Ancliffe Residential Care Home

We found the following examples of good practice.

Robust processes were in place for any essential visitors to the home. Temperature checks were taken automatically via infa-red technology, with a manual thermometer available as a backup. The monitoring system also verbally prompted visitors to put on personal protective equipment (PPE). Each visitor was required to complete a risk assessment, to confirm they were well and displaying no COVID-19 symptoms.

The home was prepared to facilitate internal visitors, in line with government guidance. Training in LFD testing had been completed, with a file set up for each person, in which their nominated visitor was recorded, along with sections to document test results and feedback on how the visit had gone.

The home had robust cleaning procedures in place, which had been increased in response to the pandemic. Frequent touch points had been cleaned as often as hourly, with records evidencing this. Cleaning and infection control audits had been completed monthly, alongside daily walkrounds, to ensure best practice was maintained.

The home had a plentiful supply of PPE, which was worn correctly and consistently by staff. A toilet and washroom close to the entrance, had been converted into a PPE hub, where staff and professional visitors could wash their hands and put on PPE. Additional PPE stations were located across the home. Staff had completed both internal and local authority training in infection control and the safe use of PPE.

Information booklets written in an easy read format had been created and given to each person, which explained all about COVID-19, the need for staff to wear PPE and other relevant information. This had helped people adjust to the changes within the home and reduce any anxieties.

Contact with relatives had been maintained throughout the pandemic, in line with local and government guidance. When permitted, screened indoor visiting had been facilitated via an appointment system. Clear guidance had been drawn up to ensure these were completed safely. Alongside these, the home had supported video and telephone calls, alongside window visits.

Social distancing was promoted, with furniture in communal areas spaced out to support this. Limits on how many people could access each communal area was also in place. Where people had displayed any symptoms, isolation had been used effectively. To date, the home had not had any cases of COVID-19.

Ancliffe Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The home is located in Goose Green, a residential area approximately one mile from Wigan town centre and is registered to provide accommodation for up to 40 people who require personal care and support. At the time of this inspection 40 people were living at the home, although three were in hospital.

The service had a registered manager. 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.

Each person we spoke with told us they felt safe and enjoyed living at Ancliffe Residential Care Home. Relatives were also complimentary about the standard of care provided. We saw staff had received training in safeguarding, which was refreshed in line with the providers policy and knew how to report concerns. The home had appropriate safeguarding policies and reporting procedures in place and had submitted notifications to the local authority and CQC as required.

We found the home to be clean with detailed cleaning checklists and appropriate infection control processes in place. Staff wore personal protective equipment (PPE) to prevent the spread of infection and toilets and bathrooms contained hand hygiene equipment and guidance.

People, relatives and staff told us enough staff were on duty to safely meet needs. Staffing levels were based on people’s dependency levels and rotas we viewed during the inspection confirmed the required number of staff had been deployed at all times, with any shortages due to sickness or absence filled by existing staff members, to ensure consistency of care.

We saw medicines were stored, handled and administered safely and effectively. All necessary documentation was in place and had been completed consistently. The home’s quality monitoring procedures, had highlighted any gaps or omissions in medicines documentation and taken steps to address this. Staff responsible for administering medicines had been trained and had their competency assessed.

We found care files contained detailed risk assessments, which had been regularly reviewed to reflect people’s changing needs. This ensured staff had the necessary information to help minimise risks to people living at the home.

Staff spoke positively about the support and training provided. We saw staff had completed an induction programme upon commencing employment and on-going training was provided, both e-learning and practical, to ensure skills and knowledge remained up to date. Staff also told us they received regular supervision and annual appraisals, which along with the completion of quarterly team meetings, meant they were supported in their roles.

We found meal times to be a positive experience, with people being supported to eat where they chose. Staff engaged in conversation with people and encouraged them throughout the meal, providing support to those that required it as per their care plan. Food and fluid charts had been used where people had specific nutritional or hydration needs, with clear guidance in place for staff to follow.

Throughout the inspection we observed positive and appropriate interactions between the staff and people who used the service. Staff were seen to be caring and treated people with kindness, dignity and respect. It was apparent from our observations, staff knew the people they supported and had formed positive relationships. People told us they would feel comfortable raising any issues of concern with staff members.

All staff members we spoke with demonstrated a good knowledge and understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS), which is used when someone needs to be deprived of their liberty in their best interest. We saw the service was working within the principles of the MCA and had followed the correct procedures when making DoLS applications.

People living at the home were encouraged to make decisions and choices about their care and had their choices respected, whilst being supported in the least restrictive way possible; policies and systems in the home supported this practice. People's consent to care and treatment was also sought prior to care being delivered.

We looked at five care files, all of which contained personalised information about the people who used the service and how they wished to be supported and cared for. Each file contained concise, yet informative care plans and risk assessments, which helped ensure people’s needs were being met and their safety maintained. People and their relatives told us they were involved in care planning and reviews.

Throughout the inspection we observed positive and appropriate interactions between the staff and people who used the service. Staff were seen to be caring and treated people with kindness, dignity and respect. It was apparent from our observations, staff knew the people they supported and had formed positive relationships. People told us they would feel comfortable raising any issues of concern with staff members.

Peoples’ social and recreational needs were met through the provision of an activities programme. Alongside in-house activities, we saw the home arranged visiting entertainers and speakers as well as group outings to places people had shown an interest in attending or had been discussed during resident meetings.

The home had a range of systems and procedures in place to monitor the quality and effectiveness of the service. Audits were completed on a daily, weekly, monthly or quarterly basis, depending on the area being assessed and covered a wide range of areas including medication, accidents and incidents, infection control and training. Provider level audits had also been completed on a monthly basis, to provide further oversight of all aspects of service provision.