Care Home: The Anchorage

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What the care home does well The needs of people using the service are appropriately assessed to ensure the home can meet their needs and information is available to help those thinking about moving into the home to make an informed decision about using it. People living in the home are encouraged to maintain contact with their friends and relatives and staff support them well with their health needs. The concerns of people using the service are taken seriously and staff training is provided to ensure they can safeguard them from potential harm. A good training programme is provided to ensure staff can support people living in the home and good administrative systems are in place to support the smooth running of the home. Relative comments stated the home was `Friendly and caring` and that it `Feels homely with excellent hardworking and caring staff` What has improved since the last inspection? Improvements have been made in the way staff record medication and a programme of further activities has been developed to enable people using the service to have better choices about these. Staff have started to receive more regular supervison to help them do their jobs. What the care home could do better: Staffing levels should be further reviewed to ensure the personal dignity of people using the service can be further enhanced and respected and the activities provided should continue to be monitored to ensure people living in the home have more choices about these. The general standard of decoration in the home should be upgraded in order to ensure the wellbeing of people using the service can be further promoted. The chef should be more directly involved in the process of consulting with people living in the home about their food to ensure their wishes and preferences about these can be further met and more regular staff meetings should be held to ensure they are provided with guidance and leadership. Staff should continue to receive regular supervision to help them to do their jobs. Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Anchorage Rutland Street Grimsby North East Lincs DN32 7RS     The quality rating for this care home is:   two star good service 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: Rob Padwick     Date: 1 6 0 6 2 0 0 9 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. that people have said are important to them: They reflect the things 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 Older People 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. Care Homes for Older People Page 2 of 24 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: The Anchorage Rutland Street Grimsby North East Lincs DN32 7RS 01472250817 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : manager.theanchorage@hica-uk.com Humberside Independent Care Association Limited care home 40 Number of places (if applicable): Under 65 Over 65 40 40 40 dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home 0 0 25 The Anchorage Care Home is one of several in the Grimsby area owned by the not for profitorganisation, HICA, based in Hull. It is registered for the care of 40 residents with nursing and residential care needs. The categories of care include dementia, physical disabilities and problems associated with old age. The home was purpose built and provides accommodation on two floors with access to the upper floor via stairs or a passenger lift. All rooms are for single occupancy, have en-suite facilities and are decorated to a good standard. In addition residents have access to four lounges and a large dining room. The home has four bathrooms, two of which have specialised baths and two shower Care Homes for Older People Page 4 of 24 Brief description of the care home rooms. There are sufficient toilets strategically placed throughout the home. The grounds are secure and easily accessible. The home is situated close to the town centre of Grimsby and near to local shops, amenities and bus routes. Information about the home and its services can be found in the statement of purpose and service user guide, both these documents are available from the manager of the home. The manager advised the current fee at the time of this inspection visit ranged from £361 to £535. The home also charges third party top-up fees. In addition service users are expected to pay for hairdressing, private chiropody treatments, toiletries and newspapers/magazines. Care Homes for Older People Page 5 of 24 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 Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This inspection report is based on information received by us since its last key inspection, which took place on 20th June 2007 and includes information gathered Care Homes for Older People Page 6 of 24 during a site visit to the home. As part of the inspection process, we send out a self assessment document that the Registered Person must complete and return to us. This helps us know how well the home is meeting regulations and national minimum standards and what has been done to improve it and what still needs to be done. The self assessment was completed by the manager and information from this used as part of the inspection process. Other information used, included feedback from people living in the home and their relatives, Professional people who know the home well, together with official notifications sent to us by the home. This information helps us to reach judgments about the service provided. The site visit took place on 16th June 2009 and lasted for 5 hours. The provider was not told in advance when it would take place. The manager was available throughout the period of our site visit and as well as speaking to her, we talked staff who were on duty and people living in the home. We looked round the building, including the bedrooms and shared areas of the home and we inspected the records of peoples care, staff files, health and safety documents and other records kept by the service. What the care home does well: What has improved since the last inspection? What they could do better: 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 24 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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 needs of people using the service are appropriately assessed to ensure it is able to meet their needs and information is available to help those thinking about moving into to the home to make an informed decision about using it. Evidence: Up to date information about the home was available to help those thinking about using the service to make an informed decision about it. The manager told us she tried to visit people thinking about moving in to the home to check it was suitable for them. The case files belonging to people using the service contained information which confirmed their needs had been carefully considered as part of the homes admission process, in order to ensure the service could meet these appropriately. Care Homes for Older People Page 10 of 24 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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. Whilst the health and personal care needs of people living in the home are appropriately met more attention should be given to assure their personal dignity can be respected and enhanced. Evidence: People living in the home indicated their health and personal care needs were being appropriately met and their case files inspected contained evidence of careful monitoring and actions taken about these. Comments received from the people using the service stated We are very satisfied with the care received and everyone is very caring and friendly whilst relatives told us the Home is friendly and caring..with excellent hardworking and caring staff. All residents are treated as individuals and there is good bonding between personal carers and residents. Individual care programmes had been developed from the assessments of people living in the home and the case files inspected contained good quality care plans which detailed how staff should support them to ensure personal wishes and preferences are Care Homes for Older People Page 11 of 24 Evidence: respected. We saw evidence care plans were being regularly reviewed to ensure they are kept up to date, together meetings held involving both people using the service and their representatives to ensure they are happy with the way their care is provided. A relative told us the home Provides personal support to a high level, paying particular attention to medical needs and that It keeps me very well informed of xxx welfare. Case files documented assessments concerning the management of risks, together with daily recordings and evidence of liaison and involvement of professionals about these. Local Doctors told us they felt the service be a well run home with good Care and attention to patients and a senior nurse in the Community told us staff Always follow instructions and give feedback, I have no concerns and am quite happy to use their services. Policies and procedures were in place to ensure staff know how to give medication safely and there was evidence of appropriate training about this and a range specialist health conditions. The medication records we checked were being appropriately maintained and the standard of recording for these was satisfactory. We saw evidence of close attention paid to ensure medication needs of people living in the home was recorded and consistently monitored and that a previous requirement about this was now met. A significant number of people using the service experiece a high level of dependency associated with their complex needs and some comments received from both them, their relatives and staff indicated there were consequently occasions when staff were too busy to afford time to spend with clients. The manager told us about plans to increase staffing levels in the near future; however a recommendation is made about this. Care Homes for Older People Page 12 of 24 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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. Whilst people living in the home can maintain contact with friends and families further opportunities for them to take part more meaningful activities would enable them to have greater choices about their lives. Evidence: Information provided by the manager indicated people using the service were currently able to participate in a somewhat limited range of activities following the departure of a member of staff responsible for these. We saw evidence of activity sessions; involvement of Community groups, trips out and some social events, but there was evidence in the activity records these need to be further developed to ensure those using the service can make more meaningful lifestyle choices. Relatives commented on the Friendly and Caring nature of staff but stated the home feels understaffed at week ends and holidays with Social actives dependant on staff volunteering to work on days off. The manager told us she had recently interviewed for a replacement activity worker and that agreement had been reached to increase the hours for this. A recommendation is made about this. The service has an open visiting policy that encourages people living in the home to keep links with their friends and families and relatives we spoke to were generally very satisfied with the home. Links are Care Homes for Older People Page 13 of 24 Evidence: maintained with local churches to enable the spiritual needs of people using the service be met and we were told about visits from lay preachers and a monthly interdenominational service that takes place in the home. Case file inspected documented likes and dislikes of people living in the home together with evidence that staff consulted them about personal preferences. People using the service told us that staff generally listened to them well and we saw evidence in daily notes of individual choices about things. People living in the home confirmed they generally liked their meals and there was evidence these included a range of nutritious and healthy options. Case files contained evidence the nutritional needs of people using the service were appropriately monitored and inspection of menus indicated special diets were provided where needed. The manager told us about plans to improve the general availability of food and that the cooks hours are due to be increased in the near future. The quality of food served to people using the service is regularly surveyed although a recommendation is made that the cook is more directly involved in this process. Care Homes for Older People Page 14 of 24 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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 concerns of people using the service are taken seriously and staff training is provided to ensure they can safeguard them from potential abuse. Evidence: Policies and procedures are available to ensure the concerns of people using the service are taken seriously and that they are safeguarded from potential harm. Details about these are included in information given to people when they consider moving into the home and feedback received from them confirmed they were generally very satisfied with the service. The complaints log contained evidence the manager followed up concerns received in an appropriate manner and information provided by her indicated these are then discussed in staff meetings. We saw evidence of training to ensure staff know how to protect people living in the home from potential abuse and those we spoke to confirmed appropriate action would be taken should they have any concerns. Since the last time we visited the home some incidents had been referred to the Local Authority for investigating under its duties to safeguard vulnerable adults and we were told this had resulted in a member of staff being dismissed on one occasion. Care Homes for Older People Page 15 of 24 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, 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. 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. Whilst people living in the home are provided with an environment that meets their needs and is kept safe and clean, a general upgrade to the building would enable their wellbeing to be further promoted. Evidence: The home was warm, clean and tidy and we saw evidence of regular checks to ensure the building is kept safe and in good order. The building was built some time ago and some areas were in need of general refurbishment and appeared somewhat out dated. Communal areas were well utilised during the period of our visit and whilst people confirmed they were happy and comfortable, some of these areas were rather cramped. The manager told us about plans to upgrade the building in the near future and it is recommended these are carried out as a priority in order to enhance the wellbeing of people living in the home. People using the service told us they were able to bring items of personal possessions with them and their bedrooms were observed to reflect their interests and personalities and all of those seen were clean and bright. The home is built on two floors and has good access for those with limited mobility. Policies and procedures are in place for the control of infection and there was evidence of staff training about these to ensure those using the service are protected from potential harm. Care Homes for Older People Page 16 of 24 Care Homes for Older People Page 17 of 24 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. People living in the home are supported by staff who are well trained to ensure they can do their jobs. Evidence: We observed staff interacting with people living in the home in a friendly and sensitive manner and comments we received described them as Excellent, hardworking and caring. Staffing levels were observed to be generally satisfactory, but as previously noted we were told about times when these could be further improved. The people that run the home have an excellent training department to ensure staff have the skills needed to do their jobs and we saw evidence of this in the staff files we inspected. All new staff undertake a thorough five day induction period before starting to work in the home and this is then followed up with a range of specialist and mandatory training. Since the last time we visited the service, the home owners had developed further plans to extend the training opportunities provided for staff and we saw evidence of a programme of new additional Vocational Related Qualification training courses in Medication, Palliative care, Dementia and Nutrition, which were due to be started in the near future. Staff files inspected contained evidence that appropriate recruitment checks had been carried out together with annual appraisals of their skills to enable career progression and development. Care Homes for Older People Page 18 of 24 Care Homes for Older People Page 19 of 24 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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. Good systems are in place to support the smooth running of the home and ensure that the health, safety and welfare of people using the service can be promoted. Evidence: The manager is a trained nurse with extensive experience and qualifications in management. Staff told us she takes her job seriously and is open in her approach and supportive to them. Good systems were in place to support the smooth running of the service and the records of finances belonging to people living in the home that we checked were accurate and well maintained. We saw evidence of regular checks carried out of a range of aspects of the home to ensure its effectiveness and people using the service and their relatives told us they were able to contribute their views about the running of the home. We saw evidence of surveys sent out to people living in the home and their relatives and there was evidence of regular checks and training carried out to ensure the health, safety and welfare of people living in the home. The standard of record keeping for these was generally of a good standard although some Care Homes for Older People Page 20 of 24 Evidence: staff records indicated regular staff meetings and professional supervision still needed further development but that recent action had been taken to improve this. A recommendation is made about this. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 22 of 24 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 Requirement 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 Requirement Timescale for action 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 1 10 The Registered Preson should review staffing levels in the home to ensure the personal dignity of people using the service can be respected and enhanced at all times. The Registered Person should ensure activities provided continue to be monitored to ensure the lifestyle needs and choices of people living in the home can be met. The Registered Person should ensure the chef is more directly involved in the process of consulting with people living in the home about their meals. The Registered Person should take steps to upgrade the building in order to ensure the wellbeing of people using the service can be further promoted. The Registered Person should ensure regular staff meetings occur and that staff are regularly supervised to ensure they are provided with the appropriate guidance and leadership. 2 12 3 15 4 19 5 36 Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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. 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