Background to this inspection
Updated
5 November 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by two inspectors, and one '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.
Service and service type
Anchorage Nursing Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with CQC. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and the local Healthwatch. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with two people who lived in the home about their experience of the care provided. We spoke with three members of staff employed in the home. These were the provider, one nurse and one care member of staff. We also spoke with three relatives.
We completed checks of the premises and observed how staff cared for and supported people in communal areas. We reviewed a range of records that included four people's care and medication records. We looked at three staff files in relation to recruitment and staff supervision. We also looked at a variety of records relating to the management of the service, including audits, policies and procedures, and accidents records.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at audit and governance data, as well as infection prevention and control policies and procedures.
Updated
5 November 2021
About the service
Anchorage Nursing Home is a 'care home' providing accommodation, nursing and personal care for up to 40 older people; some of whom lived with dementia. At the time of the inspection 34 people were living at the home.
People's experience of using this service and what we found
The provider and staff worked together to help ensure people received a good service. However, on our first day of inspection we found issues of concern with COVID 19 weekly testing regimes that did not fall in line with government guidance. We also had concerns regarding the cleanliness and some aspects of the condition of the environment.
People told us they were happy with the care they received and said they felt safe living there. One person said; "It’s a nice place and I like it." We saw that people living at the service were relaxed and comfortable with staff. We observed staff spent time chatting with them and supporting them when they became distressed or anxious.
People were protected from abuse because staff understood the correct procedure to follow if they had any concerns. People received their medicines as prescribed and staff had clear information about how people liked to be supported with their medicines. Staff were knowledgeable about people's health needs and the provider had sought support from other health professionals as appropriate to support people's needs.
Care records were individualised and reflected each person's needs and preferences. Risks were assessed and identified, and staff had guidance to help them support people to reduce the risk of avoidable harm. We did however see missing entries in the daily records and some key information in people’s care records that we looked at. The provider addressed these concerns immediately and made appropriate changes and updates to care records.
Staffing levels were appropriate, and we found that due to several permanent members of staff being off long term, the home used a high volume of agency staff. The provider assured us that they were continuously working to recruit more staff. Staff received training and support to enable them to effectively meet the needs of the people they supported.
People were supported to maintain good health and nutrition. Staff worked closely with professionals such as speech and language therapists, GP's, commissioners and other health professional.
The provider had addressed issues identified from the last inspection relating to the environment and had implemented changes to the building that made it safer.
Rating at last inspection
The last rating for this service was requires Improvement (published 26 January 2021). This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
We carried out an unannounced focused inspection of this service on 7 October 2021 following a number of concerns relating to staffing numbers and intelligence gathered through various sources and our system. This report only covers our findings in relation to the Key Questions of Safe and Well-led.
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.
Our report is only based on the findings in those areas at this inspection. The ratings from the previous comprehensive inspection for the caring, effective and responsive key questions were not looked at during this visit. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used to calculate the overall rating at this inspection.
The overall rating for the service has remained 'requires improvement'. This is based on the findings at this inspection. We found evidence that the provider still needs to make improvements.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Anchorage Nursing Home on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
At this inspection we have identified breaches in relation to safe care. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.