Inspection Report On
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Inspection Report on Brynhyfryd House Nursing Home BRYNHYFRYD HOUSE NURSING HOME 36 WEST CROSS LANE WEST CROSS SWANSEA SA3 5LS Date of Publication Tuesday, 2 October 2018 Welsh Government © Crown copyright 2018. You may use and re-use the information featured in this publication (not including logos) free of charge in any format or medium, under the terms of the Open Government License. You can view the Open Government License, on the National Archives website or you can write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: [email protected] You must reproduce our material accurately and not use it in a misleading context. Description of the service Brynhyfryd House Nursing Home provides care for up to 32 people aged 65 and over. The home can accommodate up to 26 people in a three storey house and up to six people in a separate, two storey cottage. It is set within its own grounds and is located in the West Cross area of Swansea. Plas Newydd Care Limited owns the home, and the responsible individual is Yolanda Jones. There is a manager in place with day to day responsibility for its running. Summary of our findings 1. Overall assessment People can be assured that the home is well managed. People receive a good service and are supported by caring, professional staff that know them very well. Both managers and staff are professional, well trained and motivated The home actively promotes the importance of maintaining people’s health and wellbeing. We saw people are actively engaged in a wide range of activities of their choice. These activities take place both within the home and the wider community. People live in accommodation where they are safe, warm, secure and happy. People also benefit from living in a home which is continually improving. 2. Improvements Staff recruitment records are now maintained to an appropriate standard and meet legal requirements. We saw improvements in record keeping in relation to the care and support being provided. The health and welfare of people is actively promoted and documentation has improved. Summaries of any accidents and incidents are being recorded, and were made available at inspection. 3. Requirements and recommendations Section three of this report sets out our recommendations to improve the service and the areas where the home is not meeting legal requirements. Page 1 1. Well-being Summary People are encouraged and supported to do things for themselves and to be as independent as possible. People can access a wide range of activities of their choice and are actively involved in their communities. People enjoy living an active life in a home that promotes health and well-being. Our findings People benefit from living in a home where a healthy diet and lifestyle is actively promoted. We saw good links between the home and external health and social care professionals. This included district nurses, general practitioners (GP), dentists and podiatrists. At the time of the inspection a GP was attending the home to review a person’s medication. In addition we were told nurse assessors attended the home on a regular basis. This was evidenced in the documentation inspected. We saw people’s diet and nutrition was closely observed. Records evidenced all meals and drinks were recorded, and people’s weight was monitored on a regular basis. Both catering staff and care workers were fully aware of the specific dietary needs of people living at the home. People benefit from a varied diet and attention to hydration. We saw menus were varied, healthy and offered plenty of choice. Food choices for the day were displayed on a board in the dining area. The kitchen had achieved a Level 5 rating (very good) awarded by the Food Standards Agency. We observed people eating both breakfast and lunch. Care workers were seen assisting people who required additional support to eat and drink. This was carried out with patience and sensitivity. In addition and throughout the day staff were attentive in ensuring people were hydrated. One person living at the home said “I have been here a number of years, the food is always good”. A relative told us “the diet of x is always closely monitored”. We saw people were actively promoted to maintain their independence. We saw daily notes of one individual who required support in relation to washing, dressing and grooming. Notes evidenced staff encouraged the person to do as much for themselves as possible, and would assist when required. We saw well documented repositioning charts. We saw nursing staff administered medication in a sensitive and professional manner. They provided us with detailed information on the medication people received and why it was being administered. Medication was stored appropriately and the relevant temperature checks were carried out by nurses on a daily basis. This was to ensure medication was stored at appropriate temperatures. The medication administration record (MAR) charts we saw were accurately completed. This demonstrates that people are supported to be as safe and healthy as they can be. People are encouraged to be involved in communal/ community activities and have opportunities to socialise with people. We saw people were watching television and listening to music in the communal lounge areas. We were told people were encouraged to access the communal areas whenever possible. The home employed two activity coordinators. They were both care workers who were responsible for activities on a part- time basis. At time of the inspection we had the opportunity to speak to one activity Page 2 coordinator. It was evident throughout our discussion they were passionate in making a difference to the lives of the people they supported. People, relatives and staff were extremely complimentary on the work they carried out. One person said “they are great”, a relative told us “always things going on” and a staff member said “it’s made a big difference to the home”. We were shown a number of photograph albums highlighting previous activities. This included attending the theatre, celebrating the royal wedding and an Easter party. They also told us people had enjoyed watching the Swansea air show from the patio area. We found that individual activities were also provided. Example included reminiscence boxes for people living with dementia. These boxes included access to old household items, and historical local information such as the Swansea to Mumbles tram. Another example was providing talking books in Welsh for a person whose first language was Welsh. Care workers told us they made every effort to speak a few words in Welsh to this person on a daily basis. This was observed during the inspection. There was also a one fluent Welsh speaking member of staff. The activity coordinator told us a relative of a person living at the home would be providing poetry reading afternoons. In addition external entertainers regularly visited the home. At the time of the inspection people were seen enjoying a singer in the main lounge. This demonstrates that people can be involved and do things that matter to them. Page 3 2. Care and Development Summary People are cared for by staff that know, understand and are able to meet their individual needs in a respectful way. People can be confident that documentation is person centred and reflects their current situation. Our findings People living at the home have developed good relationships with care workers, who genuinely care about their wellbeing. We saw nice interactions between people and care workers throughout the inspection. People living at the home provided us with a range of positive comments. These included “they are great, they really look after me” and “they are very kind”. Relatives were equally complimentary saying “very happy with the care provided, staff work very hard”. Another said “I have excellent communication with staff”. In discussion with care workers we found them to have a good knowledge of the care and support needs of the people they supported. Care workers portrayed people in a positive light and displayed a caring attitude throughout the inspection. We saw a person living at the home become very distressed and agitated. Care workers used a number of different techniques in trying to distract the person and improved their mood. This included sitting with the person holding their hand and providing a number of activities of which they usually enjoyed. We saw another example where a person had slid to the floor, and required assistance into a chair. Care workers were able to reassure the person throughout the lifting procedure. We heard them explain how they were going to be lifted, whilst carrying out the procedure safely. We heard staff discussing a range of subjects with people, and it was clear they knew the people they supported very well. There were a high number of care workers and nurses that had worked at the home for a significant period of time. We were told that staff turnover was low, and only occasional agency staff used. This appeared to have a positive impact on the home. We observed care workers communicating with people with limited verbal communication. We saw pain identification procedures in place for people who were unable to communicate when in pain. This included the “abbey pain scale”. A relative told us “staff identify and manage x’s pain very well”. People, therefore are treated with warmth, kindness and compassion in their day to day care. People’s have the right care at the right time in the way that they want it. We saw good pre- admission processes in place and the relevant information about people was being recorded.