Updated
10 March 2021
About the service:
St Anne’s provides accommodation with personal care for up 33 people. There were 33 predominantly older people using the service at the time of our inspection.
People’s experience of using this service and what we found:
St Anne's provided outstanding dementia care and support in an extremely dementia friendly environment. Bathrooms were warm, cosy and decorated making it look more like a domestic bathroom. A great deal of co-production had taken place between staff and people, working together to enhance the environment. Each corridor was themed. The registered manager told us, “I want the corridors to have some use, I don’t want them just to be corridors.”
The entrance of the service was designed as a village square, complete with sweet shop, post office, bank and book shop. All were accessible for people to visit and purchase items or receive help with their finances and queries.
The registered manager had focused on further improving people’s dining experience. A tea service delivered on a tray to each person had been added since the last inspection. At lunch time one staff member told us, “We make sure there is space between the tables. Everything is laid up, so they have what they need, we set it in the same way, so it's familiar, even make sure we put the table cloth the right way or it could cause confusion. One man didn't like green, so we waited to see where he wanted to sit and then put a cream table cloth on.”
Staff provided a visual choice of meal as well. ‘Show plates’ of each meal option were bought to people to help them choose what they would like to eat.
To further increase their knowledge staff had recently received training on the International Dysphagia Diet Standardisation Initiative (IDDSI) Dysphagia is a term used to describe swallowing difficulties. IDDSI is a global standard with terminology and definitions to describe the texture of food and thickness of liquids provided to people with dysphagia.
Staff were recruited safely in sufficient numbers to ensure people’s needs were met. The registered manager encouraged new people to join the staff team by becoming apprentices. The apprentice role meant people without care worker experience could work for 30 hours a week alongside and in addition to existing care staff, providing personalised activities and meal support.
People living at the service helped the registered manager with the interview process. Prospective staff were shown around the service and spent time with people. Later the registered manager would seek the views of the people who had met the candidate.
People told us they felt safe being supported by staff. Staff understood risks to people and how to help reduce them. Systems were in place to safeguard people. People received their medicines on time from staff who had received training in medicines administration.
Infection control measures were in place to prevent cross infection. A member of staff, who was the appointed link person to the project, had been acknowledged in a Plymouth university hygiene study paper having supported the research into how the robotic pets, used at the service, could be kept hygienically clean and not pose an infection risk.
St Anne’s continued to support an intergenerational dementia awareness initiative, The Archie Project. The aim of this project was to engage children at a young age, dispel any fear of dementia, and develop caring attitudes towards others. Staff told us, “Some people don't have younger children in their family anymore and they really enjoy the contact. [Person’s name] is 100 years old and his face was a picture listening to the children read. You can see on their faces, the impact it has on them.”
The service continued to receive exceptional feedback. Relatives told us, "It’s a wonderful place. I cannot imagine it’s a care home it’s more like a hotel. So friendly and kind, Mum has really settled well and look at her with the children she is very sociable, so this is perfect for her." "This place is outstanding, we have seen others and they don’t even come close."
There were activities provided for people in the morning and the afternoons, seven days a week. Five staff ‘Champions’ had been given additional training and responsibility for providing arts, crafts, activities and exercise and supported the whole staff team in delivering the planned programme.
The service continued to be a certificated member of the National Activity Providers Association, upholding the values of the uniqueness of everyone and providing person centred and meaningful activities.
The provider was keen on the use of technology to bring new experiences to people. They funded Virtual Reality (VR) headsets which had enabled people to have experiences that they would not usually be able to have in reality.
St Anne’s had been chosen as the first research site for a trial of the use of robotic pets’, by Plymouth university. Feedback from the university was that St Anne’s, ‘really are the best home I have worked with, totally pro-research with a really engaged team’.
St Anne’s were also involved in the ‘Smart Speakers Scheme’. A research project which provides devices to care homes. These can be tailored to meet individual’s needs. For example, hearing the latest games scores for the keen sports fan and cooking along with the device which works at the user’s pace. People could also be supported to use the device to contact relatives, often abroad.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Any restrictive practices were regularly reviewed to ensure they remained the least restrictive option and were proportionate and necessary.
The registered manager continued to be passionate about, ‘bringing the outside in’. The Macular Degeneration Society continued to hold their local meetings at the service once a month. The local library visited to bring large print books, talking books and advertise their events and resources to people living at the service. Volunteers were welcomed. St Anne’s supported the recent ‘My Saltash’ weekend, opening their doors to the public when over 40 people visited, chatted with people and staff over tea.
The registered manager involved people living at the service and their families with the local ‘Dementia Voice PL12’. Through involvement with this organisation people at the service had access to ‘singing for the brain’ sessions at the local church, a dementia café in Saltash held each Tuesday, walking groups and a Veterans group.
The registered manager sat on the monthly End of Life care forum linked to the Daffodil standards, at the local GP practice. The Daffodil Standards help spot areas for improvement and build on the good care already provided to people.
Staff had completed the ‘Six Steps to Success’ in end of life care. Covering discussions with people as end of life approaches, assessment, care planning and review, co-ordination of high-quality care in the last days of life and after death.
Audits were carried out regularly to monitor the service provided. Actions from these audits were being acted upon to further improve the service. Records were stored appropriately and were accessible and up to date.
Many compliments had been received from people, relatives and healthcare professionals. Comments included, “I cannot praise the care my mother has had at St Anne’s enough. I have over 40 years of nursing experience and the care and emotional support I have seen since my mother was admitted here is exemplary. Simply superb,” “You also looked after us, anything we needed was your concern. I don’t think there are many people who could say that as they lose a loved one,” “I can only say that I think people are extremely lucky to live there. The environment really is wonderful” and “The surroundings are really very good indeed. So much to look at and occupy people,” “It is a very special home” and “We are all very proud of the home. We have a wonderful boss.”
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
At the last inspection the service was rated as outstanding (report published 24 August 2017)
Why we inspected:
This was a planned inspection based on the previous rating.
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.