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Inspection on 05/05/05 for The Anchorage Rest Home

Also see our care home review for The Anchorage Rest Home for more information

This inspection was carried out on 5th May 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home has a group of staff who are friendly and welcoming. Staff assist residents in an unhurried and sensitive manner. Residents find the home comfortable and homely and are encouraged to personalise their bedrooms. The home is clean and well furnished, and the gardens are well maintained. Residents feel able to complain if they have concerns. Residents are offered a choice of meals, and say the quality of the food is good. Residents appreciate that they can choose to join in an activity or not. The arrangement of the sitting areas maintains the sense of a homely environment.

What has improved since the last inspection?

No staff have left during the past few months, which residents and visitors said helps create a sense of stability for residents Lockable boxes for residents to keep their medicines in are now provided (where residents hold their own medicines) Information about the home for residents and visitors (the statement of purpose) has been updated A weekly art therapy group has recently started in the home.

What the care home could do better:

All staff should have sit-down supervision with a senior member of staff at least six times per year, so that staff are fully supported in their work. The adult protection policy for staff on what to do if a member of staff puts residents at risk needs to be updated and reviewed.

CARE HOMES FOR OLDER PEOPLE The Anchorage Rest Home Coombelands Lane Pulborough West Sussex RH20 1AG Lead Inspector Ed McLeod Unannounced 5 May 2005 V222219 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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Anchorage Rest Home H60-H11 S14767 Anchorage V222219 050505 Stage 1.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Anchorage Rest Home Address Coombelands Lane, Pulborough, West Sussex, RH20 1AG 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) 01798 872779 Rhymecare Limited Mrs Sheila Marion Wyatt Care Home 30 Category(ies) of OP Old Age registration, with number of places The Anchorage Rest Home H60-H11 S14767 Anchorage V222219 050505 Stage 1.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: No additional conditions of registration. Date of last inspection 9.2.05 Brief Description of the Service: The Anchorage is a Care Home registered to accommodate up to thirty service users in the category of older persons over the age of 65 years, not falling within any other category. The property is detached and is situated near Pulborough in West Sussex. Accommodation is provided on ground and first floor levels, and there is a passenger lift. The registered provider is Rhymecare Limited, for whom the responsible individual is Mr Nick Wyatt. The registered manager is Mrs Sheila Wyatt. The Anchorage Rest Home H60-H11 S14767 Anchorage V222219 050505 Stage 1.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was not announced and lasted just under 5 hours. A tour of the building took place and the inspector spoke with 7 of the 30 residents, 2 visitors, the registered manager, 2 of the 3 care staff on duty, and a visiting district nurse. Five sets of care plans were inspected. The inspector also looked at the complaints record, the certificate of registration, the certificate of liability insurance, and policies and procedures relating to adult protection and managing residents’ money. An updated statement of purpose for the home was seen. An inspection by a fire officer was also taking place on the day the inspector visited. What the service does well: What has improved since the last inspection? No staff have left during the past few months, which residents and visitors said helps create a sense of stability for residents Lockable boxes for residents to keep their medicines in are now provided (where residents hold their own medicines) Information about the home for residents and visitors (the statement of purpose) has been updated The Anchorage Rest Home H60-H11 S14767 Anchorage V222219 050505 Stage 1.doc Version 1.30 Page 6 A weekly art therapy group has recently started in the home. 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 Rest Home H60-H11 S14767 Anchorage V222219 050505 Stage 1.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection The Anchorage Rest Home H60-H11 S14767 Anchorage V222219 050505 Stage 1.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 Prospective residents are given good information by the home which assists them to make their choice about where to live. EVIDENCE: The statement of purpose which gives information to residents and visitors on what the home provides has been updated. The Anchorage Rest Home H60-H11 S14767 Anchorage V222219 050505 Stage 1.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 11 The home is meeting the health and personal care needs of residents. EVIDENCE: The care plans for four residents were seen by the inspector, and these show that residents needs such as diet control for diabetes and encouragement with walking to assist mobility are being included in the care plans. There was evidence from talking to residents and looking at medical appointments information for the home that residents are being assisted to attend eye and ear appointments and follow-up outpatient clinic appointments. A district nurse visiting the home said that the home contacts her when advice or instruction is needed, and that her advice and instruction are being followed by staff in the home. The district nurse said that the facilities in the home for staff to wash their hands are good, which helps maintain good hygiene. Residents who hold their own medication now have a lockable space in their bedrooms in which to store their medicines. The Anchorage Rest Home H60-H11 S14767 Anchorage V222219 050505 Stage 1.doc Version 1.30 Page 10 Two relatives said they found that a doctor is called when the need arises, but that staff “don’t panic where panic isn’t needed”. Where terminal care has been provided in the home, discussion with staff indicated ways in which this is done with sensitivity and respect, and involving family and nurses from the community. The Anchorage Rest Home H60-H11 S14767 Anchorage V222219 050505 Stage 1.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13, 14, 15 Residents are helped to exercise choice and control over their lives, and to maintain contact with family, friends, representatives and the local community. Residents have a balanced diet and enjoy the meals provided. EVIDENCE: Four residents and two relatives told the inspector that their visitors were always welcomed by staff, and offered a cup of tea and biscuit. The relatives said that staff were reasonably good at contacting them about changes to the care plan. Residents spoken to shared a view that the atmosphere of the home was relaxed and unhurried, and that there were opportunities to socialise if they wished. One resident said that she appreciated that there was no compulsion to join in activities and said, “You don’t feel you’re regimented around”. One resident talked about the societies and events he continues to attend in the community. Residents are being offered a choice of meals, and say they are asked to make suggestions for additions to the menu. The inspector visited the dining room during lunch, where the atmosphere was relaxed and residents said they were enjoying their choice of meal. The lunch looked balanced and nutritious. One The Anchorage Rest Home H60-H11 S14767 Anchorage V222219 050505 Stage 1.doc Version 1.30 Page 12 resident with diabetes talked of how staff supporting her with her diet helps control her diabetes. The Anchorage Rest Home H60-H11 S14767 Anchorage V222219 050505 Stage 1.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16. 17, 18 Adult protection procedures need to be reviewed and updated to ensure there is a proper response to any suspicion or allegation of abuse. EVIDENCE: Entries in the complaints book were seen by the inspector, and staff had written about what action had been taken. There is a suggestions book in the hallway which residents mentioned, and staff had also written into this what action was being taken on the suggestion. Guidance on how to complain are included in the Statement of Purpose for the home which residents receive. Four residents were asked who they would talk to if they had a complaint, and all said they would talk to Mrs Wyatt the manager, and that they felt she would give them a fair hearing. The day of the inspection was also general election day. Five residents asked by the inspector said they had been offered a postal vote, and had accepted or declined this. No prior arrangement for staff to take residents to the polling station had been made at the time of the inspection. The policy and procedures seen in the home for preventing residents suffering abuse were not signed or dated, and did not include when information such as when referrals of incidents will be made to the local authority (who are the lead agency for adult protection) and when referrals for staff who have put residents at risk will be made to the Protection of Vulnerable Adults register. The Anchorage Rest Home H60-H11 S14767 Anchorage V222219 050505 Stage 1.doc Version 1.30 Page 14 Adult protection procedures should be signed and dated, and reviewed to include information such as when referrals of incidents will be made to the local authority, and a policy for referring staff who have put residents at risk to the Protection of Vulnerable Adults register. The Anchorage Rest Home H60-H11 S14767 Anchorage V222219 050505 Stage 1.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 23, 24, 25, 26 The building and grounds are well maintained, and the environment is homely, safe and comfortable and meets the needs of residents. EVIDENCE: The inspector visited 6 bedrooms, the communal areas, the kitchen, and the laundry room. All areas seen were found to be clean, hygienic, and free from obstruction. Two gardeners were tidying up the gardens on the day of the inspection. Residents spoken to said they enjoyed the garden, especially the fish pond. The home is clean and has good standards of hygiene. One resident described the home as “spotlessly clean”. The communal sitting areas are popular with residents, and are all on ground floor level. There was no evidence of a need for redecoration, replacement or repair. Residents have brought with them personal effects and belongings and have personalised their bedrooms. The Anchorage Rest Home H60-H11 S14767 Anchorage V222219 050505 Stage 1.doc Version 1.30 Page 16 The laundry room has two large washing machines which have a programme for incontinence washes, and a sluicing facility. The laundry has an impermeable floor and is not sited near kitchen or dining areas. The kitchen is suitably equipped to make the meals on the menu provided. The Anchorage Rest Home H60-H11 S14767 Anchorage V222219 050505 Stage 1.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 30 The staff team is stable and is able to provide consistent care for residents. EVIDENCE: There has been no change in staff since the previous inspection. The consistency of the staff team was remarked upon by residents, relatives and staff during the inspection, who felt this was positive. The inspector observed during the inspection that staff take time to talk to residents and staff assistance is being provided in an unhurried and sensitive manner. One resident said that staff always allowed enough time to help her with washing, dressing and bathing. “They look after us very well” said another resident. One relative said that staff were “sympathetic to mum’s problems”. Records indicate that 3 staff have the National Vocational Qualification (NVQ) in care at level 2, one member of staff has NVQ in care at level 3, and 3 staff are presently undertaking NVQ in care at level 2. At the time of the inspection 3 staff had arranged to undertake a one-day training in health and safety. The Anchorage Rest Home H60-H11 S14767 Anchorage V222219 050505 Stage 1.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 35, 36 There is a friendly atmosphere and clear sense of leadership in the home. Staff should be receiving supervision to ensure that they are meeting the needs of residents and to assist in recognising the training needs of staff. EVIDENCE: One resident said that the home was “nice, relaxed” and “seems to work pretty well”. Residents said they found registered manager Mrs Wyatt approachable and gave a clear sense of leadership. One relative said the atmosphere in the home was friendly. Mrs Wyatt said that no money is held for residents, but that staff sometimes act in passing on amounts of cash in sealed envelopes to a resident from another party. The Anchorage Rest Home H60-H11 S14767 Anchorage V222219 050505 Stage 1.doc Version 1.30 Page 19 Mrs Wyatt said that sit-down staff supervision was not arranged for all staff at present, but that she planned that this would commence in the middle of May 2005. The Anchorage Rest Home H60-H11 S14767 Anchorage V222219 050505 Stage 1.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 2 x 3 x x 3 2 x x The Anchorage Rest Home H60-H11 S14767 Anchorage V222219 050505 Stage 1.doc Version 1.30 Page 21 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 OP18 Regulation 13.6 Requirement Adult protection polcies and procedures should be signed and dated, and include advice on the referral of incidents to the local authority and to the referral of staff who have put residents at risk or harmed them to the Protection of Vulnerable Adults register Timescale for action 30.08.05 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 OP36 Good Practice Recommendations Care staff should receive formal supervision at least 6 times a year The Anchorage Rest Home H60-H11 S14767 Anchorage V222219 050505 Stage 1.doc Version 1.30 Page 22 Commission for Social Care Inspection 2nd Floor, Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Anchorage Rest Home H60-H11 S14767 Anchorage V222219 050505 Stage 1.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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