Archived: Sarah Anne Residential Home

Updated 15 September 2015

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 was carried out on 25 June 2015 and was unannounced. The inspection team consisted of two adult social care inspectors.

We reviewed the information we held about the service before we carried out the visit. This usually includes a review of the Provider Information Return (PIR). However, we had not requested the provider submit a PIR. The PIR 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 looked at the notifications the Care Quality Commission had received about the service.

We received information about the home from one of the commissioners of the service prior to carrying out the inspection.

During the inspection visit we spoke with seven people who lived at the home and a visiting relative. We also spoke with two care staff, a senior carer and the registered manager.

We viewed a range of records including: the care records for three people who lived at the home, staff files, records relating the running of the home and a number of policies and procedures.

We carried out a tour of the premises and this included viewing communal areas such as the lounge, dining room and communal bathrooms. We viewed a sample of bedrooms and we also viewed the kitchen and laundry facilities.

Updated 15 September 2015

Sarah Anne Residential Home is a care home that provides accommodation for up to 13 adults. The home is a four storey building and accommodation is provided over three floors. Access to upper floors is via a staircase or passenger lift. The service is situated close to a railway station in Blundellsands, Merseyside.

There was a registered manager at the service at the time of our inspection. 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.

The registered manager told us they had managed and owned the home for 29 years. The manager was described as ‘approachable’ and people who lived at the home told us they felt able to discuss any concerns they had with them.

Care staff told us they were confident about recognising and reporting suspected abuse and during discussions with the registered manager they told us they were aware of their responsibilities to report abuse to relevant agencies. However, there was no adult safeguarding policy available for us to view at the time of the inspection.

Staff worked well with health and social care professionals to make sure people received the care and support they needed. Staff referred to outside professionals promptly for advice and support. A visiting health professional gave us very good feedback about the service and told us they thought the standard of care was good.

Care was not well planned and records relating to the care and treatment provided to people were poor. People’s needs had not been appropriately assessed before they were admitted to the home. Care plans we viewed did not provide sufficiently detailed information/ guidance on how to meet people’s needs. Risk assessments were not being carried out appropriately. Those we viewed were basic and inaccurate and there were no corresponding care plans in place to show how risks were managed/mitigated. Other records about people’s care were poor and failed to demonstrate the care provided. The manager told us they were working alongside the commissioners of the service to improve the records they made about people’s care and support.

We checked a sample of medication in stock against medication administration records. Our findings indicated that people had been administered their medicines as prescribed. However, some medication practices required improvement. This included: the way in which medicines were stored and the way in which records were maintained.

The manager was able to tell us how they would ensure a decision was made in a person’s best interests if it was deemed that the person did not have the mental capacity to make a specific decision. At the time of our inspection the manager advised us that nobody living at the home lacked the mental capacity to make the decisions required of them. Some members of the staff team had been provided with training in the Mental Capacity Act but this had not been provided to all staff.

During the course of our visit staff supported people in a warm and a caring way. People who lived at the home and a visiting relative gave us positive feedback about the staff team.

There were sufficient numbers of staff on duty to meet people’s needs. This was reported to us by people who lived at the home, members of the staff team and a visiting relative.

The turnover of staff was low and most staff had worked at the home for a number of years. We were therefore not able to assess the way in which staff were recruited currently. We did however see some shortfalls in the recruitment of the newest member of staff who was employed at the home over 12 months ago.

Staff told us they felt sufficiently trained and experienced to carry out their roles and responsibilities. However, we found some gaps in staff training as some staff had not been provided with updated/refresher training. Staff told us they felt well supported in their work. However, we found staff were not being provided with regular formal supervision or appraisal and team meetings were not taking place on a regular basis.

The premises were warm, comfortable and homely. The provider was able to demonstrate that a number of checks were being carried out on the home environment. However, some of the records of these checks were not sufficiently detailed.

People told us they felt the home was clean and most areas we viewed were appropriately clean and tidy. Staff had been provided with infection control training and we saw them follow infection control practices. Staff training records however, showed that some staff had not had up to date training in infection control.

The home is a four storey detached house and there were steps to access the premises both at the front and the side. There was no ramped access for people who use wheelchairs to access the building. The provider had obtained a specialised chair to assist people to gain access via the front steps. A passenger lift was available for people to access rooms on the upper floors.

Records relating to the needs of the people who lived at the home and the running of the business were not maintained appropriately. The provider was not able to clearly demonstrate the care provided to people who lived at the home and to evidence that risks to people’s welfare and safety were being mitigated. Many of the records we saw relating to the running of the home were poorly maintained and not fit for purpose.

The provider did not have effective systems in place to regularly check on the quality of the service. There were no quality audits carried out and the views of people who lived at the home and their relatives had not been sought for some time.

You can see what actions we have told the provider to take at the end of this report.