The Anchorage – Care Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection. This inspection took place on 31 May and 5 June 2018 and was unannounced.

The Anchorage – Care Home is registered with the Care Quality Commission to provide personal care for up to 40 older people who may have physical disabilities and dementia related conditions in one adapted building. The main area, known as The Anchorage, accommodates older people who may have a physical disability. There is a separate wing, known as The Haverstoe unit, which provides support to older people living with dementia. The Haverstoe unit bedrooms are all contracted by the Clinical Commissioning Group and supported by NAViGO, a Community Interest Company and a not for profit social enterprise that emerged from the NHS, to run all local mental health and associated services in North East Lincolnshire. People there are jointly supported by the service and NAViGO along with input from professionals from the Clinical Commissioning Group. There were 39 people using the service at the time of this inspection.

At the last inspection in January 2015 the service was rated overall as 'good' with one section rated 'outstanding'. At this inspection the service was rated overall as 'outstanding'.

The service had a registered manager who has been registered for the past seven and a half years. 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's wealth of experience, competence and knowledge ensured the service was exceptionally well-led. They effectively used quality monitoring and assurance systems to continuously improve the service, understood their legal and registration responsibilities, maintained supportive working relationships with others and ensured the secure and consistent completion of records and documentation.

The staff were outstandingly caring. People, their relatives and visiting professionals, without exception told us that staff were consistently caring and compassionate. The staff fostered, championed and facilitated a person-centred culture. They respected people’s rights, privacy, dignity, diversity and independence.

People received an outstandingly responsive service. Staff found imaginative ways of supporting people to meet their needs through effective care plans. Support overwhelmingly reflected people’s preferences and cultural needs. People were supported to experience an extensive range of activities, pastimes and occupation. Complaints were positively responded to so that outcomes for people were satisfactory. People’s end of life care was extremely responsive to their individual wishes.

The safety of people, staff and visitors was actively maintained using risk management systems. Safeguarding referrals were promptly made to the responsible investigating body. Suitable numbers of staff were recruited and deployed to meet people’s needs. The provider and staff safely managed medicines and the control and prevention of infection.

Staff were trained, skilled and competence assessed to carry out their roles. People’s nutritional and healthcare needs were met. People's rights were upheld through adherence to the Mental Capacity Act and associated legislation. Advocacy services were accessed for people that required them. The premises were suitable for providing support to people and particularly those living with dementia or physical disability.

We found that people or their relatives were involved in decisions about their care and treatment. People we spoke with told us they were able to make choices. One person said, “I can choose when I get up or when I go to bed.” Another person told us, “I tell the staff what I want to eat and how I want to spend my day."

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Care and treatment was planned and delivered in a way that ensured people's safety and welfare. Where risks were identified a more detailed plan of care was written which contained actions needed to maintain people's safety, for example on moving and handling and nutrition. People we spoke with said they received a good standard of care. One person told us,”The staff look after me well. I am happy here.” Another person told us staff attended to their care needs in a timely way.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. People we spoke with confirmed they felt safe in the care of the staff.

There were enough qualified, skilled and experienced staff to meet people’s needs. We spoke with two relatives of people who used the service. They told us they were happy with staffing levels. One relative told us, “It is a very relaxed atmosphere here; the staff do not look like they are rushed off their feet.” We sat in the dining area and saw staff supporting people to eat and drink in a way that respected their dignity. We found there was sufficient staff to meet people’s needs.

People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

People told us about how they liked living in the home and how they were supported to do what they wished. They said they were able to choose their room when they moved in. Relatives spoke with us about the activities that people did. One relative said, “There’s the bench (a workman’s bench) and the chickens in the garden. When I came in the other day they had a ball they were playing with.” Another relative spoke with us about table games that her husband enjoyed. She told us, “Staff are very sociable with the residents. When he first came in they had activities for them, they got four or five people together for table games and he enjoyed that. We took him to the air show last weekend.”

People we spoke with mentioned their appreciation of the care they received. A person who had been at the service for some time told us, “It’s all right, it’s as good as a hotel if not better. On the whole the care is pretty good.” A person who had recently arrived said, “They are treating me very well. I enjoyed my meal. It was very nice fish and chips. They asked if that was all I wanted for dinner, and some pudding.” A relative told us, “My impression is they are very good; they look after him, and attend to his wants, particularly with drinks and his personal care needs.”

People we spoke with said they felt safe in the provider’s care. A relative said, “They have been fine with my dad and look after him very well.”

People spoke positively about the staff that worked with them. One person told us, “Staff are very good, you can’t fail them anywhere.” A relative told us that staff were “Very good.” Another relative said, “The staff all seem very pleasant and they are pretty good at their job.”

People told us they felt their concerns were listened to when they attended the residents and relatives meeting and they knew how to take forward a complaint. One person said, “I do attend the resident and relative meeting. They can be very useful and they take action. I complete surveys occasionally but have not done so recently. If I have a complaint, I mainly tell the carer or the senior on duty and take it from there.”

The Anchorage Care Home is registered with the Care Quality Commission to provide personal care for up to 40 older people who may have physical disabilities and dementia related conditions. It comprises of two units, the Haverstoe Suite which is newly refurbished and provides enhanced dementia care for up to 10 people, and the Anchorage which currently has 28 people living there.

The service had a registered manager in post. 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.

This inspection was unannounced and was undertaken on 5 and 8 January 2015. The previous inspection of the service took place on 10 October 2013 and was found to be compliant with the regulations inspected.

People who used the service told us they were safe. Comments included, “XXX is a lot safer here than at home”, “I feel very safe”, “The best thing about here is that I am protected from any falls and things like that” and “It’s (the home) incredibly clean and safe.”

Medicines were stored securely and administered safely. Records showed people received their medicines on time and in accordance with their prescription.

People who used the service received regular positive interaction from members of staff. The service monitored closely the levels of staff interaction.

The service was kept clean. The building was well maintained and furnished.

People were supported by staff to maintain their privacy, dignity and independence. Everyone looked clean and well-cared for. Staff involved people in choices about their daily living and treated them with compassion, kindness, and respect.

People had access to a wide range of activities. People were provided with one to one support and a wide variety of activities to suit their individual needs. Relatives and friends were able to visit at any time.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and staff followed the Mental Capacity Act 2005 for people who lacked capacity to make decisions for themselves. These safeguards provide a legal framework to ensure people were only deprived of their liberty when there was no other way to care for them or to safely provide treatment.

People’s care plans were written to meet people’s individual needs. The service was responsive to people.

People who used the service knew how to make a complaint. People felt they were able to express their views at any time and that they were listened to.

Leadership and management of the service was good. There were systems in place to effectively monitor the quality of the service.