Background to this inspection
Updated
10 July 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team
Our inspection was completed by one inspector, a nurse specialist 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.
Service and service type
Anchorstone Nursing Home is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
Our inspection was unannounced.
What we did before the inspection
Our inspection was informed by evidence we already held about the service. We also checked for feedback we received from members of the public, local authorities and commissioning groups. We checked records held by Companies House. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with three people who used the service and seven relatives about their experience of the care provided. We spoke with the registered manager, the provider and five staff. We observed the care and support provided to those people that we were unable to communicate with. We reviewed four people's care records, three staff files, audits and other records about the management of the service.
After the inspection
We received information from the registered manager to further evidence the care and support people received. We obtained feedback via email from a further eight relatives and six healthcare professionals. All of this was positive about the care and support given.
Updated
10 July 2019
About the service
Anchorstone Nursing Home is situated in a residential street in Farnham, Surrey. The home is registered to provide care and nursing for up to 40 people. The people accommodated at the home are elderly and have a variety of care and mobility needs. All of the people are living with the experience of dementia. At the time of our visit 23 people were living in the home.
The home had been scheduled to close in January 2019, but this was postponed due to additional funding being made available to keep the home open. At the time of our inspection the provider was still looking to sell the home as an ongoing business. This did not impact the level of care and support that people received. It did however impact the provider’s expenditure on the fabric of the building, with maintenance and building work being placed on hold until the future of the home was known.
People’s experience of using this service and what we found
Despite the issues with the building, people, relatives and healthcare professionals overwhelmingly said they would rate the care given at the home as exceeding their expectations. Care staff were focussed on getting to know people and their families and did everything they could to provide an excellent standard of care. Staff knew people as individuals and were able to communicate with them in a way they could understand. The exceptional levels of care and compassion were displayed by staff during and after a person’s life. Families who had lost people while they lived at Anchorstone were thankful for the level of support they had received both during the end of life journey, and afterwards when their loved one had passed away.
The caring nature of staff was obvious in the processes they used to keep people safe. Nursing staff had detailed knowledge of dementia and ensured use of medicines to manage behaviours or sedate people were kept to a minimum. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the home supported this.
Staff understood their roles and responsibilities around keeping people safe, including the identification and reporting process if abuse was suspected. Staffing levels were kept at safe numbers to ensure peoples support needs could be met. These levels were increased when needed, for example when new people came to the home, to ensure the outstanding level of care was maintained. Hazards to people’s health and safety had been identified and well managed to reduce the risk of harm.
Staff received training and supervision which ensured they had the skills necessary to provide care and support that people needed. Nursing staff were given appropriate support and supervision to enable them to maintain their registration with the nursing and midwifery council. Feedback from health care professionals such as doctors and social workers was very positive. They commented on the competence and knowledge of the nursing and care staff which met people’s needs.
People had enough to eat and drink, and the staff kept up to date with best practice. Involvement in hydration projects and use of adaptive equipment such as coloured cups and plates encouraged people living with dementia to eat and drink. This minimised the risk of dehydration and malnutrition.
People were involved in assessments of their needs to make sure the staff could meet those needs in a way people preferred. People had care plans that detailed their care and support needs. We noted that the care records had become very large and would benefit having the old information within them being archived so staff only had access to the most up to date records. Wherever possible people or their relatives were involved in reviews of their care. People had access to indoor activities to help keep them active and stop them being bored.
People and their relatives confirmed the home was well managed. There was a calm and relaxed family atmosphere at the home with people and staff enjoying each other’s company. People, their relatives and staff were all involved in giving feedback about the home, and any areas that may need to be improved. The registered manager listened to feedback and complaints and made changes where they could.
Rating at last inspection:
At the last inspection, the service was rated Good. At this inspection we found the service remained Good.
Why we inspected:
This was a planned inspection based on the previous rating.
Follow up:
We will continue to monitor intelligence 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.