Annefield Grange

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We assessed all quality statements within the effective key question. People’s needs were assessed and care plans were developed in partnership with them and professionals involved in their care. Staff followed evidence-based good practice and carried out regular reviews of the support people required. People were supported to maximise their independence, choice and control. Where people lacked capacity to consent, staff upheld their rights and acted in accordance with the Mental Capacity Act 2005.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s care records demonstrated robust processes were in place to assess people’s needs and develop up to date care plans. People told us they were asked about their needs and wishes and felt staff knew them well and treated them with respect. Relatives described to us how they felt supported by staff and always welcome when they came into the home. They described how staff listened to them, updated them on their relative's care and asked how they were as well.

The registered manager described the assessment process. It was clear there was a robust system to assess people's needs prior to admission and determine if they could safely meet their needs at Annefield Grange. The registered manager explained once people were admitted they were supported by a key member of staff who asked them about their life history, cultural or religious beliefs, protected characteristics, and preferences. The deputy manager or registered manager used this to develop people’s care plans and discussed further with them and or their relatives as appropriate.

A range of monitoring tools were used to continually assess people's needs. These included the national early warning score (NEWS), malnutrition universal screening tool (MUST), food and fluid intake and weight monitoring. These were being used where appropriate for the person's level of risk and in line with best practice Where risks had been identified, these were regularly monitored and action taken when needed.

People told us they were asked their views about what they wanted to eat and we saw menus and records of people's nutritional intake. People were offered alternatives if they did not like the choices on the menu. People were involved in making decisions and supported to understand options. We observed this during a residents’ meeting where people discussed if they wanted to try introducing a continental style breakfast. One relative told us, "My relative's eating habits are erratic, but the staff go above and beyond to try and tempt [relative] to try different foods, which has proven quite successful. As [relative] is very slight, it is very reassuring to know that the staff are aware of their appetite and take the time and effort with [relative]." People also had monitoring records to demonstrate identified risks had been monitored, with action taken when needed. These were discussed with people and they or their relatives were involved in decisions about their health and support needs.

Staff explained the system which enabled them to take monitoring readings of people’s health. This was done in partnership with their local GP service and enabled staff to monitor people's blood pressure, oxygen levels or other health needs. Information could quickly be submitted and reviewed by a medical professional so that if any intervention was needed, this could be arranged.

The management team and staff worked well with external professionals to ensure they were contacted for people when needed. Medical interventions were promptly sought, and care planning and monitoring processes updated following any advice received.

People had hospital passports and information about their needs and medicines could easily be printed when needed to share with medical professionals. The need to share information with others had been discussed with people and they had consented to this to ensure good continuity of care.

The registered manager described how they shared information with relevant healthcare professionals and sought their advice and support when needed. Staff told us they knew who to contact in an emergency or how to seek medical advice.

We received positive feedback from external health and social care professionals about their involvement. They told us staff contacted them and shared information with them to enable them to effectively support people's needs.

Staff received subject specific supervisions to ensure their understanding of how to meet people's needs and to keep them safe was of a good standard. Staff had a handover at the start of every shift, to ensure they were up to date about people's needs.

People and their relatives told us they were supported to have medical appointments when they needed, and staff were supportive and caring. They also were supported with pain relief as and when needed. Where people were able to, they had homely remedies they could take to manage their own health and wellbeing.

People had regular reviews and discussions with staff and the management team to ensure they were involved in decisions about their health and wellbeing. They were offered wellbeing sessions with a local charitable organisation who came into the home to run sessions.

People were listened to and respected and there were processes in place to help people make choices, whilst also supporting them to understand risk. Staff and leaders liaised with external health professionals and updated people's risk assessments and care plans to ensure their health needs were safely met.

People were regularly asked their views on the service and if there was anything they wanted doing differently. This was done through informal 121 conversations with staff and the management team, through resident meetings and through feedback surveys. People and their relatives had reviews of their support plans and staff discussed with them when there were changes to their health or support needs. One relative told us, “I’ve been involved in discussions several times.”

The registered manager explained how they or the deputy manager monitored people’s electronic care records and ensured staff had supported people with agreed tasks. They monitored this throughout the day to ensure people's needs were met.

The provider had an electronic care planning system that enabled staff and the management team to record and monitor people's needs and take action when needed. Feedback surveys were used to monitor the effectiveness of the service. In addition, people were provided with outcomes of their feedback through ‘You said we did’ records, which showed the management team used the feedback about people's experiences to make improvements.

People were supported to make decisions about their care. Where they were unable to, their capacity had been assessed. We spoke with people who were able to make and communicate their own decisions and also used our observation tool (SOFI) to observe those who were not. One person had an advocate (IMCA) who was available to support them to make decisions. Their involvement had led to increased support to do the things they enjoyed. This had improved their wellbeing and reduced behaviours that posed a risk to themselves and others. We observed staff asking people for consent prior to providing support. During a residents’ meeting it was clear people’s opinions were listened to and valued.

The registered manager was able to clearly describe the process to assess people’s capacity when needed and we saw records to support this. Where people could consent, the management team had ensured records were completed. Staff clearly understood the importance of supporting people to make choices and consent to care needs. A staff member told us, “We [staff] always ask people, we involve them as much as possible and listen if they say no or not yet.”

There were clear processes in place to ensure people were able to consent or not to specific areas of their care. Where they lacked the capacity to do so, clear and decision specific records of capacity assessments and best interest decisions had been made. These included decisions around medicines management, finances and the use of bed rails.