Annefield Grange

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We assessed all quality statements within the responsive key question. Staff worked in partnership with people to respond to any changes in their needs. They worked alongside other professionals to ensure people had access to the support they required and to deliver joined-up care. People were invited to share feedback and ideas to improve their experience and the service. People were supported to plan for important life changes, including at the end of their life.

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 and their relatives were involved in developing their care plans. Information about people's needs was detailed and included how staff should support them and their preferences for care and support. For example, one person's care plan described they preferred to spend time in their room rather than with others in communal areas. Another person's care plan described things that were important to them and how staff should communicate with them, to ensure they would recognise when the person needed support. A relative told us, "Staff have gone out of their way to learn [relative’s] little ways." Information about people's life histories including their interests, family members and past jobs was included in their care plans. This meant staff were supported to understand how to support a person's wellbeing and meet their emotional and social needs. Relatives told us they felt staff knew their relative well and listened and involved them in care planning. One relative said, "Staff really know what [relative] likes, for example they do her make up each day, as they know it is important to her. They [staff] all know her well and she trusts them, as do we."

Staff knew people well, understood what was important to them and involved them in decisions about their own life. The registered manager told us the whole staff team worked hard to get to know people and tailored the service provided to meet individual needs. They operated a key worker system to ensure all people had a dedicated member of staff to discuss their needs and any changes they wanted. There was a set day each month to focus on each person and review how things were going. This meant people were receiving person centred care.

We observed staff supporting people in a person-centred way and they clearly knew them well and had developed supportive caring relationships with them.

People's individual needs and life choices were assessed and respected. They were supported to access social, religious and cultural events and opportunities that were important to them. For example, one person practiced a religious belief and their minister visited the service regularly to support them. Another person had specific assessed needs which meant they needed to regularly go out and this was built into their support plan.

The registered manager and staff advocated on people's behalf to ensure they had access to health provision and social, religious and cultural activities. They demonstrated they had people's best interests at the centre of the service and worked well with external professionals and other members of the community to provide opportunities to people. For example, people were supported to attend religious or social events in the community and access health and social care provision.

External professionals told us staff understood people’s needs. One external professional told us, “I required to speak with a [person] over the phone. They [staff] sat with the person, while I spoke with them. The phone was on loudspeaker so they could support, with the answers when needed. Without this intervention this would have impacted on this [person’s] goals and wishes, which were to return home. They [staff] took the time out to support this person and demonstrated empathy throughout the discussion, as at times it was [a sensitive] discussion. With their reassurance this gave the person the confidence to participate.”

People’s needs were assessed, and the staff had regular conversations with them or their relatives to ensure their health and social care needs were met. The provider employed a staff member to provide activities and also engaged external activities provision to come into the service.

Information was shared with people. There were signs around the home to support people to understand information. In the reception area of the home there were printed documents such as welcome information, how to complain, 'you said we did' record and information about the activities and support available. The registered manager office was located in an accessible area and had an open-door policy, so people could visit and ask anything they wished to. People were regularly consulted about their care and support. For example, we observed a residents’ meeting. Staff involved people in decisions and encouraged them to have their say and express their views, as well as providing information to them about upcoming events and any changes to how staff support them. For example, the provider arranged for a singing group to come into the service regularly. People were asked their views about the type of music they sang. This resulted in people giving clear opinions about the type of music they liked and what they did not. In addition, people were asked about a themed day coming up where the focus was on a famous author. People said they would like staff to read one of their books to them. This demonstrated people were given information, which enabled them to make informed choices and enhanced their experiences.

Staff told us people had access to their care records, and these could be printed off in large font or broken down into summaries to be easier to read. The provider also had a large tablet computer available for people to be able to use and access any care records about them, or information they wished to see.

People's care records were in an electronic format. These were reviewed and updated following conversations with people, their families or after changes to needs were recognised. People's communication needs were identified within their care plans. For example, if people wore hearing aids or needed glasses, this was clearly described.

People and relatives all told us they felt they could talk to staff or the management team if they needed to and said they felt listened to. One person said, “I think they [staff] are there when you want to talk to them.” Another said, ““Two of the seniors [staff] have sat with me and talked to me about my feelings which was lovely, they made suggestions and asked if I would like something done.” Comments from relative’s included, "We can always talk to staff or the [registered] manager. We had a meeting last week to discuss plans for [relative]. We are so happy we found this place, they [staff] honestly couldn't be better" and, "I feel confident that I can raise concerns regarding [relative’s] wellbeing if I need to." We observed people's views being sought in a residents’ meeting. For example, discussions were had about going to the cinema and several people said they would like to do this. They also discussed going out to town and for coffee and talked about the summer months and getting an ice cream van to come to the home. People were asked their views on these ideas and also what they thought about arranging a music festival in the garden. We observed people were very positive about this and their views and wishes were listened to and respected. We also observed discussions with people about the changing menu for Spring and the registered manager went through options and asked for any other suggestions. People contributed and said what they liked and did not. This demonstrated an open and inclusive culture where people were supported to be involved and share their thoughts and views.

The provider had a complaints process which was shared with all people and relatives and was also on display within the home. The registered manager reviewed all complaints and feedback received so they could analyse any themes or trends and take action for individual people. This meant they addressed any concerns or changes needed promptly. Staff told us they always listened to people and involved them in decisions about their care.

The provider had a process to actively seek feedback from people and their relatives. This was analysed and the results were displayed in the front reception of the home, so everyone could see where action was needed. They also had a 'you said we did' system, so that when feedback was received, they could show that they had listened and taken action.

People's human rights were met, and consideration given to how their individual care and support needs could be provided. People were registered with the local GP surgery and were supported to access healthcare as soon as they needed it. In addition, community nurses visited the service if anyone was assessed to require their medical oversight and people were supported to attend the hospital for appointments or if they were admitted. Each person had a hospital passport, so that information about their health and care needs was shared with the relevant people with their permission. Reasonable adjustments had been made for people's needs such as handrails, access to mobility equipment, support with communication barriers or consideration of language barriers.

Staff advocated for people and ensured they had access to medical interventions and equipment promptly. The management team were aware of the risks of discrimination and inequality that could disadvantage different groups of people in accessing care, treatment and support, whether this was from wider society, within organisational processes and culture or from individuals. They ensured they had positive working relationships with external professionals to be able to get the right support at the right time for people.

We were told by all external professionals they felt the staff team always sought advice and support when needed and acted on it promptly to achieve good outcomes for people. One external professional told us, "I have always had excellent feedback from the [registered] manager and staff. They have always been able to update me and have demonstrated how they are meeting individual needs. They have demonstrated they interact fully with the person and attempt to find out their likes and dislikes and will put everything possible in place."

People 's individual needs were assessed to ensure they could be met within the environment at Annefield Grange. The registered manager recognised the environment would not be suitable for all people. However, those that were living in the home had appropriate adaptions and support in place to ensure their human rights were met.

People human rights were protected, and they were supported by staff who actively promoted equality and addressed discrimination. Staff knew people well and developed relationships of trust. This meant people could share any information they wished to and receive the appropriate care and support to meet their individual needs. One person said, “The staff are all very conscientious and well suited to the work. There is a mix of ages and they [staff] all seem to know how to behave and what to do. They are caring.” Another said, “They [staff] come round with questions, and you can answer, I say most staff are lovely.”

Staff and the management team were very clear that discrimination against people or staff would not be tolerated. Staff described to us how they would always challenge discrimination and would raise concerns with the management team if needed. They were confident this would be addressed, and people would be supported without discrimination. One staff member said, “The culture here is open and everyone is accepted for who they are.”

There were processes in place to assess people’s protected characteristics and promote an open culture that was inclusive to all. For example, within the reception area of the home there was information about how the service promoted individuality and human rights of people, including religion, sexuality, race and gender. People were consulted about the preferences of the sex of staff members supporting them, and this was adhered to.

People’s end of life wishes had been captured within their care plan. We observed the dedicated care and support provided to one person as they approached the end of their life. They had a detailed and supportive end of life plan which considered all their wishes and involved their family. Their end-of-life plan and the person centred care from staff and management, meant they received the health care and support they needed to have a comfortable, dignified death. Where appropriate, people had records to show they had made decisions about whether they wished to be resuscitated. This was clearly communicated to the staff supporting them so they could share this with emergency medical professionals should they need to.

Staff understood how to support people at the end of their life. We observed high quality end of life care for one person, which demonstrated staff provided person-centred care that was adapted to their changing needs and involved external health professionals. This meant the person had the care and support they needed, and their preferences were understood and met at the end of their life.

The provider had an end-of-life policy in place and plans were implemented and discussed with people and their families as they moved towards the end of their life.