- Care home
Archived: Sarah Anne Residential Home
All Inspections
25 and 26 June 2015
During a routine inspection
Sarah Anne Residential Home is a care home that provides accommodation for up to 13 adults. The home is a four storey building and accommodation is provided over three floors. Access to upper floors is via a staircase or passenger lift. The service is situated close to a railway station in Blundellsands, Merseyside.
There was a registered manager at the service at the time of our inspection. 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.
The registered manager told us they had managed and owned the home for 29 years. The manager was described as ‘approachable’ and people who lived at the home told us they felt able to discuss any concerns they had with them.
Care staff told us they were confident about recognising and reporting suspected abuse and during discussions with the registered manager they told us they were aware of their responsibilities to report abuse to relevant agencies. However, there was no adult safeguarding policy available for us to view at the time of the inspection.
Staff worked well with health and social care professionals to make sure people received the care and support they needed. Staff referred to outside professionals promptly for advice and support. A visiting health professional gave us very good feedback about the service and told us they thought the standard of care was good.
Care was not well planned and records relating to the care and treatment provided to people were poor. People’s needs had not been appropriately assessed before they were admitted to the home. Care plans we viewed did not provide sufficiently detailed information/ guidance on how to meet people’s needs. Risk assessments were not being carried out appropriately. Those we viewed were basic and inaccurate and there were no corresponding care plans in place to show how risks were managed/mitigated. Other records about people’s care were poor and failed to demonstrate the care provided. The manager told us they were working alongside the commissioners of the service to improve the records they made about people’s care and support.
We checked a sample of medication in stock against medication administration records. Our findings indicated that people had been administered their medicines as prescribed. However, some medication practices required improvement. This included: the way in which medicines were stored and the way in which records were maintained.
The manager was able to tell us how they would ensure a decision was made in a person’s best interests if it was deemed that the person did not have the mental capacity to make a specific decision. At the time of our inspection the manager advised us that nobody living at the home lacked the mental capacity to make the decisions required of them. Some members of the staff team had been provided with training in the Mental Capacity Act but this had not been provided to all staff.
During the course of our visit staff supported people in a warm and a caring way. People who lived at the home and a visiting relative gave us positive feedback about the staff team.
There were sufficient numbers of staff on duty to meet people’s needs. This was reported to us by people who lived at the home, members of the staff team and a visiting relative.
The turnover of staff was low and most staff had worked at the home for a number of years. We were therefore not able to assess the way in which staff were recruited currently. We did however see some shortfalls in the recruitment of the newest member of staff who was employed at the home over 12 months ago.
Staff told us they felt sufficiently trained and experienced to carry out their roles and responsibilities. However, we found some gaps in staff training as some staff had not been provided with updated/refresher training. Staff told us they felt well supported in their work. However, we found staff were not being provided with regular formal supervision or appraisal and team meetings were not taking place on a regular basis.
The premises were warm, comfortable and homely. The provider was able to demonstrate that a number of checks were being carried out on the home environment. However, some of the records of these checks were not sufficiently detailed.
People told us they felt the home was clean and most areas we viewed were appropriately clean and tidy. Staff had been provided with infection control training and we saw them follow infection control practices. Staff training records however, showed that some staff had not had up to date training in infection control.
The home is a four storey detached house and there were steps to access the premises both at the front and the side. There was no ramped access for people who use wheelchairs to access the building. The provider had obtained a specialised chair to assist people to gain access via the front steps. A passenger lift was available for people to access rooms on the upper floors.
Records relating to the needs of the people who lived at the home and the running of the business were not maintained appropriately. The provider was not able to clearly demonstrate the care provided to people who lived at the home and to evidence that risks to people’s welfare and safety were being mitigated. Many of the records we saw relating to the running of the home were poorly maintained and not fit for purpose.
The provider did not have effective systems in place to regularly check on the quality of the service. There were no quality audits carried out and the views of people who lived at the home and their relatives had not been sought for some time.
You can see what actions we have told the provider to take at the end of this report.
1 May 2014
During a routine inspection
Below is a summary of what we found. If you wish to see the evidence supporting our summary please read the full report.
Is the service safe?
People who lived at the home told us they were treated with respect and dignity by staff. People told us they felt safe and that if they had any concerns they would raise these with staff or with the manager.
People were encouraged to make choices and to use their independence. At the time of our visit everybody who used the service was able to make their own decisions. The manager was aware of the action to take if they had concerns with regards to a person's capacity to make their own decisions.
People's health, safety and welfare were protected in how the service was provided. People got the support they needed when they needed it and risks to people's safety were managed.
Is the service effective?
People received the care and support they required to meet their needs and maintain their health and welfare. People's care and support had been reviewed on a regular basis and their and care plans updated. People told us they felt listened to and included in decision making.
Is the service caring?
People who lived at the home told us staff were 'good' and 'respectful'. Staff we spoke with were clear about their roles and responsibilities to promote people's independence and respect their privacy and dignity.
Staff were readily available to support people when they needed support and we saw that staff showed warmth and familiarity when supporting people. People commented, 'It's a good home, we get good care' and 'You only have to ask and it's done, they are very good here.'
Is the service responsive?
The service worked with other agencies and services to make sure people received their care in a joined up way. GPs, district nurses and other health professionals were referred to promptly when people required support with their health care needs. One person told us 'If I am unwell they get the doctor in straight away, no delay.'
People who lived at the home were listened to and their views were acted upon. People were asked to give feedback on their experience of the service. This was done on an informal basis through one to one discussions with people and through the use of surveys. People's feedback was then used to make improvements to the service.
Is the service well-led?
Systems were in place for assessing and monitoring the quality of the service. These included regular checks on aspects of the service and seeking the views of people who lived at the home and their relatives.
The service was managed in a way that ensured people's health, safety and welfare were protected and the interests of the people who lived at the home was at the centre of how the service was run and managed.
24 September 2013
During a routine inspection
The Registered Manager told us that some people had lived there for a long time. Also some of the staff had worked there for several years saying, 'We haven't needed to recruit anybody for over nine years'.
During our inspection we spoke with some of the people who lived in the home. People's comments were positive including, 'I get treated with respect in every single way', 'they (staff) have been brilliant, everybody's fantastic', 'the place is spotless' and 'the foods fantastic and you don't have to wash up'.
A visiting relative commented, 'Can't speak highly enough of the family atmosphere. They (staff) know each person individually and make it personal' and 'couldn't wish for anywhere better'.
We carried out a tour of the premises and checked the management of medicines.
We also looked at the care files for some people living in the home and some of the staff records, focusing on the recruitment process.
We observed different members of staff positively interacting with people in a sensitive, inclusive and unhurried manner.
15 January 2013
During a routine inspection
The registered manager told us that some people had lived there for a long time. Also some of the staff had worked there for several years.
During our visit we spoke with some of the people who were living at the home.
Their comments overall were positive about the care received. They told us they liked living at the home and some of the comments were, 'They (staff) do treat me with respect, very much so' and 'It's not bad here. I have lived here for a long time'.
We observed staff being polite and respectful in their interactions with people. We saw that staff took time to sit and talk with people and responded promptly to people's requests for assistance.
We spoke with two of the care staff about how they promoted privacy and dignity for people who used the service. Some of the comments from staff members were, 'When providing personal care, always make sure the bedroom or bathroom door is closed and always reassure people of what you are going to do' and 'Always acknowledge a person's wishes and their preferences. You have got to be patient and tolerant at all times'.
We saw training records that showed that members of staff had received training related to promoting dignity and respect. One person said, 'I did dignity and diversity training'.
4 November 2011
During a routine inspection
Following our visit we spoke with one of the team of district nurses who provide support for the home. She said that she has been visiting Sarah Anne Rest Home for a number of years and has no concerns. She told us that Pauline (Mrs May) "Treats all the residents as though they were her own family and they are very well cared for." The district nurse's highest recommendation was that they would be happy for a relative to live there.