Annacliffe Residential Home

Annacliffe Residential Home provides accommodation for persons who require support with personal care. The care home accommodates up to 60 people in the main building and in the purpose build dementia unit. At the time of the inspection there were 55 people living at Annacliffe Residential Home.

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

We have made recommendations about documentation related to recruitment and personal emergency evacuation plans (PEEPs). We have made a recommendation about supporting people with meals. There were enough staff to meet people’s needs and the provider ensured staff were of good character. Staff had received training to keep people safe and knew what action to take in response to any allegations of abuse. The premises were clean, tidy, and maintained, and there were no restrictions on family and friends visiting.

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.

The service was led by a registered manager who was described as approachable, supportive and caring. Staff understood their roles and responsibilities. The provider monitored the quality of the service using a range of systems. Staff had received appropriate training and people received good care that met their needs and improved their wellbeing. The staff team were dedicated and enthusiastic, and people said they were kind.

People, relatives, and staff spoke positively about the management of the service. The culture at the service was open and inclusive. The provider had governance processes in place to ensure regulatory compliance and drive improvement. Staff worked with as the local authority and healthcare professionals to meet people’s health and social care needs.

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 (published 24 January 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

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.

Staff had received training to help ensure their knowledge on infection prevention and control was up to date. Personal protective equipment (PPE) and infection control hand gel was available throughout the home for all staff and visitors. The registered manager and staff told us enough stocks of PPE were available and we confirmed this on the visit. One staff member told us, “We are not going to run out of PPE. I have never been scared that we are not protected, because we are.”

The home was clean and hygienic. Cleaning schedules were in place with additional cleaning protocols to ensure all high touch points were regularly sanitised. One person told us, “Housekeeping staff clean my room every day. They are very good.”

People were supported to maintain contact with those who were important to them, in line with current government guidance. Face to face visits took place in either a separate ‘visiting hub’ or in bedrooms. These visits were risk assessed on an individual basis. Window visits, internet messaging, video and telephone calls were also available and used to maintain contact with loved ones.

The home maintained close links with other professionals and if medical advice was needed, this was obtained. One relative told us, “[Family member] has thrived since they have been here.”

People living in the home and the staff were tested regularly for COVID-19. There were no staff employed who had not been vaccinated as is now required. The provider’s IPC policy was up to date and had been audited during the pandemic to reflect best practice and current guidance.

We found the following examples of good practice.

¿ The registered manager had ensured staff could access comprehensive and informative training in various aspects of infection control. Staff competency in infection prevention and control was checked to ensure they followed good practice.

¿ The environment and equipment had been arranged to minimise the risk of infection and was clean and clutter free. Equipment was available throughout the home to reduce the risk and spread of infection.

¿ Information was gathered from visitors to help minimise the risk and spread of infection. The home followed best practice guidance to relation to the testing of visitors.

¿ Risk assessments were carried out to minimise the risk and spread of infection.

¿ Processes to minimise the risk of infection were carried out by staff. For example, temperature checks, safe waste disposal and increased cleaning of the home took place.

¿ Covid-19 policies and risk assessments were available and known by staff.

¿ Checks and audits were carried out on the cleanliness of the home and action taken if this was needed.

¿ Adequate handwashing facilities, infection control gel and personal protective equipment (PPE) was available to support best practice.

¿ Staff supported people to maintain contact with their loved ones by using the dedicated 'visitors' hub' when this was possible. Other forms of contact were used to help people and their loved one stay in touch. For example, electronic tablets and private social media sites. The home had 3 telephones which were dedicated to visitors calls.

¿ People were supported to access health professional advice and maintain their well-being.

¿ The service was taking part in the whole home testing process and to access COVID-19 vaccinations. People at the home were supported to decide if they wanted to participate. If people were unable to make this decision for themselves, best interest discussions were held with relatives and documented.

¿ Appropriate signage was displayed throughout the home to promote best practice.

Rating at last inspection.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this inspection we found the service Good. We found the registered provider continued to provide a good standard of care to people who lived at the home.

Why the service is rated Good

At this inspection we found the registered provider had systems to record safeguarding concerns, accidents and incidents and acted as required. The service carefully monitored and analysed such events to learn from them and improve the service. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices. The registered provider had reported incidents to the Care Quality Commission when required.

People told us staff were caring and respectful towards them. Staff we spoke with understood the importance of providing high standards of care and enabled people to lead valued lives.

We found there were sufficient numbers of staff during our inspection visit. They were effectively deployed, trained and able to deliver care in a compassionate and patient manner. One person told us, “They [staff] are excellent, I can’t fault them, they’re awfully kind and thoughtful.”

Staff we spoke with confirmed they did not commence in post until the management team completed relevant checks. We checked staff records and rotas and noted employees received induction and training appropriate to their roles.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. Care records showed they were reviewed and any changes had been recorded.

We looked around the building and saw the home was clean and a safe place for people to live. We found equipment had been serviced and maintained as required. Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection.

Medication records provided staff with a good understanding about specific support needs of each person who lived at Annacliffe Residential Home.

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

People told us they had plenty of food and drink with the option of additional snacks and drinks between meals.

We observed only positive interactions between staff and people who lived Annacliffe Residential Home. We observed humour used to foster positive relationships. There was a culture of promoting dignity and respect towards people. We saw staff spent time with people as they completed routine tasks.

There was a complaints procedure which was made available to people and visible within the home. People we spoke with, and visiting relatives, told us they were happy and had no complaints.

The management team used a variety of methods to assess and monitor the quality of the service. These included regular audits, staff meetings, unannounced visits at night and daily discussions with people who lived at the home to seek their views about the service provided.

People were supported with activities and social interaction but the registered provider also respected people’s right to not participate and engage in valued activities independently.

The registered provider offered people dignified end of life support that extended after their passing. People preferences related to end of life care were recorded and respected.

Further information is in the detailed findings below.

section with the people who use their service and the staff that work there.

This is a large residential care home situated close to Blackpool town centre. Parking facilities are available at the front of the home. The home offers accommodation for a maximum of 46 people who require nursing or personal care. At the time of the inspection, 41 people were living at the home. There are ensuite facilities and lift access to all floors. A number of lounges are available so people can choose where to relax. There is a large garden at the rear for people to access. There is ramp access to the home for people with mobility problems. At the time of our inspection, there was building work on site as the provider was having a unit built alongside the main building. The unit will specialise in the care and support of up to 14 people with dementia.

The service did not have 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. There was an interim manager to guide and support the newly appointed manager. The new manager was in the process of submitting their application to become registered manager at the time of our inspection.

At the last inspection on 12 November 2013, we found the provider was meeting the requirements of the regulations inspected.

During this inspection, staff had received abuse training and understood their responsibilities to report any unsafe care or abusive practices related to the safeguarding of vulnerable adults. Staff we spoke with told us they were aware of the safeguarding procedure.

The provider had recruitment and selection procedures to minimise the risk of inappropriate employees working with vulnerable people. Checks had been completed prior to any staff commencing work at the service. This was confirmed from discussions with staff.

We found staffing levels were suitable with an appropriate skill mix to meet the needs of people who used the service.

Staff responsible for administering medicines were trained to ensure they were competent and had the skills required. Medicines were safely kept and there were appropriate arrangements for storing medicines.

Staff received training related to their role and were knowledgeable about their responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.

People and their representatives told us they were involved in their care and had discussed and consented to their care. We found staff had an understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

Comments we received demonstrated people were satisfied with their care. The management and staff were clear about their roles and responsibilities. They were committed to providing a good standard of care and support to people who lived at the home.

A complaints procedure was available and people we spoke with said they knew how to complain. Staff spoken with felt the management team were accessible, supportive, approachable and had listened and acted on concerns raised.

The general manager had sought feedback from people who lived at the home and staff. They had consulted with people and their relatives for input on how the service could continually improve. The provider had regularly completed a range of audits to maintain people’s safety and welfare.

Outcome 14 ' Supporting Workers

Outcome 16 ' Assessing and monitoring the quality of service provision

This was because the home was not compliant at the previous inspection.

We spoke with a range of people about the home. They included the manager, staff and people who lived at the home. We also had responses from external agencies including the local authority contracts team. This helped us to gain a balanced overview of what people experienced living at the Annacliffe.

We checked records and systems that related to the support of staff and the quality monitoring of service provision. Staff told us they felt supported. Both staff and people living at the home expressed feeling safe and happy at the Annacliffe. One person told us, 'The staff are really good and I have no complaints'.

We discussed with the manager the action plan she had developed in order to achieve compliance. We confirmed that the home had carried out the actions it had planned.

The service demonstrated good practice that ensured people were cared for in a supportive and respectful manner. One person told us, 'Staff are very caring and respectful ' I really like them all'. A relative said, 'They're always working hard and keeping the place clean and tidy'. This was underpinned by the service's understanding of consent and infection control practices.

However, care practice and record-keeping was not fully underpinned by clear, regular auditing procedures. The home did not undertake formal, recorded supervision. Regular, updated mandatory training had not been provided.

Nevertheless, we observed that staff were able to provide care in a respectful, timely and unhurried way. People appeared relaxed and comfortable.

People told us they were treated respectfully by staff, comments included, "The staff are all polite and respectful." Also, "I need help walking the staff help me in a dignified way."

People told us they were happy with the service and knew how to raise issues, should they have any. People we spoke with said they didn't have any complaints or concerns. A relative spoken with said, "This was the best place we looked at and it has proved to be. We have never had to complain. The manager and staff sort any issues out straight away."

People we spoke with told us they could express their views and were involved in decision making about their care. Staff confirmed to us they also involved relatives where possible. This was to ensure people received the right care and support. This was confirmed when we spoke with residents and relatives. One resident spoken with said, "I have breakfast in my room every day it's my choice and not a problem for the staff."

We spoke with Blackpool council contracts monitoring department and they had no concerns or issues with the service.