Archived: Anchorage House

Anchorage House provides accommodation and personal care for up to six people who have learning disabilities, some health conditions and some complex and challenging behavioural needs.

There were six people living at the service; we met and spoke with five of them. People told us they liked living at the service and received the care and support they needed. They were happy with their support arrangements; they liked the staff and told us staff were kind and caring. They thought the service was clean and tidy and provided a comfortable living environment.

Accommodation is arranged over three floors and each person had their own bedroom. Bath and shower facilities were shared.

The service did not require a registered manager as the provider manages this service and another owned locally by her. 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. The provider was present during the inspection.

Staff followed correct and appropriate procedures in the storage and dispensing of medicines. People were supported in a safe environment and risks identified for people were managed in a way that enabled people to live as independent a life as possible. People were supported to maintain good health and attended appointments and check-ups. Health needs were kept under review and appropriate referrals were made when required.

A system to recruit new staff was in place. This was to make sure that the staff employed to support people were fit to do so. There were sufficient numbers of staff on duty to make sure people were safe and received the care and support they needed.

Staff had completed induction training when they first started work at the service. Staff were supported during their induction, monitored and assessed to check that they had the right skills and knowledge to be able to care for, support and meet people’s needs. There were staff meetings, so staff could discuss any issues and share new ideas with their colleagues, to improve people’s care and lives.

People were protected from the risk of abuse. Staff had received safeguarding training. They were aware of how to recognise and report safeguarding concerns. Staff knew about the whistle blowing policy and were confident they could raise any concerns with the provider or outside agencies if needed.

Equipment and the premises received regular checks and servicing in order to ensure it was safe. The provider monitored incidents and accidents to make sure the care provided was safe. Emergency plans were in place so if an emergency happened, for example a fire, the staff knew what to do.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The provider and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). People had been assessed as lacking mental capacity to make complex decisions about their care and welfare. At the time of the inspection the provider had applied for DoLS authorisations for people who were at risk of having their liberty restricted to help keep them safe.

The care and support needs of each person were complex, and each person’s care plan was personal to them. People had detailed care plans, risk assessments and guidance in place to help staff to support them in an individual way.

Staff encouraged people to be involved and feel included in the running of the service. People were offered activities and participated in social activities when they chose to do so. Staff knew people and their support needs well.

Staff were caring, kind and respected people’s privacy and dignity. There were positive and caring interactions between the staff and people and people were comfortable and at ease with the staff.

People were encouraged to eat and drink enough and were offered choices around their meals and hydration needs. Staff understood people’s likes and dislikes and dietary requirements and promoted people to eat a healthy diet.

Quality assurance audits were carried out to identify any shortfalls within the service and how the service could improve. Action was taken to meet any improvements identified.

Staff told us that the service was well led and they felt supported by the provider. The provider had good management oversight and was able to assist us in all aspects of our inspection.

Anchorage House provides accommodation and personal care for up to six people who have learning disabilities or autistic spectrum disorder, some health conditions and some challenging behavioural needs.

Accommodation is arranged over three floors and each person had their own bedroom. Bath and shower facilities were shared.

Six people lived at the service and we met and spoke with each of them. People told us that they liked living at the service and received the care and support they needed. They were happy with their support arrangements; they liked the staff and told us staff were kind and caring. They thought the service was clean and tidy and provided a comfortable living environment.

The service did not require a registered manager as the provider manages this service and another owned by her locally. 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. The provider was present during the inspection.

At this inspection we found improvement was required in some areas where some regulations were not being met.

Arrangements for the maintenance and repair for some parts of the service were not given sufficient priority; one person’s bedroom was damp with mould visibly growing on a wall and shelves.

Quality assurance checks were not fully effective because they had not identified the maintenance shortfalls we found or ensured they were completed in an appropriate time scale.

Medicines were safely stored and correctly administered; established processes were in place to order medicines and safely dispose of any medicine that was no longer needed.

People were supported by engaging and enthusiastic staff who received regular training and appropriate supervision. There were enough staff to meet people’s needs.

Recruitment processes were robust, proper consideration was given to Disclosure Baring Service (DBS) checks to ensure suitable staff were employed by the service.

Where the service had a legal obligation to notify the Commission of certain decisions and events, correct notification was made.

Staff were aware of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and applied these principles correctly.

People had personalised records detailing their care and support, including well developed support plans for their emotional and behavioural needs.

People were supported to access routine and specialist health care appointments. People told us staff showed concern when they were unwell and took appropriate action.

People enjoyed their meals, they were involved in deciding what they wanted to eat and went shopping to buy groceries.

Staff were caring and responsive to people’s needs and interactions between staff and people were warm, friendly and respectful.

Staff spent time engaging people in communication and activities suitable for their current needs.

People felt comfortable in complaining, but did not have any concerns. People, relatives and visiting professionals had opportunities to provide feedback about the service provided both informally and formally. Feedback received had been reviewed and acted upon.

The provider had a set of values forming their philosophy of care. This included treating everyone as an individual, working together as an inclusive team and respecting each other. Staff were aware of these and they were followed through into practice.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Care records showed that people had been supported and encouraged to make decisions about their lives. We saw that people had been involved in planning their care and support and in giving consent for care to take place. When people's needs changed, we found that records had been updated to reflect this.

Medicines were stored correctly and administered in line with the home's procedure. Staff were trained in medication management and records were kept clearly and concisely.

The premises were suitable for the people living in them. Maintenance work was undertaken on a routine basis. Effective communication took place to record and prioritise works.

Staff spoken with demonstrated good understanding of how to support the people they worked with. Training records showed that staff were suitably trained and supported in their role. This included training specific to the people living in the service. Staff reported feeling supported by managers and colleagues.

People told us they were happy with the care they received and they felt that they were listened to and well looked after.

Staff were observed interacting with people in a relaxed and friendly way. They listened to people's requests and responded quickly and cheerfully. People's wishes for independence was encouraged and staff showed a good understanding of people's needs.

We saw that people were treated with dignity and respect and had choice, and their views and needs were taken into account and catered for. We found that there were enough staff on duty to meet people's needs.

Records showed that staff had been properly recruited, trained and supervised and that the service had systems in place to safeguard people. We found that the service monitored quality of care regularly and acted on any issues that had arisen.