Background to this inspection
Updated
11 July 2018
We carried out this comprehensive inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 8 and 12 June 2018 by two inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
The home was last inspected in March 2017 when it was rated as 'Requires improvement' overall with a breach of Regulation 12 of the Health and Social Care Act 2008 relating to Safe Care and Treatment.
Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. We reviewed information we held about the service, including previous inspection reports and notifications of significant events the provider sent to us. Notifications are information about specific important events the service is legally required to tell us about.
During the inspection we spoke with nine people who use the service and three family members. We observed care and support being delivered in communal areas of the home. We also spoke with the registered manager, the deputy manager, the service auditor, the house keeper, five care staff and the cook. We also received feedback from two health care professionals who had contact with the service.
We looked at care plans and associated records for nine people and records relating to the management of the service. These included staff duty records, three staff recruitment files, records of complaints, accidents and incidents and quality assurance records.
Updated
11 July 2018
Annefield Grange is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is registered to provide accommodation for up to 18 people. There were 16 people living at the home at the time of the inspection.
Accommodation is arranged over four floors which could be accessed by a passenger lift or a turning/spiral staircase. There was a number of communal areas available to people including a dining area, lounge and conservatory.
The inspection was conducted on 8 and 12 June 2018 and was unannounced.
A registered manager was 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.
At our last inspection in March 2017, we gave the service an overall rating of ‘Requires improvement’ and identified a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider has failed to ensure risks relating to the safety and welfare of people using the service were assessed and managed and that all reasonable action is taken to ensure people's safety. The provider wrote to us, detailing the action they would take to address the concerns.
At this inspection we found that appropriate actions had been taken that and therefore the service was no longer in breach of this regulation.
People felt safe living at Annefield Grange. Staff knew how to identify, prevent and report abuse. Safeguarding investigations were thorough and identified learning to help prevent a reoccurrence.
Individual and environmental risks to people were managed effectively. Risk assessments identified risks to people and provided clear guidance to staff on how risks should be managed and mitigated.
There were enough staff to meet people’s needs in a timely way and staff were able to support people in a relaxed and unhurried way. Appropriate recruitment procedures were in place to help ensure only suitable staff were employed.
Arrangements were in place for the safe management of medicines. People received their medicines as prescribed. The home was clean and staff followed best practice guidance to control the risk and spread of infection.
People’s needs were met by staff who were competent, trained and supported appropriately in their role. Staff acted in the best interests of people and followed legislation designed to protect people’s rights and freedom.
People had access to health professionals and other specialists if they needed them.
Procedures were in place to help ensure that people received consistent support when they moved between services.
People were cared for with dignity and respect and were treated in a kind and caring way by staff. Staff know people well, encouraged people to remain as independent as possible and involved them in decisions about their care.
Staff protected people’s privacy and dignity and responded promptly when people’s needs or preferences changed.
Staff worked in partnership with healthcare professionals to support people at the end of their lives to have a comfortable, dignified and pain-free death.
People had access to a range of activities. They knew how to make a complaint and felt any concerns would be listened to and addressed effectively.
People and their relatives felt the service was run well. There was a clear management structure in place and the registered manager had access to appropriate support from the provider.
There were robust auditing processes in place. The quality of the service was monitored and appropriate actions were taken when required.
People, their families and staff had the opportunity to become involved in developing the service.