Annfield House Care Home Service 58 Annfield Gardens Stirling FK8 2BJ Telephone: 01786 451122 Type of inspection: Unannounced Inspection completed on: 26 May 2017 Service provided by: HC-One Limited Service provider number: SP2011011682 Care service number: CS2011300632
About the service The service was registered with the Care Inspectorate on 31 October 2011. The care home provider is HC One. Annfield House Care Home is registered to provide a care home service to 50 older adults. There is a dedicated respite placement in one bedroom in the basement level. The accommodation is provided over four levels of the building. Bedrooms are single and have a variety of en-suite facilities. There is a patio area with seating and tables to the rear of the building which is accessed from the dining room on the ground floor. There are a range of communal areas which can be used by residents and their visitors throughout the care home. The provider states that they "want HC One homes to be the kindest homes in the UK with the kindest and most professional staff, where each and everyone matters and each and everyone can make a difference". What people told us People were complimentary about the service and the following comments were made: "I feel that am looked after well and enjoy staying here everyone is friendly" "food good, a good dinner whatever you like. Staff are nice to me." "am happy with the care I receive." "I am glad that my family helped me choose this care home as I am happy and content here." "very well kept clean home with lots of lovely small welcoming touches such as fresh flowers, chocolates and a coffee machine for guests and residents " "staff are all very caring and always willing to discuss and help with any concerns the family may have." Self assessment Providers are not currently requested to submit a self assessment. From this inspection we graded this service as: Quality of care and support Quality of environment Quality of staffing Quality of management and leadership 5 - Very Good What the service does well People were complimentary about the manager, the staff and the care they received. Staff were hard working and supported people in a kind, caring and friendly way. It was clear that good relationships had been developed between people living in the home, their relatives and staff. We saw many examples where staff were attentive to people's health needs, for example, when they were supporting people during mealtimes. page 2 of 7
When we spoke with the managers and staff from different departments of the home, we found them to be friendly, caring and committed to their role in providing a good service and to continual improvement. There were two activities organisers in the home and we saw some people were enjoying some of the group activities which were arranged. We saw that regular outings were organised. The home had also been accepted to be part of a new programme about physical activity led by the Care Inspectorate and commissioned by the Scottish Government called the 'Care...about physical activity (CAPA) improvement programme'. This showed a firm commitment to enhancing opportunities for people. There were clear and comprehensive quality assurance processes in place including monthly visits to the service by external managers. The manager reflected that they found these supportive in feeling safe and that any gaps and need for improvement were identified. In discussion with the internal and external management team, there was a reassuring openness about exploring ways in which improvements could be made. A Clinical Lead was now in post which was helpful to supporting staff team development. We heard about plans to support the staff team to develop a more reflective approach to enhance their confidence and also to provide more training opportunities and follow up support to enable staff to put their learning into practice. The home had a very attractive sheltered garden area to the rear of the building with seating, tables and parasols and there was also seating to the front of the home. Some people were enjoying sitting out together in the sunshine and meals and drinks were served outside for people who wished this. We were told about plans to install an additional gate to make the garden more safe and secure. Throughout the home, large well maintained communal rooms provided scope for activities and watching television. Dining areas had heated food serving areas. Freshly prepared food was sent up from the main kitchen in a "dumb waiter" which meant there were appetising smells from the food in the dining rooms as people waited to be served. Redecoration and refurbishment of the home was on going and regular maintenance checks took place. There was a clear and knowledgeable focus on safety within the home in relation to the use of equipment such as bed rails. What the service could do better More focus was needed on the support being provided for people who needed help with eating and drinking. Although the mealtime experience was good for some people, more consistency in staff practice was needed across the home and in particular, the second floor. We were unable to clearly track what supports were in place, for example, when someone was at risk of losing weight and also how staff kept up to date with any changes to people's needs. Relevant records such as care plans, weekly weight overviews and the food charts needed to be clearer and up to date to reflect how people were being supported. We have made a recommendation about this. Please see recommendation 1. We saw many people spending a lot of time either in their room or in communal areas with very limited stimulation or support to engage in meaningful activities of their choice. An enhanced focus was needed to make sure that more resources and staff time was available to improve outcomes for people. We have made a recommendation about this. Please see recommendation 2. When we looked at care plans we found that they needed to be written in a more person-led way in terms of the detail and also the language that was used. page 3 of 7
We found it hard at times to find clear guidance about how care and support was to be provided. We could not clearly see the care plans had been written in consultation with people and/or their representatives. We have made a recommendation about this. Please see recommendation 3. We had to intervene to get support for some people who needed help during our visits. We acknowledge that when we spoke with the manager they arranged for immediate support for them from staff on other floors. When we spoke with people we observed that some people needed more support with their personal care such as, hygiene, nail care and glasses being cleaned. Given this and our findings overall, we discussed the need to reconsider people's dependency needs and staff deployment. We also discussed the use of more observational supervision and management involvement in relation to staff practice and people's outcomes. We will look at the progress on this on our next inspection visit. Records about the number of aids and equipment in use were unclear so we suggested that an inventory of all aids and equipment was drawn up to show precisely what was currently in use in the home. Requirements Number of requirements: 0 Recommendations Number of recommendations: 3 1. The provider should make sure that everyone living in the care home has the right care and support in relation to eating and drinking and that records such as, food and fluid charts and risk assessments are clear and up to date. National Care Standards - Care Homes for Older People, Standard 5: Management and staffing arrangements 2. The provider should make sure that more resources and staff support is available to everyone living in the home in relation to daily activities. National Care Standards - Care Homes for Older People, Standard 5: Management and staffing arrangements 3. The provider should make sure that care plans are clear, person-led and up to date in relation to people's needs and in particular their needs in relation to eating and drinking, activities, falls and stress/distress responses. National Care Standards - Care Homes for Older People, Standard 6: Supporting arrangements. Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at www.careinspectorate.com. page 4 of 7
Inspection and grading history Date Type Gradings 15 Jun 2016 Unannounced Care and support Management and leadership 29 Sep 2015 Unannounced Care and support Not assessed Not assessed Not assessed Management and leadership Not assessed 8 May 2015 Unannounced Care and support Management and leadership 29 Oct 2014 Unannounced Care and support Management and leadership 19 May 2014 Unannounced Care and support Management and leadership 8 Nov 2013 Unannounced Care and support Management and leadership 17 Jan 2013 Unannounced Care and support Not assessed Management and leadership Not assessed page 5 of 7
Date Type Gradings 10 Oct 2012 Unannounced Care and support Management and leadership page 6 of 7
To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. Care services in Scotland cannot operate unless they are registered with the Care Inspectorate. We inspect, award grades and help services to improve. We also investigate complaints about care services and can take action when things aren't good enough. Please get in touch with us if you would like more information or have any concerns about a care service. You can also read more about our work online at www.careinspectorate.com Contact us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com 0345 600 9527 Find us on Facebook Twitter: @careinspect Other languages and formats This report is available in other languages and formats on request. Tha am foillseachadh seo ri fhaighinn ann an cruthannan is cànain eile ma nithear iarrtas. page 7 of 7