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Care and Social Services Inspectorate Wales Care and Social Services Inspectorate Wales Care Standards Act 2000 Inspection Report Tan-yr-Allt House Care Home 16 Alltwen Hill Alltwen Pontardawe SA8 3AB Type of Inspection – Focussed Date(s) of inspection – 23 November 2012 Date of publication – 14 December 2012 You may reproduce this report in its entirety. You may not reproduce it in part or in any abridged form and may only quote from it with the consent in writing of Welsh Ministers Please contact CSSIW National Office for further information Tel: 0300 062 8800 Email: [email protected] www.cssiw.org.uk Summary About the service Tan yr Allt House is registered to provide nursing care for up to 16 people aged 40 years and over. People currently supported are primarily older people with a diagnosis of dementia or a related condition. The home is situated in Alltwen in the Swansea valley and is approximately five miles north of the M4 motorway. The home is operated by Tan yr Allt House Ltd. a subsidiary company of Fieldbay Ltd who operate three other homes in Swansea, Bridgend and Alltwen. This latter home, Tan yr Allt Lodge, is immediately adjacent to Tan yr Allt House and a close working relationship has developed between the two homes. The responsible individual is Paula Lewis and the registered manager is Aldo Picek. A deputy manager has been appointed in recent months and it is the long-term plan that she will in the future seek registration as manager. What type of inspection was carried out? A focussed inspection was carried out on November 23rd, 2012. The inspection was primarily concerned with the quality of peoples’ lives. The unannounced visit lasted approximately three hours and included discussion with service users, staff on duty and the deputy manager. Discussion also took place with the responsible individual. Life in the home was observed and a tour of the facilities took place in the presence of the deputy manager. Two service user files were also seen. The registered manager was not available on the day of the inspection visit. However, discussion about the service and its future direction took place during an interview to finalise his registration on November 19th. Version 1.1 07/2012 What does the service do well? Tan yr Allt House is a very good service with a longstanding and positive reputation for good quality, person-centred care. People living at the home are seen as individuals and wherever possible they are encouraged to make choices which affect their lives. There is a high service user-staff ratio at Tan yr Allt House and staffing levels can, and often are, increased, where there is a need to do so. Staff are motivated, skilled, knowledgeable and well supported. In recent years the professionalism of the collective staff team has been further enhanced by the recruitment of senior clinical nurses, occupational therapists and access to a psychologist. Tan yr Allt House offers a holistic service – peoples’ physical, social, emotional and spiritual needs are given equal consideration when support is offered. Community based activities are a regular feature of life in the home – it is anticipated that this will increase still further with the purchase of additional vehicles in the coming weeks. The Tan yr Allt House service is particularly well managed. Senior managers are visible and approachable and are frequent visitors to the home. Relatives are often supported in terms of their emotional needs and their views are encouraged and acted upon where appropriate. What has improved since the last inspection? Tan yr Allt House is a service which has consistently developed year on year. Improvements since the last inspection have focussed upon the complete refurbishment of the first floor accommodation – all rooms now have an en-suite facility. There are no longer shared rooms on this floor and the overall occupancy of Tan yr Allt House has been reduced from 19 to 16 people. The passenger lift connecting the ground and first floor has also been replaced. A landscape gardener has recently been employed by the providers. There are plans to renew the secluded rear ‘patio’ garden and for people to have supported access to the sensory garden which is currently being built and which will be shared with Tan yr Allt Lodge. A two day ‘refresher’ training programme has been devised for all staff and this is provided to all staff annually. The on-call management system has been reviewed and now offers improved availability of advice, direction and support for staff whilst ensuring managers who are not on call are not contacted except in the case of an emergency. What needs to be done to improve the service? No non-compliance issues have been made as a result of this inspection. 3 Version 1.1 07/2012 Quality of life People who use the Tan yr Allt House service can be confident that their identified needs will be well met. Care planning is of a good standard and those plans seen were clearly set out, accessible and person centred. A ‘life history’ is collated, usually with the help of relatives, and this helps to give staff a real sense of the person concerned. People can be assured that they will be supported to live their lives as fully as possible and to realise their potential as individuals. Tan yr Allt House offers a holistic service – peoples’ physical, social, emotional and spiritual needs are given equal consideration when support is offered. During the last few years occupational therapists have been employed by the provider – there are now four in post. This has helped enhance this aspect still further and resulted in a more defined professional edge to the way people are supported. Community based activities are a regular feature of life in the home – it is anticipated that this will increase still further with the purchase of additional vehicles in the coming weeks. Discussions with staff, and evidenced by photo-boards, show that people are able to enjoy a wide range of activities and experiences which are well supported in terms of staff and time. Examples include a recent visit to see a ballet and the musical Grease. Visits to local fetes, festivals and fayres take place whenever it is felt that individuals can benefit. Visits to shops, café’s and restaurants are commonplace. A pantomime has been booked and during the inspection a group of service users were going out for a pub meal. There is an emphasis upon promoting experiences for people which take them outside of the home and value is placed upon even the simplest of activities as a way of enhancing the lives of individuals. Activities also take place in-house. Television and music are regular features – a large- screen TV was showing an old black and white film. An occupational therapist was reading to a service user and elsewhere staff were sitting, talking to people prior to lunch. The deputy manager is developing a ‘sensory’ approach to the environment and is looking to introduce more tactile and visual stimuli around communal areas of the home. Overall the home offers people an environment where they can relax and engage with others where are able to do so. Staff are not rushed and people are supported with much kindness, sensitivity and patience. A local vicar has been contacted and is planning to make regular visits to the home to meet people living there and offer communion and other spiritual support if required. 4 Version 1.1 07/2012 Quality of staffing Whilst this aspect was not the focus of this inspection it can be noted that the staff team at Tan yr Allt House, totalling 50 employees, are well trained and supported. This headline figure includes 11 qualified nurses and 10 domestic, administration, maintenance and catering staff. A majority of care staff have achieved a qualification. New staff are expected to enrol for a qualification once they have completed their induction programme. All staff receive a wide range of training which allows them to meet both the general and specific needs of people. All attend a two week induction training programme prior to starting work; there is frequent training thereafter, much of which is provided by the organisation. Fieldbay Ltd. has developed a robust recruitment process which is overseen by their own HR department. For the most part staff selection proves successful and this results in positive outcomes for people who use the service. Staff turnover is low and retention high; there is therefore consistency of support and the opportunity for staff to develop meaningful relationships with individuals. This is apparent from discussions and observations; staff interact with service users in very personal and human manner – it is apparent that there is a genuine affection by staff for the people they care for; staff members were seen to be patient, understanding and sensitive to the needs of people in their care. Staff are well supported – all receive formal and recorded supervision with a line manager as well as an annual appraisal of their work. A staff ‘bank’ has been developed. These staff members are treated in the same way as permanent colleagues and offered training and supervision in the same way. 5 Version 1.1 07/2012 Quality of leadership and management Again, this aspect was not the focus of this inspection visit, however the following comments are meant to give an overview of the management and organisation of the home. The home is operated by Tan yr Allt House Ltd. a subsidiary company of Fieldbay Ltd who operate three other homes in Swansea, Bridgend and Alltwen.
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