply the medication. Part of the aforementioned complaint had stated that medication had been incorrectly recorded. Since that time the home has put into place systems to limit the chance of this problem recurring. At the time of the inspection no residents were self-medicating. Care plans referred to service users having this right if they were assessed as having the ability to take on this responsibility. There is a record of medication administered and received by the home. There is also a record of all medicine received by the home and a signed record of all medicine returned to the pharmacist The Anchorage D54 D06_s22116_anchorage_v230399 060705 stage 4.doc Version 1.30 Page 14 Care plans and records showed that service users physical and emotional health needs are met. Two service users have appointments with a consultant psychiatrist who specialises in working with people who have learning disabilities. Two others have annual check ups with a consultant who specialises in working with people who have epilepsy. All service users have an annual medication review carried out by the general practitioner who has responsibility for those resident at the home. A psychotherapist has also assisted staff in working with a service user who had depression. A chiropodist visits the home every six weeks. Printed information supplied by the home showed that in the last twelve months in addition to the above, all service users had seen an ophthalmologist, another had visited a diabetic consultant, two had been seen by an occupational therapist and another by a gynaecologist. Whilst several service users do not require personal support, some do. In discussing one of these residents it was apparent that his mobility had been enhanced by the purchase of an electric wheelchair and recent eye surgery. This person had received the support of a physiotherapist and from discussion with the manager and from examination of records, it was clear he could communicate with staff through gestures and facial expressions. The Anchorage D54 D06_s22116_anchorage_v230399 060705 stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 The home safeguards service users by having a complaints procedure presented in a user friendly format, however this could be enhanced if the procedure was displayed in a prominent position within the home as well as being kept on service users’ files. EVIDENCE: The home has a complaints procedure. To make it more easily understood by residents it has also been written using the ‘widget’ system of symbols. Copies are kept on residents’ files. Two residents spoken to were aware that they could look at their files on request. One resident considered that she would inform her keyworker if she was not happy with the service she got at ‘The Anchorage.’ It was suggested that a copy of the complaints procedure was displayed on the notice board in the kitchen to ensure that residents could see it. Responses back from 6 residents stated that they knew who to go to should they be unhappy with their care. A response from a relative and another from a visitor confirmed that these people were aware of the home’s complaints procedure. Staff have received in-house training relating to the Protection of Vulnerable Adults (POVA) and in August 2005 all staff are attending POVA training run by Devon Social Services. The manager and proprietor were quick to respond to the conclusions of the complaint made to the CSCI and to take positive action to address the issues raised. The Anchorage D54 D06_s22116_anchorage_v230399 060705 stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 30 The home has appropriate standards of hygiene and cleanliness. The home is undergoing refurbishment with residents’ choices being sought whenever possible in the choosing of décor for the refurbishment of the home and in particular their bedrooms. EVIDENCE: On the day of the inspection a new carpet covering the main hallway and all the stairs and landings was being installed. Due to this, and several service users being out not all bedrooms were inspected as part of this inspection. Of the three bedrooms seen in the company of the service users, all were seen to have been personalised by the addition of books, ornaments, posters, pictures and items of furniture. All residents said that they liked their rooms. Over lunch another service user spoke about choosing the colour of her new bedroom carpet. Residents had keys to their bedrooms and were able to go to their bedrooms whenever they wished to. The Anchorage D54 D06_s22116_anchorage_v230399 060705 stage 4.doc Version 1.30 Page 17 Minutes of residents’ meetings showed that service users were consulted about colour schemes for their own bedrooms as well as for other areas, including, more recently, that for a bathroom and adjacent w.c. The home itself is indistinguishable from other residences in this mainly residential locality. Externally it has garden areas to both the front and the rear, which are in the process of being tidied and maintained to a better standard than it had been previously and there is consideration of a resident assisting with this after consideration of appropriate safeguards. The home had an appropriate standard of hygiene. Service users were responsible for keeping their bedrooms tidy and the manager has instituted a schedule for night staff to carry out certain cleaning duties. The Anchorage D54 D06_s22116_anchorage_v230399 060705 stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35, 36 Service users are being enabled to make informed choices regarding their lifestyles by a staff group who are receiving training focused on empowerment. EVIDENCE: The proprietor has commenced a course of six workshops entitled ‘Values in Action’ which he will lead personally. These workshops are looking at good practice and using everyday examples from the home to highlight the issues under discussion. Regulation 26 forms forwarded to the Commission by the proprietor showed the training to have an emphasis on staff enabling residents to make an informed choice about issues affecting their lives. All staff have attended the Learning Disability Award Framework (LDAF) foundation course run by ARC training. In September all staff will be attending ‘Total Communication’ training organised by Devon Health and social Care Partnership. Of the eight care staff employed at the home, two have NVQ 2, one has NVQ 3, and two are working on NVQ 2, with another due to commence NVQ 2 training in 2006. By the end of 2005 it is anticipated that more than half of the staff will have attained NVQ 2 or above. This will mean that this home will have slightly in excess of the minimum number of NVQ qualified staff required in the National Minimum Standards. The Anchorage D54 D06_s22116_anchorage_v230399 060705 stage 4.doc Version 1.30 Page 19 In addition, the manager has a written ‘Annual Training Plan’. This includes a schedule to ensure that all mandatory training is up to date. Due to the needs of one resident there is always a member of staff on duty who has been trained in the application of rectal diazepam. Staff have also attended SCIP courses which were considered relevant due to the assessed needs of a prospective service user. The registered manager is responsible for the supervision of most staff, with the deputy taking responsibility for the remainder. It was seen that the registered manager records fully the contents of supervision sessions and that these are held regularly. The Anchorage D54 D06_s22116_anchorage_v230399 060705 stage 4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 and 42 The manager is evolving an open, positive and inclusive atmosphere within the home, whilst also developing and increasing her own knowledge of the needs of people with learning disabilities. EVIDENCE: As stated earlier, a recent complaint which was investigated by the CSCI concerned a practice issue. The manager and proprietor have responded positively and professionally to the findings of the complaint. This is reflected in her extending her NVQ4 qualifying training by a further module which relates to the values which underpin the principle of ‘Normalisation’. She has also reviewed her practice and is seeking to involve staff more in decision making within the home. In addition the proprietor, who has experience in the field of caring for people with learning disability, has put on a series of six workshops to enhance staff skills. The manager is expecting completing her NVQ 4 by September 2005 which meets the requirement set by the National Minimum Standards. The Anchorage D54 D06_s22116_anchorage_v230399 060705 stage 4.doc Version 1.30 Page 21 In 2004, the home sent out questionnaires to residents’ next of kin asking how the felt about aspects of the service. In 2005, the home devised a questionnaire for residents which, in order to make it more user friendly was written using the ‘widget’ system of symbols. In discussing the responses of service users to the questionnaire, the manager, through entries in the diary and on residents’ files, was able to show that resident’s comments had been acted upon. The manager keeps a record of health and safety issues regarding the home. These showed that the home staff had appropriate training regarding fire safety and that risk assessments had been compiled for activities around the home. There was valid certification confirming the safety of the home’s portable electrical appliances, electric wiring and gas appliances. A record of accidents is kept and the manager has increased the scope of the accident report to include, where necessary, the need to review risk assessments, a summary of any investigation and action necessary to avoid a recurrence. The Anchorage D54 D06_s22116_anchorage_v230399 060705 stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 ENVIRONMENT Score 2 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score x x x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME 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 3 x x 3 x D54 D06_s22116_anchorage_v230399 060705 stage 4.doc Version 1.30 Page 23 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 Regulation Requirement Timescale for action 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 22 Good Practice Recommendations That the complaints procedure is displayed prominently The Anchorage D54 D06_s22116_anchorage_v230399 060705 stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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. 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