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Reports


Inspection carried out on 10 August 2020

During an inspection looking at part of the service

St Anne's Nursing Home provides nursing and residential care to a maximum of 65 men and women who are elderly, have physical care needs or enduring mental health support needs. The service is provided by Blackberry Hill Limited and there were 65 people in residence at the time of our inspection.

We found the following examples of good practice.

The home had an effective admission procedure. All newly admitted people had been tested for Covid19 prior to them coming to live at the home. Each new person had undergone 14 days self-isolation to protect other people living in the home in case the person developed coronavirus symptoms.

An allocated staff member accompanied and supported each new person during the self isolation period. This assured the number of staff exposed to the person in case they developed coronavirus symptoms was limited. This also provided the continuity of care in the new environment and helped the person to settle easier at the home.

People’s and staff individual needs, health and wellbeing had been considered to ensure they lived and worked in the environment that was safe from infection. Each person using the service and staff supporting them had an individualised risk assessment. It reflected their specific risks, personal protective equipment (PPE) required and specific risk management strategies to provide safe care.

Strict cleaning regimes helped to protect people and staff from accidental infection cross-contamination. Additional cleaning staff were deployed to ensure hourly, daily and weekly cleaning schedules were completed.

Staff were appropriately trained. They understood risks related to Covid19, infection prevention and control measures and what action they needed to take if them or a person using the service developed Covid19 symptoms.

The provider and the home’s management team ensured staff were up to date with the latest government guidelines and best practice on how to provide safe care during the pandemic. Staff participated in regular staff meetings, supervisions and additional training when required.

Further information is in the detailed findings below.

Inspection carried out on 29 November 2019

During a routine inspection

St Anne's Nursing Home provides nursing and residential care to a maximum of 65 men and women who are elderly or have physical care needs. The service is provided by Blackberry Hill Limited and there were 63 people in residence at the time of our inspection. Since our previous inspection in May 2017 the service had grown by developing a 15 place unit on the ground floor to accommodate older people who had enduring mental health support needs.

People’s experience of using this service and what we found

Staff knew what they should do to minimise the risks that people faced and to keep people safe but did not restrict people’s right to take reasonable risks.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service understood people’s needs and made detailed plans of care. Decisions about what care people needed and how this should be provided were made with the inclusion of people using the service and their families.

Staff were caring. People we spoke with told us this and we observed many occasions where warm and kind interactions took place. During observations staff were interacting with people in a friendly, patient and compassionate way. All staff, including the activity coordinator and nurses, demonstrated a positive rapport with the people they cared for.

The service was respectful of people living at the home, their relatives and was responsive to people’s current and changing needs.

People using the service and relatives were happy with the care they received, the prompt response of staff when people called for assistance was praised as too was the management of the home.

The home was clean and was well maintained. People were kept safe from fire and other potential hazards.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (Inspection report published on 9 August 2017). At this inspection the service remained good.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information 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.

Inspection carried out on 10 May 2017

During a routine inspection

St Anne's Nursing Home provides nursing and residential care to a maximum of 50 men and women who are elderly or have physical care needs. The service is provided by Blackberry Hill Limited and there were 47 people in residence at the time of our inspection.

This inspection took place on 10 and 11 May 2017 and was unannounced. At our previous comprehensive inspection in March 2015 we found that, although risks were identified and reviewed, there was a lack of consistency among the staff team about how to respond to all potential risks. We also made two recommendations regarding activities and recommended a wider variety and inclusion of activities aimed to promote people’s mobility. At our focused inspection on 23 February 2016, we found that the breach of regulation 9, regarding risk assessments, and the recommendations regarding activities had both been resolved and all the areas of the service were rated as good.

At the time of our inspection, a manager was employed at the service. This person had applied to register with CQC. 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.

There were a mixture of views from people about the choice and diversity of food provided and menu options. The provider acknowledged that improvements to people’s dining experience could be achieved and was taking action to do so. The policy of protected mealtimes lacked clarity, which was acknowledged by the provider and changes were made to explain this more clearly to visitors and staff.

The provider had a policy and guidance available for staff about keeping people safe from abuse and staff had training about this. The members of staff we spoke with had a good understanding of how to keep people safe and what they should do if they had any concerns.

Risks to people using the service were considered and common risks such as the risk of falls and those associated with people’s healthcare needs were included. Any risks associated with people’s individual circumstances were also given attention and responded to.

There were policies, procedures and information available in relation to the Mental Capacity Act 2005 [MCA] and the Deprivation of Liberty Safeguards [DoLS] to ensure that people who could not make decisions for themselves were protected. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People were supported to maintain good health. Nurses were on duty at the service 24 hours and a local GP visited the home each week, but would also attend if needed outside of these times. A GP was visiting and spoke with us during this inspection and told us of how well the home co-operated in response to people’s known and emerging healthcare needs.

Eight people we spoke with that either used the service, or were relatives, specifically commented about caring attitudes of staff and gave examples. The care plans we looked at showed that attention was given to how staff could ascertain each person’s wishes. There had been significant improvement to the efforts that were made to engage people in varied and interesting activities. This received praise from people living at the home and activities were offered to people whether they were able to participate in a group or to do so individually.

Communication between people using the service, relatives and staff were respectful. Although some people said they felt some staff could be more communicative. Staff we spoke with talked about the people they cared for with dignity and respect and we observed compassionate interactions between people using the service and the s

Inspection carried out on 23 February 2016

During an inspection looking at part of the service

St Anne's Nursing Home provides nursing and residential care to a maximum of 50 men and women who are elderly or have physical care needs. The service is provided by Blackberry Hill Limited.

We carried out an unannounced comprehensive inspection of this service on 10 and 16 March 2015. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to Regulation 9 (Person Centred Care).

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for St Anne’s Nursing Home on our website at www.cqc.org.uk.

This focused inspection took place on 23 February 2016 and was unannounced. At our last inspection on 10 and 16 March 2015 the service was not meeting Regulation 9 in respect to person centred care associated with the Health and Social Care Act 2008. There had been insufficient activities or opportunities for people to maintain their mobility. We found at this inspection that the staff we spoke with were aware of the need for encouraging mobility and offering people the opportunity to engage in activities. The service was also able to demonstrate that action had been taken to address the previous breach of regulation.

At the time of our inspection a registered manager was employed at the service. 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 service had been rated as good at the previous inspection and this rating has not changed.

Inspection carried out on 10 & 16 March 2015

During a routine inspection

St Anne's Nursing Home provides nursing and residential care to a maximum of 50 men and women who are elderly or have physical care needs. The service is provided by Blackberry Hill Limited and there were 41 people in residence at the time of our inspection.

This inspection took place on 10 and 16 March 2015 and was unannounced. This is the home’s first inspection since transfer to a new provider on 1 December 2014.

At the time of our inspection a registered manager was employed at the service. 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 staff of the service had access to the organisational policy and procedure for safeguarding people from abuse. They also had the contact details of the London Borough of Islington which is the authority in which the service is located and, with the exception of a small number of people, is the main authority which places people at the service. The members of staff we spoke with said that they had training about protecting vulnerable adults from abuse, which we verified on training records and most were able to describe the action they would take if a concern arose.

We saw that risks to people using the service were considered and common risks such as the risk of falls and those associated with people’s healthcare needs were included. Any risks associated with people’s individual circumstances were also given attention and responded to. The instructions for staff about how to minimise risks were clear.

We saw there were policies, procedures and information available in relation to the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure that people who could not make decisions for themselves were protected. The service was applying MCA and DoLS safeguards appropriately in the small number of cases where people were thought to require assessment. We also viewed follow up action and the new service provider had undertaken a re assessment of all people using the service to ensure that there was an accurate picture of who these areas would apply to.

People were supported to maintain good health. Nurses were on duty at the service 24 hours and a local GP visited the home twice each week, but would also attend if needed outside of these times. Staff told us they felt that healthcare needs were met effectively.

Everyone we spoke with who uses the service and relatives praised staff for their caring attitudes. The care plans we looked at showed that attention was given to how staff could ascertain each person’s wishes, even in the small number of cases where people were suffering with dementia, to maximise opportunities for people to make choices that they were able to make.

It was not evident that enough was being done to encourage people to maintain their mobility or to engage in activities. The provider informed us that an activities co-ordinator was being recruited.

We found that communication between people using the service, relatives, visitors and staff was usually open and respectful. Staff talked about the people they cared for with dignity and respect and knew their responsibilities in providing effective care.

We found that the staff team communicated effectively and there was trust in approaching senior staff and the registered manager to raise anything of concern and to discuss care practices. The views of staff were respected as was evident from conversations that we had with staff and that we observed.

At this inspection we found one breach of regulation. You can see what action we have asked the provider to take at the back of the full version of the report.