Anchor House - Doncaster

Anchor House is a residential care home providing personal care for up to 23 people. At the time of our inspection there were 20 people using the service, some of whom were living with dementia.

People’s experience of using this service and what we found

The registered manager was supported by a deputy manager and an assistant deputy manager. Since our last inspection the management team had improved the systems in place to monitor the quality of the service. However, accidents, incidents and safeguarding concerns had been identified and recorded, but not reported to the appropriate bodies such as the local authority and the Care Quality Commission (CQC).

The home was predominantly clean, and people were protected from the risk and spread of infection. Some maintenance work had taken place since our last inspection which had made it easier to clean certain areas of the home.

Risks in relation to people's care had been identified and were managed safely. Systems in place to manage risks in relation to the building and maintenance had improved.

Sufficient numbers of staff were available to meet people’s need in a timely way. People received their medicines as prescribed. Staff had received training in safeguarding and told us how they would recognise, report and record abuse. We recommend the provider ensures visits take place in accordance with the current government guidance.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (20 July 2021).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Anchor House is a residential care home providing personal and nursing care to 23 people. It is situated on the outskirts of Doncaster. Accommodation is provided on both ground and first floors. At the time of our inspection there were 21 people using the service.

People’s experience of using this service and what we found

Systems in place to monitor the quality of the service had improved and were beginning to identify areas of improvement. Some issues we found during our inspection had not been identified during the audit process. Therefore, the providers monitoring system required further development to show consistency.

The service was predominantly clean, and people were protected from the risk and spread of infections. However, some areas of the home required some maintenance work to enable them to be cleaned more effectively.

Risks in relation to people's care had been identified and were managed safely. Systems in place to manage risks in relation to the building and maintenance had improved. However, these required embedding in to practice.

Sufficient numbers of staff were available to meet people’s need in a timely way. People received their medicines as prescribed.

People were safeguarded from the risk of abuse. Staff confirmed they received training in this subject and could explain what action they would take if they suspected abuse taking place.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 20 February 2019). The provider completed an action plan after the last inspection to show what they would do to improve.

At this inspection enough improvement had not been made or sustained and the provider was still in breach of regulation.

Why we inspected

This was a planned inspection based on the previous rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

Enforcement

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Anchor House is a care home providing personal and nursing care for up to 23 people. It is situated on the outskirts of Doncaster in the area of Town Moor. Accommodation is provided on both ground and first floors. At the time of our inspection there were 22 people using the service.

People’s experience of using this service and what we found

The provider had a system in place to monitor the quality of service provided. Some concerns raised during the auditing process were identified, although some issues were not resolved. We found concerns with about the way health and safety issues of the building were managed. People's views were captured in residents’ meetings; however, an annual quality survey was available but had not been completed for about two years.

Medicines were administered in a safe way. Storage of medicines needed review as the medication room was often above the recommended temperature for storing medicines and the flooring required attention to make it safe. The home was clean and was in the process of redecoration. The registered manager was in the process of working through some actions from the last fire officer’s visit in readiness for reinspection later in February 2020.

The registered manager told us that the gas supply was serviced annually, however there was no gas safety certificate on site. However, this was sent to us following our inspection. The registered manager was also taking action following concerns which had been raised at the recent food hygiene inspection.

The provider had a system in place to ensure people were safeguarded from the risk of abuse. Staff knew how recognise and report abuse. Risks associated with people's care had been identified and appropriately managed to ensure risks were minimised. Lessons were learned when things went wrong. The registered manager kept a record of accidents and incidents and made changes to practice, where appropriate.

People's needs were assessed, and care and support were delivered in line with people’s choices. People received a balanced and varied diet which met their needs and suited their preferences. Staff we spoke with told us they felt supported by the registered manager and said they received training and support to carry out their role effectively.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

We observed staff interacting with people and found them to be kind, caring and friendly. Staff respected people’s privacy and dignity. There was a focus on people making choices and staff ensured preferences were adhered to. Staff worked together well as a team to ensure people were supported and their needs met.

Care plans were written in line with people's assessed needs and staff knew people very well. The provider had an activity co-ordinator who arranged activities and social stimulation. The provider had a system in place to monitor and deal with complaints. End of life care was documented in people's care plans as and when people felt able to discuss this. The registered manager and the deputy manager were both end of life care champions and had received training to support their role.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 20 February 2019). The provider completed an action plan after the last inspection to show what they would do to improve.

At this inspection enough improvement had not been made or sustained and the provider was still in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Enforcement

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Anchor House is a care home providing accommodation for up to 23 people. It is situated on the outskirts of Doncaster in the area of Town Moor. Accommodation is provided on both the ground and first floors and a secure accessible garden at the rear. At the time of our inspection there were 15 people using the service.

People’s experience of using this service:

At the time of our inspection the service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons.' Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Audits were in place to monitor the service. However, these were not always effective and did not always identify issues we found as part of this inspection. Some issues which had been identified had not been actioned.

There was not always enough staff available to meet people’s needs and to complete essential jobs around the home such as cleaning. Some days the home did not have a domestic staff on duty which impacted on the care staff who were then responsible for the essential cleaning of the home.

We completed a tour of the service with the deputy manager and found there were some areas of the home which required attention as they were tired and worn.

People were supported to have maximum choice and control of their lives and staff supported people in the least restrictive way possible; the policies and systems in the service were designed to offer people maximum choice.

During our inspection we observed staff interacting with people and found they were kind and caring and treated people with dignity and respect.

Health care professionals were requested when people needed their support and guidance. Staff we spoke with confirmed they received training and support to carry out their roles and responsibilities. People received a balanced diet which met their needs and dietary requirements. Drinks and snacks were provided throughout the day.

We looked at care records and found they were clear and concise and contained relevant information. We observed staff supporting people in line with their individual care plans. On the day of our inspection there were no social stimulation provided for people who used the service.

More information is in the full report

Rating at last inspection:

Good (report published 28 September 2016).

Why we inspected:

This was a planned comprehensive inspection based on the rating at the last inspection.

Anchor House is a care home providing accommodation for up to 23 people. It is situated on the outskirts of Doncaster in the area of Town Moor. Accommodation is provided on both the ground and first floors. The first floor can be accessed by stairs or a stair lift. Limited parking is available to the side of the building, with further street side parking at the front. At the time of our inspection there were 16 people living at the home.

The service had a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

The home had a welcoming atmosphere, which people described as friendly and homely. Throughout our inspection we saw staff supported people in an inclusive, caring and responsive manner. They encouraged people to be as independent as possible, while taking into consideration their abilities and any risks associated with their care. The people we spoke with made positive comments about how staff delivered care and said they were happy with the way the home was managed.

People told us that in their opinion the home was a safe place to live and work. We saw there were systems and processes in place to protect people from the risk of harm. Staff were knowledgeable about safeguarding people from abuse, and were able to explain the procedures to follow should there be any concerns of this kind. Assessments identified any potential risks to people, such as risk of falling, and care files contained management plans to reduce these risks.

Medicines were stored safely and procedures were in place to ensure they were administered correctly. We saw people received their medications from staff who had been trained to carry out this role.

There was a recruitment system in place that helped the employer make safer recruitment decisions when employing new staff. We found new staff had undertaken an induction when they commenced working at the home. Staff had access to a varied training programme and support to help them meet the needs of the people who used the service. However, training updates had not always been completed in a timely manner.

People were provided with a choice of healthy food and drink ensuring their nutritional needs were met. We saw specialist diets were provided if needed and the people we spoke with said they were happy with the meal choices available.

People had been assessed before they moved into the home to make sure their needs could be met. Each person had a care plan which contained information about their assessed needs and preferences, but some files contained more information that others.

People told us they enjoyed the social activities provided, and could choose not to participate if they preferred. However, their participation in the activities on offer had not been consistently recorded.

The company’s complaints policy was available to people using or visiting the service. People told us they had no complaints, but would feel comfortable speaking to staff if they had any concerns.

There was a system in place to enable people to share their opinion of the service provided and the general facilities available. We also saw an audit system had been used to check if company policies had been followed and the premises were safe and well maintained. These were in the process of being reorganised to ensure the areas needing improvement, found by the council and at our inspection, were identified and addressed in a more timely manner.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We saw that people were treated with respect by the staff. Individual risks had been identified as part of the support and care planning process. These were managed and reviewed by staff. This ensured people's needs were met.

Is the service effective?

People's health and care needs were reviewed, and they were involved in the reviews.

We found supporting documents in relation to monitoring people's care needs had been improved. Staff were completing them and regularly reviewing them. This ensured any changing needs were identified.

Is the service caring?

We observed care workers interacted positively with people who used the service. Staff showed patience and gave encouragement when supporting people. One person we spoke with told us, 'It is very good, I have settled in and the staff look after me and they are very nice.'

A relative said, 'My relative is getting great care, they are looking better every time we visit.'

Is the service responsive?

The manager had implemented a number of improvements since our last inspection. Which have addressed the shortfalls we had identified.

Is the service well-led?

The manager had introduced new audits and reviews. These had begun to be implemented, but were not embedded into practice.

We found the policies and procedures had not been updated or reviewed to ensure staff were aware of correct procedures to follow. The manager was in the process of completing this.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, speaking with the staff supporting them and looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We found quality monitoring systems were in place. This ensured the risks to people were identified and reduced, to be able to continually improve. However these had not been completed since May 2014 and were overdue at the time of our visit.

Assessments of needs were in each plan we looked at. However the plans were not person centred and staff did not always deliver care in line with people's assessed needs.

There were systems in place to reduce the risk and spread of infection within the home. Overall the home appeared visibly clean and tidy however there were several areas around decontamination of equipment that needed to be addressed. We also identified some environmental issues that required attention.

Is the service effective?

People's health and care needs were reviewed; however there was no evidence that people were involved in their reviews. We also identified that some monitoring records were not reviewed, which meant people's needs may not be met.

We spent time in the dining rooms during lunch and found the experience for people who used the service was very good. The food was attractive, well presented and appetising.

Appropriate checks were undertaken before staff began work and there were effective recruitment and selection processes in place.

The service did not have a designated domestic store, the equipment and chemicals were stored throughout the home. The sluice arrangements also required attention.

Is the service caring?

We observed care workers interacted positively with people during lunch time. Conversations were inclusive and we observed staff and people who used the service joking together.

People told us they were well looked after and had their needs met. One person told us, 'The staff respect me.' Another person said, 'good carers here.'

Care files contained information about people's needs and preferences. However we found not all people's needs were clearly documented. This could mean care and support may not be provided in accordance with people's wishes.

Is the service responsive?

The manager followed a quality monitoring system that identified shortfalls and ensured they were rectified. The manager had identified a number of areas which required repair and renewal at the last audit in May 2014. We saw not all the actions had been addressed.

The provider took account of complaints and comments to improve the service. We saw there was a system in place to address any complaints that arose.

Is the service well-led?

Staff told us they were supported and worked very well as a team. They told us they had regular meetings ensuring communication was good. Staff we spoke with told us they enjoyed working at Anchor House.

People experienced care, treatment and support that met their needs and protected their rights. One person said, 'It's my life and I live it the way I want to.'

We saw that staff treated people with dignity and kindness. We observed that a friendly and positive approach was used, to ensure that the wishes and needs of people using the service were respected.

We found systems protected people who used the service against the risks associated with the unsafe use and management of medication.

We found people were cared for, or supported by, sufficient, suitably qualified, skilled and experienced staff.

The provider had a complaints policy in place which was available throughout the service. People we spoke with told us they knew who to talk to if they had any concerns.