Archived: Anglesea Heights Care Home

Updated 23 June 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

This inspection took place on 19 January 2017 and was unannounced. The membership of the inspection team consisted of three inspectors from adult social care, a specialist adviser and an Expert by Experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. Their area of experience was older people/ dementia care. Our advisor was a specialist in clinical governance and dementia.

Before our inspection we reviewed information we had received about the service such as notifications. This is information about important events which the provider is required to send us by law. We also looked at information sent to us from other stakeholders, for example the local authority and members of the public.

During our inspection we observed how the staff interacted with people who used the service and spoke with six people who used the service, seven people’s relatives and 12 members of staff. We spoke with two health care professionals during the inspection.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We also looked at 12 people’s care records and examined information relating to the management of the service such as health and safety records, medicines, staff recruitment files and training records, quality monitoring audits and information about complaints.

Updated 23 June 2017

This unannounced inspection took place on 19 January 2017. This was to follow up the previous inspection completed on 1 and 2 June 2016. We had given an overall rating of requires improvement and found that it required improvement in every domain. We had found three breaches in regulation. These related to; medicines not being safely managed, a lack of sufficient suitably qualified nurses and a lack of responsiveness to emerging health conditions to ensure people’s health needs were met in a timely way. We had placed positive conditions on the provider to ensure compliance with regulation. We had restricted admissions to the service. We had met with the provider to ensure they understood our concerns and to develop a plan for compliance. At this inspection we found steady progress overall, but with some concerns remaining about Gippeswyk House and medicines management.

Anglesea Heights is nursing home and they are registered to accommodate up to 120 people. They also have the regulated activities of treatment of disease, disorder or injury. On the day of our inspection visit there were 50 people resident. 18 people resided on Alexandra. This house is for people with high nursing needs and end of life care. 18 people resided on Christchurch. This is for people with some degree of nursing needs and some people living with dementia. There were 14 people on Gippeswyk. This house is for people living with dementia with lower nursing needs.

Bourne house remained empty.

The service requires a registered manager. We at CQC had received an application and are in the process of determining the outcome of registration of the applicant. 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.

People at this service were confident and happy with the service that they were provided with. Relatives told us that they had seen improvements and any concerns they raised had been addressed. People had care plans in place, but these were not as individualised as they could have been, along with known risks not being effectively and consistently mitigated. There were a variety of activities on offer for people to participate in, but these could have been developed further based upon the known likes and preferences of the people living at the service.

The number of staff had increased since our last visit. Recruitment was ongoing. We were given assurances that this would continue before the service was expanded into four houses again. Bourne House remained closed to admissions. CQC have given permission for planned incremental admissions to two houses, but that no admissions were in place for Gippeswyk. This was because we found a lack of stable management and oversight on this particular house. The thread of inconsistencies showed us that Gippeswyk was the weakest house with Alexandra and Christchurch providing an acceptable level of care and support to people. Despite having good staffing levels at lunchtime on Gippeswyk the mealtime was not well managed and staff understanding and implementation of their dementia training needed further monitoring and development. Mealtimes had systems in place to provide people with the food they required and needed, but the lack of staff organisation and knowledge led to inconsistencies in the service provided.

At this inspection we found one on going breach in medicines management. There were issues found on each unit, but in particular with Gippeswyk where covert and crushed medicines were not as safely managed as should be. There were missed signatures and one person missed their medicines. In other units creams were not safely managed and records were not consistently accurately kept.

You can see what action we told the provider to take at the back of the full version of the report.