Archived: Anville Court Care Home

Following the last inspection the service was rated as inadequate and placed in to special measures. At this inspection the service had demonstrated improvements and is no longer rated as inadequate in any of the five key questions, therefore it is no longer in special measures.

Anville Court is registered to provide accommodation with nursing and personal care for up to 50 older people including people with dementia and people with disabilities. On the day of the inspection there were 27 people living at the home. There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

We found that medicines were not always prepared and administered in accordance with the manufacturer’s guidelines. People told us they felt safe and we found they were supported by staff who knew how to protect people from harm. People were supported by sufficient numbers of staff who were available to respond when people needed them. Risks to people’s safety had been assessed and care and support was delivered in a way that kept people safe from harm.

People were asked for their consent before care and support was provided by staff. People’s capacity had been assessed and recorded so that staff knew how to support people when making choices and decisions. People were happy with the food and drink provided and there were systems in place to ensure people received adequate nutrition and hydration. People were supported by staff who felt they had received training to equip them to do their job. People had access to healthcare when they required it and people’s health needs were monitored by staff and any changes were identified and reported.

People told us staff were caring and everyone we spoke to told us their care was good. Staff knew people’s personal histories and understood their needs and preferences. People told us they were involved in decisions about their care. People were supported by staff in a way that maintained their dignity and protected their privacy.

People and their relatives told us they were involved in their care planning. People knew how to complain if they were unhappy about the care they received and were confident the provider would listen to their concerns and take appropriate action. People took part in activities that interested them and a resident’s committee had been established to represent the views of people living at the service.

Systems in place to monitor the care provided were effective and identified areas where improvements needed to be made. People, relatives and staff expressed their confidence in the registered manager. People and staff felt able to contribute to the development of the service and the registered manager demonstrated the skills and knowledge required for their role.

Below is a summary of what we found. The summary describes what people using the service, and the staff told us, what we observed and the records we looked at. We used the evidence we collected during our inspection to answer five questions.

Is the service safe?

People were treated with respect and dignity by the staff. Care plans had been developed. They identified people's needs and were reviewed regularly. Staff demonstrated a good understanding of people's needs. People were given choices and supported to make decisions themselves. Risk assessments were in place for things such as moving and handling, hydration and skin integrity. Control measures had been put in place. This meant that people's needs were met and people were kept safe. People we spoke with told us they felt safe. A relative we spoke with said, 'I've seen it [The home] at its worst and now at its best, it's great and safe.'

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Documented procedures were in place for The Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made. This meant that systems were in place to safeguard people as required.

Staff had received training in The Mental Capacity Act 2005. We saw mental capacity assessments and any subsequent best interest decisions that had been made. Records identified when people lacked capacity to make their own decisions. This meant that systems were in place to safeguard people as required.

People were protected from the risks of inadequate nutrition and dehydration. We saw that weekly menus were in place. These gave people choices of healthy balanced diets. Kitchen staff had details of people's dietary needs and records were maintained of people's fluid and dietary intake when they had been assessed at risk. Most of the records had been completed accurately. A hostess was employed by the home to ensure people received adequate hydration.

People received care and support from staff who had the skills, experience and knowledge to meet people's needs. This helps to ensure that people's needs are always met.

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints and concerns. People had access to a copy of the complaints procedure. This reduced the risks to people and helped the service to continually improve.

On a previous inspection we had found people were not protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not maintained. During this inspection we found that systems were in place to quickly identify any issues related to the accuracy of recording. We saw evidence that improvements had been made. This was confirmed by a relative who checks daily records for accurate recording.

Is the service effective?

People experienced care and support that met their needs. People told us how they were supported. The registered manager told us they worked with other agencies to ensure people's health and social care needs were met. Relatives confirmed that the people receiving care and support were involved in decisions about their care. This meant that people received care in the way they wanted.

Regular audits and checks took place. Issues identified were acted on. This meant the service had effective systems in place to identify improvements and continually meet people's needs.

Is the service caring?

People were supported by kind and attentive staff. Staff we spoke with told us how they supported people. People confirmed staff were caring. We saw that staff were polite, respectful and considerate towards people. They demonstrated patience and reassured people. One person said, 'It has improved a lot, I wouldn't want to go anywhere else.'

People's preferences, likes, dislikes and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. People were involved in their day to day care and were supported to maintain relationships that were important to them. Church services regularly took place at the home. This meant people's diversity and individuality were promoted and respected.

Is the service responsive?

We saw records that showed the service responded quickly to meet people's needs and ensured people's safety and dignity was maintained. For example, call bells were answered quickly. People confirmed that they were given choices and encouraged to express their views.

People told us they would speak to the registered manager if they had a complaint. A relative said, 'I have no complaints now.'

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. Staff felt supported in their roles and felt their views were now listened to. Staff we spoke with told us there had been a lot of improvements and told us that the registered manager and deputy manager were very approachable.

The service had a quality assurance system. A number of audits were regularly undertaken. The registered manager showed us information that they had to report to the provider. The registered manager told us that action would be taken as a result of findings. This meant the quality of the service was able to continually improve.

Improvements had been made to ensure people received their meals in a timely manner and to ensure people received sufficient fluids. One person we spoke with told us, 'I have enough to eat and drink.' A relative said, 'I have no concerns about the food provided, my relative seems satisfied.'

We found that some improvements had been made to ensure people's care records contained specific information about their care needs. However further improvements were required to ensure these records accurately reflected people's current needs.

People that were able to speak to us told us that staff respected their privacy and dignity and they confirmed they were involved in the way their care was provided.

People and their relatives with told us they were happy with the care and support provided. One person said, 'I am well cared for here, the staff are respectful and ensure my dignity is maintained when they support me with my personal care.' A relative told us, 'We are more than happy with the care that is provided to our relative.'

People were provided with a choice of meals, but sometimes had to wait for their meals and drinks to be provided. Not everyone had been supported to drink enough which meant they could be at risk of dehydration.

We found that there was sufficient number of staff available to meet people's care needs.

People and the relatives we spoke with confirmed they knew how to make a complaint if they needed to. This meant systems were in place to enable people or their relatives to raise any concerns they may have.

We found that people's care records were not always fit for purpose and detailed.

We found that improvements were still being made to the way people's care needs and health conditions were recorded. However we found that care was not always delivered in accordance with people's individual needs.

Some of the people and relatives we spoke with were happy with the way care was delivered. One person told us, 'The staff are brilliant and I am happy with the care I receive'.

We found that a training plan had been implemented to ensure staff received refresher training in the required mandatory areas. We found that a staff supervision plan was in place, and staff were now receiving supervision.

We found that improvements were ongoing to increase the staffing levels to ensure they were sufficient to meet people's needs.

We found that arrangements were in place to identify shortfalls, and action was being taken to make improvements.