Anson Court

Anson Court is a residential care home providing personal to up to 75 people. The service provides support to older people, some of whom are living with dementia, in one purpose-built building. At the time of our inspection there were 70 people using the service.

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

There were robust monitoring processes in place to help ensure a good standard of service. Quality assurance systems identified any areas that needed further development and any remedial actions were implemented. However, the overview of accidents and incidents needed to be more robust to help ensure any themes and trends were identified and if any additional actions were needed.

There had been a high number of falls and incidents in the home. The team were working with external professionals to review people’s needs, review medicines, check equipment, provide staff training and referrals to health professionals. They had seen a reduction In falls and incidents due to this work.

The registered manager was away from the service at the time of the inspection visit, the service was supported by manager from another of the provider’s locations. They worked closely with the care team and the regional manager to help ensure consistent management and a good service for people.

People felt they were safe and well supported by the service. Individual risks were assessed, and staff were aware of these. Reviews of events and accidents were carried out and any actions needed were undertaken. Medicines were managed well, and staff knew how to report any concerns about people’s safety or welfare. People told us there was usually enough staff to meet their needs. Staff communicated well to help ensure needs were met in a timely way.

Infection control was managed well. People were happy that staff no longer needed to wear masks. There was a risk assessment in place should the use of masks be needed.

Staff received appropriate training for their role and people felt they had good knowledge and skills. Staff felt supported by the provider and management team. People told us staff assisted them with eating and drinking as needed and respected their preferences and choices.

People and relatives told us staff were kind and caring, they were happy living at Anson Court. Interactions observed were very positive, staff responded to people in a way that anticipated their needs and demonstrated they knew people well. All observations found staff to be attentive and caring about the people they supported.

People told us they enjoyed the activities available. Observations found people having plenty to do and a positive atmosphere in the home. The building set up enabled people to move around and gave opportunities for socialising. The building was decorated nicely and felt homely.

Staff enjoyed working at Anson Court and wanted to ensure people were happy and well cared for. Care plans included all information needed to support people safely and in accordance with their wishes and preferences. These were reviewed regularly.

People, relatives and staff felt their views about the service could be sought more often. People and staff told us that the registered manager was often around the home and meetings were held but more opportunities for sharing views would be helpful.

People were supported to have maximum 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.

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 inspection was not rated (published 2 February 2021). The last rating for this service was good (published 14 April 2018).

Why we inspected

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The inspection was prompted in part by notification of an incident following which a person using the service died. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk of people’s safety and incidents. This inspection examined those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Anson Court Care Home on our website at www.cqc.org.uk.

Recommendations

We recommend that the management team ensure that staffing levels are amended as needed during times when factors may increase incidents between people or when they may become more unsettled causing them to fall. For example, when people may be suffering from an infection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

¿ The staff at the home helped people to keep in touch with their families and friends. Physical visits within the home had stopped due to the national lockdown. There were phone and video calls and letters and postcards.

¿ At Christmas each unit had a socially distanced video party with an online singer and families could log in and join in. In addition to this all relatives were sent a Christmas card with a photo of the person and a personalised message.

¿ Staff were seen engaging well with people. People told us staff worked hard to limit the impact of the restrictions on them.

¿ The individual units were being managed as cohorts so people living on those units could socialise with each other, if they were not isolating. Staff worked on the same units to reduce the risk of cross infection.

¿ The provider had developed policies, procedures and risks assessments for managing the service in relation to COVID-19. Staff told us the management team checked they were working safely.

¿ When people moved into the home or returned from hospital, they were required to isolate in their rooms, for a set period of time, even if they had a negative test. Staff were clear on what it meant to isolate and what symptoms of COVID-19 to look out for.

¿ There was clear signage and guidance displayed.

¿ Staff received training on donning and doffing Personal Protective Equipment (PPE), infection control and COVID-19. They told us they felt very supported and had enough information to do their jobs.

Further information is in the detailed findings below.

We found the following examples of good practice.

¿ The service had introduced video calls to help people stay in contact with their families and friends. Letters and cards were sent and a social media page was set up so relatives could see their family members participating in events and activities. When visits were safe to go ahead, there were effective systems in place to facilitate these.

¿ The individual units were being managed as social bubbles so people living on those units could enjoy a range of activities together and eat meals together. Staff mainly worked on the same units to reduce the risk of cross infection and to establish relationships with people.

¿ The provider had developed policies, procedures and risks assessments for managing the service in relation to COVID 19.

¿ When a person was new to the home or returning from hospital, they isolated for a set period of time, even if they had a negative test. Guidance on isolation dates was displayed so the person and staff knew how long this needed to be. Staff were clear on what it meant to isolate.

¿ Staff received training and told us they felt supported and equipped for their roles.

Further information is in the detailed findings below.

Anson Court 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.

Anson Court provides accommodation for up to 75 people. Some of these people live with dementia, old age and physical disability. The home is not currently registered to provide nursing care but an application was in progress to provide nursing care at the time of the inspection. At the time of the inspection there were 45 people living there.

The service had a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run.

The service was run by a management team that knew people well and had a people first outlook. There were quality assurance systems in place and these identified shortfalls allowing for appropriate remedial action to be taken. People, relatives and staff were positive about the management of the service.

People’s care needs, for all aspects of their lives, needed to be met consistently. Care records at times had gaps that did not allow for effective review of people’s wellbeing. There was also a need for further development was needed in relation to activities. People’s feedback was sought, although this had only commenced recently.

People felt safe and were supported by sufficient staff who had undergone appropriate recruitment process. Medicines were managed safely and risks were identified and management plans were in place to mitigate these risks. The management team shared learning from any events such as medicine errors, themes from incident analysis or complaints.

People were supported in accordance with the principles of the Mental Capacity Act. People were supported by staff who were trained and had opportunities for supervision.

People were encouraged to eat a healthy and balanced diet and there was appropriate access to health and social care professionals. We found the design of the building promoted a friendly and welcoming environment.

People were supported by staff who were respectful and kind. We found that privacy and dignity was promoted in most instances. Confidentiality was maintained.