19 January 2017
During a routine inspection
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.