We carried out a review of the data available to us about Anvil Close on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Anvil Close, you can give feedback on this service.
About the service
Anvil Close is a residential care home providing personal care for up to 12 people with learning disabilities, the service is arranged into 4 flats each accommodating up to 3 people in individual bedrooms and communal spaces. At the time of the inspection, there were 11 people living at Anvil Close.
People’s experience of using this service and what we found
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right Support:
The service supported people to have the maximum possible choice, control and independence. People were able to be independent and had control over their own lives. Staff supported people to achieve their aspirations and goals and to pursue their interests. Staff supported people to take part in activities and pursue their interests in their local area and to interact online with people who had shared interests. People had a choice about their living environment and were able to personalise their rooms.
Right Care:
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. The service had enough appropriately skilled staff to meet people’s needs and keep them safe. People could take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities that enhanced and enriched their lives.
Right Culture:
Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. Staff turnover was low, which supported people to receive consistent care from staff who knew them well. People and those important to them, including advocates, were involved in planning their care. Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. The service enabled people and those important to them to work with staff to develop the service. Staff valued and acted upon people’s views. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection.
The last rating for this service was good (published 03 May 2018).
Why we inspected
We undertook this inspection to assess that the service is applying the principles of right support, right care and right culture. The inspection was prompted in part due to concerns received about a number of issues including the culture and management of the service. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the well led section of this full report.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Anvil Close on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
We found the following examples of good practice.
Facilities were in place for visitors to wash hands or use hand sanitiser on entering and leaving the home. Visitors were permitted, this was done in a safe way. All visitors were screened for symptoms of acute respiratory infection before being allowed to enter the home. Information was easily accessible on arrival or before visits to ensure visitors followed guidance and procedures to ensure compliance with infection prevention control (IPC).
Staff wore Personal Protective Equipment (PPE) in areas where 2m social distancing could not be achieved. Use of PPE was in accordance with current government guidelines. Signage on PPE and handwashing was visible in all required areas, including for visitors. Staff had received training in IPC and PPE. The provider had assessed the impact of how PPE may cause fear and anxiety for people.
People who were in isolation did not attend communal areas, including shared lavatories and bathrooms. Alternative facilities were provided.
The service ensured people were tested for COVID-19 by the hospital and from the community before being admitted. People were assessed daily for the development of symptoms of COVID-19.
Testing scheme for all staff and residents was conducted – known as ‘whole home testing’. The registered manager knew how to apply for coronavirus testing kits to test people and staff. Risk assessments had been carried out on people using services and staff belonging to higher risk groups.
Communal areas such as outdoor spaces and garden areas were used creatively to help with IPC. Staff had cleaning schedules, which they were required to complete and include frequency of cleaning of high touch areas, e.g. light switches and door handles. Records/checks of cleaning showed compliance with the cleaning schedule.
All members of staff worked in only one care setting. The provider understood and was meeting COVID-19 staff vaccination requirement. This includes, monitoring vaccination and COVID-19 status of deployed staff, ensuring deployed staff maintain an up-to-date vaccination status, including providing guidance and assistance for staff to get vaccinated.
At the last inspection, the service was rated Requires Improvement.
At this inspection, the service was rated Good.
Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions Safe, Effective and Responsive to at least good. At the last inspection, there was a breach of legal requirements in relation to person-centred care.
At this inspection, the provider had made improvements to meet the relevant requirements.
Anvil Close is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Anvil Close is a residential service providing care for up to 12 adults with a range of learning difficulties. There are two flats on the ground floor and two flats on the top floor each with three bedrooms. People with more complex needs live in the ground floor flats. There were nine people using the service at the time of the inspection. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
There was a registered manager at the service. 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.
At the last inspection, we found that care plans were not always up to date and therefore did not accurately reflect people's individual needs. Accurate records were not always kept in relation to medicine administration records and stock levels of medicines. Staff did not always receive regular supervision to support them in their role. At this inspection, we found there had been improvements in all of these areas.
People were supported to take part in activities in the community and maintain their interest in hobbies. The majority of people went to day centres during the week. The people that were at the service at the time of the inspection looked happy and content. They were supported appropriately by staff.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Relatives of people using the service told us their family members were safe and they had no concerns about their wellbeing. They told us they were kept informed about any changes to the care and support their family members received and were able to visit them at any time. People and their relatives were given information about how to raise concerns and they told us they were confident their concerns would be heard and responded to.
Staff told us they felt supported by the management team and were happy with the training and supervision they received. There were robust recruitment procedures in place and new employees received an induction which included an introduction to the values of the service. Records showed that care workers received regular training in a number of relevant topics and regular supervision.
Up to date and accurate records were maintained. These included records of when people had been supported with their medicines, risk assessments and care plans. Care plans were person-centred and included guidance on the most effective ways to communicate with people, including those with limited verbal communication. There was evidence that internal and external professionals were involved in people’s care which meant people’s needs were met appropriately. These included positive behaviour support analysts and community health professionals.
People’s needs in relation to the premises were met. The service was undergoing a programme of refurbishment at the time of the inspection.
The registered manager was aware of her responsibilities in relation to regulatory requirements and appropriate notifications were submitted to the CQC.
A number of audits were completed including those in relation to health and safety, infection control, medicines and finances. An improvement plan which was reviewed on a regular basis by the registered manager and area manager was in place to monitor progress against the issues found.
The service was transparent and worked with relevant external stakeholders and agencies.
There was a registered manager at the service. 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.
Anvil Close provides care for up to 12 adults with a range of learning disabilities. There are two flats on the ground floor and two flats on the top floor each with three bedrooms. At the time of the inspection, there were 11 people using the service.
We were only able to have limited conversation with people using the service as most people using the service had limited verbal communication. However, relatives we spoke with felt that their family members were happy living at the service and had no concerns. We observed care workers interacting with people in a friendly manner. They were also familiar with people’s individual communication needs and were clear about how they sought consent from them in relation to everyday tasks.
Relatives that we spoke with told us they were confident that their family members were happy and settled living at the service. They said that staff were in regular contact with them and kept them informed about any changes to their care or health needs. They also said they would not hesitate to raise any concerns, either formally or informally if they had any.
Staff were recruited after undergoing appropriate recruitment checks and thereafter received training in a number of areas which helped them to carry out their roles. However, we found that their medicines training was not always renewed annually to ensure that they remained competent to administer people’s medicines safely. We also found that not all the care workers received regular supervision to support them in their role.
There were records in place in relation to people’s health and nutrition. These included records of upcoming health appointments, details of people’s previous contact with health professionals, health passports and prescribed food and fluid plans.
Risks to people were identified and steps that staff had to take to mitigate any risks were also identified. Appropriate environmental risk assessments and checks such as fire, electrical and gas safety were carried out.
Some records relating to medicines for one person, such as medicine administration records (MAR) and stock checks of medicines were not completed correctly.
We also found that not all of the care plans were updated. This had been identified as an area of improvement during a previous inspection.
Regular audits were undertaken in relation to a number of areas. We found that these were effective in identifying the areas of improvement that were identified during this inspection. There were action plans in place to make improvements to the service.
We found a breach of the regulations in relation to person-centred care. You can see what action we have told the provider to take at the back of the full version of this report.
We carried out an unannounced comprehensive inspection of this service on 13 and 15 January 2015. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to management of medicines and the care and welfare of people who use services.
We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements in relation to the breaches found. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Anvil Close on our website at www.cqc.org.uk
The home provides care and accommodation for up to 12 people with learning disabilities. It is located in Streatham. It is divided into four flats, each with three bedrooms. There are two flats on the ground floor and two on the top floor. People with more complex support needs live on the ground floor and more independent people live on the top floor.
There was a registered manager at the service. 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.
At our previous inspection we found that medicines management was not safe and people’s individual needs were not always met.
At this inspection, we found that improvements had been made.
Staff had attended refresher training in medicines management. Stock checks of medicines were being carried out and medicine administration record charts were completed correctly. A regional manager carried out audits which were used to minimise the risk from unsafe medicines practice.
Flats had been redecorated to make them more presentable and work was continuing to ensure activity rooms in flats were fit for purpose and utilised in a way that met the needs of people. Link worker meetings had been re-introduced which allowed staff to set and monitor goals for people using the service.
This inspection took place on 13 and 15 January 2015 and was unannounced. The service met the regulations we inspected at their last inspection which took place on 16 September 2013.
The home provides care and accommodation for up to 12 people with learning disabilities. It is located in Streatham. It is divided into four flats, each with three bedrooms. There are two flats on the ground floor and two on the top floor. People with more complex support needs lived on the ground floor and more independent people lived on the top floor.
There was a registered manager at the service. 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.
We found medicines management at the home was not safe. Audits to record the amount of medicines kept at the home were not effective in picking up discrepancies and the provider’s guidance was not followed with regards to stock control of medicines at the home.
People’s individual needs were not always met. Recommendations given by healthcare professionals, although acted upon were not always evidenced and implemented by staff. Care plans were person centred and written in a way that was easy for people to understand. However, they did not always identify goals or objectives that people could work towards especially those who were more independent..
People told us they liked living at the home and that staff were nice. Relatives also told us of their satisfaction with the staff and how content and settled their family members were at the home. The majority of people attended various day centres during the day. Some people that did not attend the day centre had access to activities in the home. Some aspects of internal activities could be improved and we found that activity rooms at the home were not fit for purpose.
The provider followed the Mental Capacity Act 2005 (MCA) and applied for Deprivation of liberty Safeguards (DoLS) authorisations where it was found that some people needed restrictions put on them limiting their freedom. These restrictions where put in place in people’s best interests to keep them safe from harm.
The provider carried out the necessary security checks before employing people. Staff told us that the training they received at the home enabled them to carry out their role more effectively. They received regular supervision and appraisal. Team meetings were held regularly.
Quality assurance checks, such as questionnaires requesting feedback from people and their relatives about the service were carried out. Incidents were scrutinised at regional level so trends could be analysed if needed. Health and safety checks around the home were also carried out. The registered manager was supported by a team of four senior care workers, each with responsibility over one flat.
We found breaches of regulations relating to care and welfare of people who use the service and medicines management. You can see the action we have asked the provider to take at the back of the full version of this report.
We saw that the issues previously identified relating to the fire door system, central heating and general maintenance had now been repaired. The communal areas of each flat had been redecorated and the damaged furniture in one of the lounges had been replaced.
The relatives we spoke with confirmed that they were involved in the development and review of the care plans for the people using the service. We saw that the care plans were up to date and a new detailed care plan format was being introduced.
The relatives we spoke with said "I am very happy with the care provided" and "The home provides very high class care". They also said that they were happy with the cleanliness of the rooms and communal areas.
Both relatives we spoke with commented that the staff provided a good standard of care and their relatives who were using the service were both happy and settled. During our visit we saw the staff speak with the people who use the service is a positive and encouraging way and treated them with dignity.
A relative and two members of staff we spoke with all confirmed that there had been a problem with the central heating system which had left the home feeling cold.
The members of staff felt that they had enough training to do their job and were given support from the senior staff.
A relative we spoke with said "I can't speak more highly about them".
However, at our last visit to the service, in June 2011, the people told us that they liked living at the home, and that they could make choices about their daily lives, what they wanted to do and what they wanted to eat. We also found that people got the right support to meet their needs and develop independence in their lives. People also liked that the environment was calm and relaxed.