Background to this inspection
Updated
23 August 2018
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 team consisted of three inspectors and an expert by experience. Experts by experience are people who have personal experience of using or caring for someone who uses this type of service.
Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give key information about the service, what the service does well and improvements they plan to make. We reviewed the PIR and other information we had about the service including statutory notifications. Notifications are information about specific events that the service is legally required to send us.
We spoke with seven people using the service and five relatives. We interviewed eight staff, including the manager.
We looked at four staff files, seven care plans, the falls analysis document, medication audit and associated action plans. We reviewed the accident and incident forms, audit and associated analysis and action plans, staffing rotas and the staffing dependency tool that covered the period of one. We looked at staff training and induction records.
We reviewed various policies and procedures, including safeguarding, whistleblowing, complaints and the consent to care policy. We also undertook pathway tracking; pathway tracking is a process which enables us to look in detail at the care received by an individual in the home. We also observed interactions between staff and staff and people.
Updated
23 August 2018
Annabel House 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.
Annabel House is in a residential street in Weston Super Mare, close to local amenities and with onsite parking. Accommodation is offered over two floors and there is a mixture of single and double bedrooms. Communal spaces include two lounges and a kitchen-dining area, the garden is accessible and there is a decking area for people to use on the first floor.
The home is registered to provide nursing and personal care for up to 30 people.
During our inspection there were 23 people living in the home.
This inspection of Annabel House was carried out on the 10 July 2018 and was unannounced.
We last inspected Annabel House on the 7 and 8 July 2016 and during this inspection a breach of regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) 2014.
The manager had made improvements to the service to ensure that the requirements of this regulation were met. Two activity coordinators were now working in the home and they had introduced meaningful and varied activities; people’s areas of interests were identified and activities designed with those in mind. Improvements made regarding the management of medicines and pressure care have been sustained.
The Care Quality Commission is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DOLs) and to report what we find. We saw that when people lacked capacity to make decisions for themselves that staff understood the requirement to work within the Act.
People were supported to ensure that they had enough to eat and drink. There was a choice of food available and people spoke positively about the food. When required, food and fluid intake was recorded accurately.
People received care and support from staff who were safely recruited and benefited from training and supervision to enable them to meet people’s needs.
Staff treated people with kindness, respect and ensured that people’s dignity was protected. Preferences, likes and dislikes were recorded and these were understood by staff.
People’s health and social care needs had been identified and risk assessments and care plans developed to guide staff in meeting these needs.
People, staff and relatives spoke positively about the manager and were well supported. Frequent team, staff and relative meetings were used to ensure that communication remained open and honest and contributed to positive outcomes for people.
The manager ensured that staffing levels were maintained at a safe level to ensure that people’s needs were met, this included managing the types of staff required e.g. nurse/care assistant in relation to the needs of people living at the service.
There was a programme of quality audits in place and these were used effectively by the manager to identify themes, create action plans and make changes.
Prior to our inspection, we looked at the service’s website to check that the most recent rating was being displayed. There was a link to the inspection report however the ratings were not displayed on the website.
This was a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 20A.
The most recent inspection report was not being displayed in the service. We brought this to the attention of the manager. They informed us that they were unsure where the report was and that it had been displayed at some point.