Background to this inspection
Updated
21 January 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 03 and 04 December 2015 and was unannounced.
This inspection was carried out by two adult social care inspectors and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Prior to the inspection we reviewed information we held about the service including notifications the service is required to send us about significant events, such as safeguarding and deaths. We also looked at any information we had received in the form of feedback left through ‘share your experience’ forms on the CQC website, or submitted to us by email.
Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We contacted the local authority quality assurance (PMMD) team for feedback as well as the local authority safeguarding team and a social worker with recent experience of the home.
During the inspection we spoke with eight staff. This included four care staff, the registered manager, the area manager, the activity co-ordinator and a domestic. We spoke with three relatives who were visiting at the time of our inspection and six people who were living at the home. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We looked at documents relating to the care people were receiving. This included six care files and five medication administration records (MARs). We looked at other documents relating to how the service was run, including audits, rotas, training records, records of servicing and maintenance and five staff personnel files.
Updated
21 January 2016
This inspection took place on 03 and 04 December 2015 and was unannounced. At our last inspection of Ancliffe residential home on 01 July 2014 we found the home to be meeting all standards that were inspected.
Ancliffe Residential Home is located in Goose Green, a residential area approximately one mile from Wigan town centre. It is situated in close proximity to bus routes, local shops and other public amenities. The home provides personal care to up to 40 older adults. Bedrooms are located on one level and the home is arranged around two courtyard gardens. At the time of our visit there were 40 people living at the home.
At the time of our visit there was a registered manager in post. 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.
Staff and the relatives of people we spoke with told us they thought the service had a ‘family atmosphere’. We received positive feedback about the staff and the registered manager from people living at Ancliffe and their relatives. Staff told us they would be happy for a friend or relative to move in to the home, and several people told us they had either recommended the home to others, or had had a family member stay at the home in the past.
Prior to the inspection we received positive feedback from the relative of a person formerly living at the home about the caring approach of staff and in relation to activities. There was an activities co-ordinator employed by the service and we saw a large number of people during the inspection were engaged in the activities that had been arranged.
We saw that people living at the home had formed friendships with each other and staff supported social interaction between people. For example, we saw a small group of people chose to eat together in a separate area of the home where they could look out onto one of the garden areas. On the day of the inspection it was one person’s birthday and we saw people celebrate the occasion.
We found there were sufficient numbers of staff to meet people’s needs in a timely manner on the day of the inspection. However, one staff member told us that not all the shifts were covered, and the rotas we looked at confirmed this. The registered manager told us on these occasions other staff, such as domestics would help provide staff cover if required, as they were trained to do so. Staff confirmed this was the case, although this was not recorded on the rota.
People had risk assessments in place to help ensure any risks were minimised. We saw appropriate actions had been taken to help ensure people’s safety following falls. However, one person’s file was missing a falls risk assessment, and another person’s falls risk assessment had not been updated following a fall. The registered manager told us these documents had been reviewed prior to the end of the inspection.
People told us they felt safe at the home. Staff had received training in safeguarding and were able to tell us how they would identify any safeguarding concerns. Medicines were stored and administered safely.
Some adaptations had been made to the environment to make it more ‘dementia friendly’. This included pictorial signage and themed corridors. Staff were able to tell us how they would support people living with dementia effectively, despite only approximately half the staff being recorded as having received dementia training.
Staff had received training in a variety of areas such as infection control and first aid. However, no staff were recorded on the training matrix as having received training in the Mental Capacity Act (MCA) or Deprivation of Liberty Safeguards (DoLS). Staff showed a reasonable understanding of MCA and told us they had received training. The registered manager confirmed training had been provided in the past but was not recorded on the services’ training matrix. They confirmed that further refresher sessions had been booked to cover this area.
We saw people’s preferences; including preferences in relation to food were recorded. People we spoke with said they enjoyed the food provided. During the inspection we saw some people requested alternatives to what was recorded on the menu, and these were provided.
We saw people visiting throughout our inspection. Visitors told us they were always welcomed and said that communication with the service was good. There was a dining room, two quiet lounges, a main lounge and a separate visitors’ lounge at the service. People we spoke with commented that the home was always very clean and was homely.
Staff talked to us about having a person-centred approach to providing care and support to people. Staff were able to give examples of how they accommodated individual needs and preferences of people.
People’s care plans had been regularly reviewed and contained the information staff would need to support them effectively. This included information about social history and preferences.
Relatives and people living at the home told us they thought the home was well-led and that the registered manager was approachable. We received positive feedback about the service from a social care professional.
The service had not submitted notifications to CQC about safeguarding incidents as is required. This was due to a misunderstanding about when these notifications were required. This meant we would not be able to accurately monitor the home.
A range of audits were undertaken to help monitor and improve the quality and safety of the service. This included audits of infection control procedures, medicines and a provider audit.
Records did not always accurately reflect the current position of the service. For example, rotas did not always demonstrate if care shifts were covered, and training records did not show what training around MCA and DoLS had been undertaken.