We inspected Anbridge Care Home on 26 and 28 September 2017. Our visit on 26 September was unannounced.

The service was last inspected in April 2016, and rated Requires Improvement. There were two breaches of the Health and Social Care Act 2008 (Regulated Activities) 2014, relating to safeguarding people from abuse and carrying out financial assessments. Following the inspection the provider sent us an action plan which stated the breaches would be addressed. At this inspection we found significant improvements in all areas.

Anbridge Care Home provides accommodation and personal care for up to twenty people in a large converted and extended residential building approximately one mile from the centre of Oldham. At the time of our inspection the service had no vacancies.

When we looked around the home, we found it looked clean and homely with no unpleasant odours, and had been decorated in a dementia friendly fashion.

We spoke with staff who demonstrated a good understanding of safeguarding and showed they understood how abuse can occur. We saw that the service had safeguarding procedures in line with legislation and local authority policies so when incidents of potential abuse occurred these were reported and appropriate action taken to protect people from harm.

We saw that when recruiting new staff, appropriate processes were in place to ensure that they had the right quality and character to work with vulnerable people, and once in post all staff were provided with training opportunities to develop their skills. There were sufficient staff on duty, and we saw that they had time to spend talking and interacting positively with the people who used the service.

The home had good systems in place to provide safe administration of medicines, but we noticed that it would be possible for people to gain access to the room where medicines were stored when not being used. We pointed this out to the registered manager who took immediate action to ensure that the room was kept secure and accessible only to the responsible person on duty.

When we looked at care plans we saw that risks had been identified, assessed and steps had been taken to minimise the risk. When accidents and incidents occurred these were logged and audited so that any patterns could be identified and remedied.

Where people lacked the capacity to consent to their care and treatment, and were subject to a deprivation of liberty the service obtained the appropriate authorisation to provide care and support. We saw evidence in the care files of discussion and negotiation to show that people were consulted on how they liked their care to be delivered, but best interest decisions were not always documented.

Care staff at Anbridge House monitored people’s general health, and where specific healthcare needs were identified the service was proactive in seeking the right level of support; liaising with health care professionals, such as general practitioners (GPs), District Nurses and mental health workers to provide an appropriate level of support. We spoke to a health care specialist who was visiting the home, who told us that staff listened to, accepted and acted on their advice.

Systems were in place to ensure good recording of information, and communication amongst staff ensured that information was passed on in a timely manner. Staff demonstrated a good understanding of the needs of people who used the service and how they would like their needs to be met. This information was recorded in care plans.

We found the service had developed a homely and caring atmosphere. Staff demonstrated a knowledge and understanding of the people who used the service and provided care in a person centred way. Case notes and daily logs reflected interventions.

There were a variety of activities and we saw that people were not left to their own devices. Staff spent time with people to provide stimulation and activity.

The registered manager had developed a good system of gov

This inspection was carried out over two days on the 7 and 8 April 2016. Our visit on the 7 April was unannounced.

We last inspected Anbridge Care Home (Anbridge) in December 2014. At that inspection we found that the service was meeting all the standards we assessed.

Anbridge Care Home provides accommodation and personal care for up to 20 people in a large converted and extended residential building. The service is located approximately one mile from Oldham town centre. Accommodation is provided over two floors with a passenger lift and stairs between the floors. The home was fully occupied at the time of our inspection. We found the building to be well maintained, clean tidy and odour free. Care staff said that in sunny weather the door leading out into the garden was left open so that people could walk freely between the two areas.

The home had a manager who was registered with the Care Quality Commission (CQC) and was present on both days of the 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 manager has been registered since October 2010.

We identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Care records reviewed included detailed risk assessments to mitigate risks associated with falls, moving and handling, pressure relief and nutrition, with clear plans in place to show how to minimise the risk. However no financial risk assessments was in place for one person to ensure that they were protected from the risk of potential financial abuse, as he had capacity to withdraw money from a cash point.

On reviewing care records we identified that the registered manager had not completed an initial needs assessment for a person recently admitted. This meant that the registered manager could not be certain the service could meet this person’s needs.

The service had quality assurance audit tools in place. Audits were carried out by the registered manager however on reviewing these records we noted no member of staff had been identified to complete any follow up of actions. We have made a recommendation about the auditing of the quality assurance systems in place.

People who used the service told us they felt safe, and that they thought there were enough care staff available to support them.

The building and equipment were safe and secure. We saw that the home was clean and that cleaning rotas were in place and being followed to ensure that all areas were kept clean and hygienic, including kitchen and laundry areas.

We saw that systems were in place to ensure that all medicines were stored correctly and dispensed by care staff that had been appropriately trained.

The care staff we spoke with had a good understanding of people’s individual needs and the support they required, and we found that care was delivered consistently by a team of carer's who knew how to support people and meet their care needs.

We saw that mandatory training for care staff is followed and regularly updated, and care staff were supported to complete training in other issues.

People told us that they liked the meals and we saw that the food looked appetising and hot and was in sufficient quantities. Visitors commented “The food is appetising’’ and “[person] is well fed.’’

Care staff were attentive to people’s health care needs and sought appropriate medical attention when required.

The registered manager and care staff had built up good working relationships with health care professionals such as district nurses, Speech and language therapists and other health care specialists.

One v

This inspection was carried out over three days on the 3rd, 4th and 6th December 2014.

We last inspected Anbridge Care Home (Anbridge) in September 2013. At that inspection we found that the service was meeting all the standards we assessed.

Anbridge provides accommodation and personal care for up to 20 people in a large converted and extended residential building. Anbridge is located approximately one mile from Oldham town centre. Accommodation is provided on two floors with a passenger lift and stairs between the floors. The home was fully occupied at the time of our inspection. We found the building to be well maintained, clean tidy and odour free.

Anbridge is legally required to have a registered manager. 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. Mr Charles Jones has been the registered manager since becoming the owner of the service in 2004. This provided a significant level of consistency for people who used the service and the staff team.

The atmosphere in the home during our visits was calm and relaxed. Staff were friendly and respectful in their dealings with each other, visitors and people who used the service.

People who used the service were positive and complimentary about the attitude and competency of the staff team. Care was assessed, planned and reviewed on a regular basis. There was good communication between all levels of staff at the home.

The provision of food was good. Social activities were a regular part of life at the home and accessible to all who wished to participate. This included, where appropriate, involvement with the local community.

The overall service was regularly reviewed by the service providers who were keen to continually improve the home’s environment and the quality of care. Positive comments were received from health and social care professionals about their work with end of life care.

Information which we received from health and social care professionals who had contact with the home was positive about the care and support provided by the staff team.

During this inspection we spoke in private with three people who used the service, three relatives of people using the service and two members of staff. Everybody who we spoke with was positive about the care and support provided to them.

People told us they were involved in discussion and decision-making about their care. One person told us that staff treated them with "great respect".

People’s care and support was based on a written plan which in turn was based on a comprehensive series of assessments. Care plans were regularly reviewed. People told us that "they [staff] always listen to me" and "they [staff] find time to sit down and talk to you". Staff told us that communication within the home was good and they were kept up to date with the changing needs of individuals.

There was an appropriate procedure, which was followed, for the safe storage and administration of medication.

Staff were only recruited after a rigorous vetting process. This helped to ensure only suitable people were employed at the home. Staff were described by people using the service and their relatives as "friendly" and "lovely".

The home had a written complaints procedure. People told us they were confident that any complaint they may have would be appropriately dealt with.

During our visit to the care home we spoke with four people who used the service and two people who were visiting their relatives.

People were positive about the care that they received and confirmed that they could influence the way in which their care needs were met. One person who was using the service said "they know how you want to be looked after" and "staff treat me well"

People told us that they were confident that support would be provided from agencies based in the community if necessary. This included for example, calling a doctor if they were unwell.

People who were using the service, who we asked, said that they liked the accommodation that was provided. They also told us that the home was kept clean and tidy. One person said "I have no complaints about the room"; another described their room as "smashing" and another talked of the "good cleaners".