This focused inspection was unannounced and took place on 4 May 2016. The last inspection at Anley Hall Nursing Home took place on 14 May 2015 and the service was meeting all of the regulations we assessed at that time and was given a quality rating of ‘Good.’This inspection was carried out to follow up on concerns which had been raised with CQC. The person raising the concerns wished to remain anonymous. They made the following allegations:
• People were being left in a soiled condition,
• People not being bathed,
• Peoples health risks not being dealt with,
• Lack of staff training,
• Staff starting work without the relevant pre-employment checks,
• Falsification of medicine records,
• Medicines not being stored correctly,
• Medicines not being given as prescribed,
• People not being supported with dietary or hydration needs,
• People being moved around the service without just cause, and
• A spike in deaths during March 2016.
This report only covers our findings in relation to the above topics and focuses on whether the service was ‘safe, effective and responsive.’ You can read the report from the inspection in May 2015 which was a comprehensive inspection, by selecting the ‘all reports’ link for ‘Anley Hall Nursing Home’ on our website at www.cqc.org.uk
At this inspection we found that the registered provider was meeting the requirements, apart from some minor improvements needed with regard to specific care records which were discussed with the registered manager at the end of the inspection. The registered manager agreed to deal with these matters as a priority.
Anley Hall is registered to provide nursing care for up to 54 people, some of who may suffer from memory impairment, dementia, a physical disability or be terminally ill. The home is divided into two separate units; one is specifically used for people who are living with dementia. The home is a stone built country house, previously a private dwelling, and is situated in a rural setting on the outskirts of the market town of Settle, in the Yorkshire Dales. There are communal areas for dining and relaxation. Car parking is available in the grounds. On the day of our inspection 45 people were living in the home.
Anley Hall had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 told us the service was kept clean and we saw this was the case when we carried out a tour of the building. Equipment, including wheelchairs and soft furnishings were also clean.
People told us they received a good standard of care. We saw detailed information in care records which showed that people were receiving care and treatment which was planned or based on their current needs. Information was up to date and relevant.
The registered manager had made statutory notifications which are required by law. Statutory notifications are matters such as safeguarding incidents, serious injury, expected and unexpected deaths.
People told us they were safe and well cared for and this view was shared by the staff and relatives we spoke with. The service had sufficient staff to meet people’s needs and staff had the time to ensure people were provided with a good standard of care.
Medicines were managed safely and people received their medicines at the correct time and as prescribed by their doctor. Staff giving medicines were well trained and competent. The service had safe systems to store, administer, order and dispose of medicines.
People told us the food was well prepared, good and tasty. People were given choices at each meal and had a varied menu. Staff, including the chef and catering staff, knew people’s individual likes and dislikes. Care staff understood the importance of people having enough to eat and drink and we saw people being regularly encouraged to eat and drink throughout our visit.
The service was working within the principles of the Mental Capacity Act 2005 and staff routinely sought consent from people and supported them to make their own choices.
People had access to routine health care professionals and where they needed more specialised support, this was sought as appropriate.
All of the staff we spoke with told us they enjoyed supporting people and this was clear in their interactions with people, which were patient, kind and warm. Staff told us about their commitment to make sure people were well supported, comfortable and happy.
Staff we spoke with told us they felt well supported by the registered manager and provider and had access to regular training and supervision. Staff morale was described as good by those we spoke with and there was clear evidence of staff working as a team for the benefit of people living at Anley Hall.