Archived: Anne Residential Homes - 80 Coombe

Following that inspection we asked the provider to send us an action plan setting out the steps they had taken to achieve compliance, which they did on 9 July 2014. During this visit we checked these actions had been completed.

This visit was carried out by a single inspector who helped answer two of our five questions: Is the service safe? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, from looking at records and from speaking with the provider, who was also the registered manager.

Is the service safe?

We found at this visit the provider had taken appropriate steps to protect people from abuse and prevent the risk of this occurring. Training in safeguarding of vulnerable adults for staff had been planned. Staff had also received one to one support from the provider to check their current understanding and awareness of their responsibilities for identifying abuse, what this constituted and what actions they must take to protect people, if they suspected they were at risk.

We were assured of the provider's understanding of their role to ensure that proper authorisation was sought to deprive people using the service of their liberty in a safe, correct way and where this was in their best interests to do so. People's care records showed applications had been made, where this was appropriate.

People's care records had been reviewed and now contained accurate information about their current care and support needs. Risk assessments had also been reviewed regularly which meant there was up to date information about how to protect people from known risks to their health, safety and welfare.

Is the service well led?

The provider had taken appropriate action following our last inspection to make improvements that were needed, and in a timely manner. This included undertaking a review and update of care records and staff files, introducing more training and support for staff and improving work practices in relation to staff recruitment. The provider had also put in place arrangements to regularly check the quality of the service provided.

We carried out this visit to check the provider had taken appropriate steps to comply with the warning notice. We found there had been improvements.

This visit was carried out by a single inspector who helped answer one of our five questions: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, from looking at records and from speaking with the provider. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We found at this visit the provider had ensured appropriate checks had been undertaken of staff employed by the service to ensure they were of good character, physically and mentally fit to perform the work and had the necessary qualifications, skills and experience to care for people using the service. We saw new recruitment processes had been introduced to ensure that appropriate checks were undertaken before people were able to start work at the home.

At our previous inspection on 2 August 2013 we asked the provider to make improvements in relation to the recruitment checks of new employees and record keeping to demonstrate that people were receiving safe and appropriate care. During this inspection we checked whether the provider had made the necessary improvements.

The focus of the inspection was also to answer five key questions: is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found.

Is the service safe?

People were cared for and supported in a clean and tidy environment, and relatives we spoke with told us this was always the case.

People could be placed at risk of poor care and support because the home did not carry out recruitment checks on all new staff to ensure they were suitable for the role. Staff were allowed to start work without a criminal records check, a full and satisfactory employment history and checks to ensure that they were physically and mentally fit to work at the service. Qualifications and experience, as well as skills such as English language ability, were not assessed during recruitment. This meant that some staff were unable to communicate with people in English. We have asked the provider to tell us how they plan to improve their recruitment practices.

The commission monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. We found that staff and management did not fully understand their responsibilities under this act and therefore might not be ensuring the safety of people. There was no evidence that some decisions were made in people's best interests, involving the right people and at the right level. Staff did not have a good knowledge of safeguarding adults and their responsibilities in relation to this. We have asked the provider to tell us how they plan to improve this.

Is the service effective?

Records of care showed that the service was delivered in line with people's care plans, which meant that their assessed needs were being met. A relative told us, '[My relative is] being well looked after, the carers attend to [my relative's] needs. [My relative is being] given good food, everything is being done for [my relative].'

Is the service caring?

People using the service and relatives all commented that the staff were very caring and we saw many interactions between staff and people using the service where staff showed warmth and kindness. We heard how the manager went to great lengths to care for people 'as if they were her own family.'

One person who used the service and relatives told us that the level of activities was adequate for people's needs.

Is the service responsive to people's needs?

Staffing levels were appropriate to meet people's needs. The manager knew the needs of people using the service well. We heard examples of how the manager had noticed early signs of ill health and supported people to seek medication attention quickly. We were also told, 'When [my relative] went into hospital, [the manager] went with her and stayed there the whole time she was waiting, as she does with all the people there. It's a labour of love.'

Is the service well-led?

The home had an experienced registered manager in post who had run the service for around 30 years. People using the service and relatives spoke highly of the manager and commented that they provided a high level of care and attention to people. Relatives felt well listened to, and told us they had not had reason to complain but felt that they would be listened to if they needed to.

The system in place to regularly assess and monitor the quality of the service provided to people, was not always effective to make sure people were protected from the risks of poor and inappropriate care and support. During this inspection we found a number of areas where the provider needed to make improvements. These included improving the arrangements in place to protect people from abuse, having appropriate recruitment processes in place and keeping accurate and appropriate records.

People we spoke with were very pleased with the quality and choice of food provided at the home. "The food is excellent", one person told us. Another told us: "The food is always hot and beautifully served".

We saw that there were policies and procedures in place to protect people who use the service and staff from the risk of infection.

We saw that all areas of the home were clean, well-decorated and free from hazards. People were able to move safely and freely from house to gardens and had easy access to their rooms at all times. The manager had ensured that rooms were aired and kept cool during the hot weather.