Inspection on 07/03/07 for The Anchorage

This inspection was carried out on 7th March 2007.

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 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 05/11/08

The Anchorage 09/08/05

The Anchorage 04/05/05

The Anchorage 15/10/04

The Anchorage 19/04/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 The Anchorage 78 Wootton Road Kings Lynn Norfolk PE30 4BS Lead Inspector Debra Allen Key Unannounced 7th March 2007 11:15 The Anchorage DS0000027525.V332836.R01.S.doc Version 5.2 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 DS0000027525.V332836.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 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 DS0000027525.V332836.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Anchorage Address 78 Wootton Road Kings Lynn Norfolk PE30 4BS 01553 765378 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) Ms Lynda Yvonne James Ms Lynda Yvonne James Care Home 6 Category(ies) of Learning disability (6) registration, with number of places The Anchorage DS0000027525.V332836.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th August 2005 Brief Description of the Service: The Anchorage is a care home providing personal care and accommodation for six younger adults who have a learning disability.The home is privately owned by Ms Lynda Yvonne James.The home 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. The Anchorage DS0000027525.V332836.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Following a response from the provider this report has been amended and, as a result, one recommendation has been removed and the overall rating has been improved. Care Services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out, by using information from previous inspections, information from the providers, the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and the current judgements for each outcome group. This unannounced inspection took place over 5 hours, during which time a tour of the premises was carried out and discussions were held with two service users, two staff members and the manager. One requirement and three recommendations have been made as a result of this inspection. What the service does well: What has improved since the last inspection? Two bedrooms have been redecorated and a number of rooms have been re-carpeted. Two staff are always on shift when all the service users are at home. The Anchorage DS0000027525.V332836.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. The summary of this inspection report can be made available in other formats on request. The Anchorage DS0000027525.V332836.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection The Anchorage DS0000027525.V332836.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 & 4 Quality in this outcome area is good. Prospective service users’ individual aspirations and needs are assessed. Service users have an opportunity to visit and “test-drive” the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of inspection, records for two service users’ were looked at and the information available provided evidence to show a full assessment process is undertaken prior to admission. As part of this assessment, information is gathered from a number of sources including social workers, family and carers. A discussion with the manager also confirmed that service users are invited to visit the service before moving in, following which there is a three month trial period and a full care plan is compiled during the first few weeks of residence. The Anchorage DS0000027525.V332836.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 & 10 Quality in this outcome area is good. Service users know their assessed and changing needs and personal goals are reflected in their individual plan and they are supported to take risks as part of an individual lifestyle. Service users are consulted on, and participate in all aspects of life in the home and make decisions about their lives, with assistance as needed. Service users know that information about them in handled appropriately and that their confidences are kept. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans for two service users were examined in detail and found to contain very comprehensive, but clear, information with regard to how each person likes and needs to be supported. The Anchorage DS0000027525.V332836.R01.S.doc Version 5.2 Page 10 Very good notes were seen from full reviews, which take place every six months. Additional notes were also seen to be recorded where changes in need had occurred between reviews. A ‘Quality Systems’ log was also seen on the day and this showed that each service user is supported to make decisions and ‘have their say’. The comments recorded appeared to be very honest and showed that people were encouraged to say what they think and have their views listened to. The risk assessments that were looked at were comprehensive and provided evidence of an empowering and enabling environment. Some of the risk assessments also covered detailed, but easy to follow, guidance for staff to assist a service user to ‘manage everyday situations’. Service users’ information was seen to be stored securely in the locked office and confidentiality was assured. The Anchorage DS0000027525.V332836.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. Service users are provided with opportunities for personal development and are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community and are supported to 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 say they enjoy their meals and mealtimes but evidence of alternatives being provided is lacking. This judgement has been made using available evidence including a visit to this service. The Anchorage DS0000027525.V332836.R01.S.doc Version 5.2 Page 12 EVIDENCE: The records looked at gave detailed descriptions of how people are supported and encouraged to live their lives as independently as possible. Records of ‘positives & achievements’ were also noted and included comments such as: Sorted bedroom out, walked to shop to get paper and wiped up dishes without being asked Evidence of activities and outings included: Walked to shops Played dominoes Went to Gateway Club Went shopping in town Out for a meal Went to pub Visited friends and family Theatre show Day Centre One service user spoke to said the things he like best about living at the Anchorage were going to their day centre, helping staff with the cooking, going into town, watching wrestling and watching Sky TV in their room. Other comments made were that all the staff are good and that the food is always nice. During the inspection staff were observed interacting with service users and speaking to them in a respectful and appropriate manner. Two service users were at home on the day and both were seen to have unrestricted access to the communal areas. The menus were seen in the form of a food diary and showed a variety of meals that appeared to be wholesome and nutritious. Staff spoken to during the inspection said that the staff on shift generally sorted the meals with input and assistance from service users if they wanted to help. Staff also commented that the service users generally liked everything but they could have something different if they wanted. However, the records seen in the food diary rarely showed alternatives and very few desserts were recorded. Also, one service user was noted to refuse their meals quite often but records were limited with regard to the possible reasons behind this and the action taken – i.e. alternative choice offered. The Anchorage DS0000027525.V332836.R01.S.doc Version 5.2 Page 13 A recommendation has therefore been made to improve the information recorded which relates to mealtimes and, where possible, the reasons for and action taken, when someone doesn’t want their meal. A recommendation has also been made that a choice of fresh fruit, or other healthy dessert option, is offered on days when a specific dessert is not on the menu. The Anchorage DS0000027525.V332836.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. Service users receive personal support in the way they prefer and require and their physical and emotional health needs are met. Service users are protected by the home’s policies and procedures for dealing with medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The information seen in the care plans included risk assessments, communication sheets, health & well-being records & hygiene records. The care plans are reviewed fully every six months but are updated as required and any changes in support needs are recorded clearly and appropriately to ensure consistency with regard to how staff support service users. Evidence of input from professionals, such as Occupational Therapists and nurses, was also seen by the notes kept in the care plans. The local GP visited one service user on the day of inspection and it was noted the service user’s privacy and dignity was respected and upheld by staff The Anchorage DS0000027525.V332836.R01.S.doc Version 5.2 Page 15 before, during and after the doctor’s visit. Appropriate notes were subsequently recorded in the person’s care folder. None of the service users currently manage their own medication but a policy is in place if this situation changes. The policy and procedure for ‘medication handling’ was seen and the storage of medication was observed to be safe and secure. The home uses the Boots Monitored Dosage System (MDS) and, on inspection, the medication and Medication Administration Record (MAR) sheets were found to be in order, with no errors or omissions noted. The shift hand-over procedure includes an audit of medication and all PRN/loose medication is checked and counted by the ‘key-holding’ staff members and signed for accordingly. The hand-over records were also looked at during the inspection and they showed no errors or omissions with regard to medication. The Anchorage DS0000027525.V332836.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. Service users feel their views are listened to, although the action taken and outcomes of investigations were not clearly identifiable at the time of the inspection. Service users are protected from abuse, neglect and self harm as much as is possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A number of records were seen during the inspection, which showed that the service users felt able to have their say, be listened to and have their views taken seriously, if they wanted to make a complaint. However, action taken and the outcomes of investigations were not clearly identifiable at the time of the inspection, although a discussion with the manager confirmed that the complaints procedure was in fact robust. A recommendation has therefore been made for a clearer recording system to be maintained with the complaints folder at The Anchorage. Evidence was seen that confirmed a previous requirement had been met: “Consultation with relevant people such as Social services and the Consultant Psychiatrist must take place to review the behaviour of one of the residents.” The Anchorage DS0000027525.V332836.R01.S.doc Version 5.2 Page 17 The incident records continue to show regular instances of aggressive outbursts by one service user in particular. However, these incidents have reduced in frequency and severity and the manager confirmed that there has been, and continues to be, a great deal of input into this person’s program of care from all parties who are professionally aware and the staff team at The Anchorage is working very closely with all members of the multidisciplinary team. In addition, two staff are always on duty when all the service users are at home, in order to better support people and subsequently reduce the impact of volatile situations. There was a good record of positive comments, as well as complaints, made by service users and staff. The Anchorage DS0000027525.V332836.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27 28, 29 & 30 Quality in this outcome area is good. Service users live in a homely, comfortable and safe environment, which is clean and hygienic. Service users bedrooms suit their needs and lifestyles and promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs and shared spaces complement and supplement their own rooms. Specialist equipment is available, as required, to maximise service users’ independence. This judgement has been made using available evidence including a visit to this service. The Anchorage DS0000027525.V332836.R01.S.doc Version 5.2 Page 19 EVIDENCE: A tour of the premises was undertaken on the day of the inspection and the home was found to be clean, hygienic and well maintained with safe and comfortable communal rooms. Toilet, bathroom and laundry facilities were also found to be clean, hygienic and sufficient to meet the service users’ needs. Two service users were happy to show me their rooms, both of which were clean, tidy and very individualised. Some personal assistive aids were noted during the inspection and information contained in the care plans showed that individual requirements for specialist equipment would be accommodated. The Anchorage DS0000027525.V332836.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 & 36 Quality in this outcome area is good. Service users benefit from clarity of staff roles and responsibilities and are supported by an effective staff team, who are competent and qualified. 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. Staff support and supervision sessions are not currently happening six times per year. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff spoken to during the inspection confirmed that they had received job descriptions and an induction and felt comfortable and capable of carrying out their daily duties. The Anchorage DS0000027525.V332836.R01.S.doc Version 5.2 Page 21 Training records were looked at and evidence was seen of staff training in areas such as Emergency Aid, Adult abuse awareness, Principles of Care, Fire Training, Health & Safety Awareness, Food Hygiene, Manual Handling, Psychosis, Personality Disorder Awareness and Medication Handling. A good system was seen to be in place for monitoring staff training requirements and statutory training was found to be up to date and ongoing. The staff personnel files that were looked at contained appropriate records and documentation including POVA 1st check, clear enhanced CRB disclosure, identification, application form, two references and a ‘staff communications’ record. One member of staff said they felt very supported by the manager and could call her at any time if needed. One service user said “all the staff are good”. However, although support for staff is ongoing, formal supervision sessions are not currently taking place six times per year and so a requirement has been made for this to happen. Discussion with the manager confirmed that she is currently in the process of recruiting a deputy manager and it is envisaged that this will help ‘ease the load’ in respect of staff support and supervision. The Anchorage DS0000027525.V332836.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. Service users benefit from a well run home. Service users are confident their views underpin all self-monitoring, review and development by the home. The health, safety and welfare of service users are promoted and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussion with the manager and information contained within the preinspection questionnaire confirmed that the day-to-day operations are being dealt with competently. The manager is currently in the process of recruiting a deputy, which should assist her to further improve the quality of the service as a whole. The Anchorage DS0000027525.V332836.R01.S.doc Version 5.2 Page 23 The home has a good system for checking quality assurance and feedback is actively sought and encouraged from service users, staff and other relevant people. A ‘Quality Systems Log’ was seen for each service user, which contained what appeared to be honest comments with service users being able to say what they thought. Some of the policies and procedures were seen to have been recently updated and some are currently in the process of being reviewed. Safe working practices were seen to be maintained and the regulated checks for fire, environmental health, water, electric were found to be satisfactory, with relevant risk assessments in place. The Anchorage DS0000027525.V332836.R01.S.doc Version 5.2 Page 24 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 Standard No Score 1 X 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X The Anchorage DS0000027525.V332836.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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 YA36 Regulation 19 Requirement The Registered Person must ensure all care staff receive formal supervision sessions at least six times per year. Timescale for action 30/06/07 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 YA17 Good Practice Recommendations The Registered Person is recommended to improve the recorded information which relates to mealtimes and include, where possible, the reasons for and action taken, when someone doesn’t want their meal. The Registered Person is recommended to maintain a clearer recording system with the complaints folder at the Anchorage, showing the action taken and outcomes following a complaint. The Registered Person is recommended to offer a choice of fresh fruit, or other healthy dessert option, on the days when a specific dessert is not on the menu. 2. YA22 3. YA22 The Anchorage DS0000027525.V332836.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: 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 © 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 The Anchorage DS0000027525.V332836.R01.S.doc Version 5.2 Page 27 - 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!