Inspection Report on

Bronllwyn Care Home

Colwyn Road Gelli CF41 7NW

Date of Publication

Monday, 19 February 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 Bronllwyn Care Home is located in the village of Gelli, Cynon Taf. The service is registered to provide accommodation for up to twelve people age 65 years and over who require personal care. Within this number, three people with a diagnosis of dementia may be accommodated and one individual aged over 50 years on a respite basis.

The home is owned and operated by Rhondda Cynon Taf Council and the registered manager is Tracey Thomas.

Summary of our findings

1. Overall assessment We found that people living in Bronllwyn Care Home receive a good standard of care which focused on individual needs and preferences. We observed staff supporting people with warmth and in a person centred manner. We also saw that people have the opportunity to participate in daily activities.

2. Improvements No areas of non compliance with regulation had been identified at the previous inspection.

3. Requirements and recommendations Section five of this report sets out our recommendations to improve the service. One recommendation was made:  A system to record when staff have had supervision and when is next due would help to ensure people have their one to one meetings in keeping with good practice as outlined in the NMS.

1. Well-being

Summary

People’s care is person centred. They are given the opportunity to make choices, be active, be involved in their locality and achieve a fulfilled life whilst remaining safe from abuse and neglect. People live in a home that best supports them to achieve a healthy lifestyle.

Our findings

People told us the staff always provided them with good care and they felt safe living at the home. We saw evidence that where appropriate Bronllwyn had made Deprivation of Liberty Safeguarding (DoLS) applications. We saw that a book to record all visitors to the home was being used, which further promoted the safety of people living at the home. People living and working in the home can be confident that their personal information was properly protected. We saw that staff records were stored in lockable filing cabinets. Care records were also securely stored although the required daily documentation was readily accessible to staff. From the documentation we looked at we saw that people had an individual personal emergency evacuation plan in place, describing support required in the event of a fire. There were individual risk assessments and risk management plans to help reduce the risk to people receiving care and staff providing care. Accidents or incidents were appropriately reported to CSSIW using the appropriate form. The people we spoke with all told us they felt very safe at Bronllwyn. People are as far as possible protected from abuse.

People are encouraged to be involved in activities and have opportunities to socialise with others. We saw that there was no dedicated activity co-ordinator; however the staff were very enthusiastic and encouraged people to be as active as possible within their individual abilities. This ensured people living in the home were positively occupied and suitably stimulated. We saw an ‘activity board’ in the corridor. This showed the planned weekly activities, which had been planned six weeks in advance. We spoke with the registered manager who explained how people are encouraged to become involved with the running of the home. People assist with the morning tea trolley, are encouraged to do some laundry and also cleaning of their rooms should they wish to. People have the opportunity to attend the day centre which is on the same site as the home. There is a ‘shop trolley’ which is open twice a week, its sells toiletries, sweets and cards, amongst other things. People are encouraged to help staff run the shop and in particular use the till. We saw that people were also supported to access activities and shops in the community. Family are encouraged to attend special events, such as, high tea, candlelit dinners and coffee mornings. A relative told us “we are very happy with what’s going on”. There was photographic evidence of recent events; people appeared to be very happy and enjoying. Overall, people had a choice in the activities they pursued and were encouraged to follow their interests People living at Bronllwyn are involved, participate and feel valued. We saw that there were regular residents’ meetings for people living at the home. These meetings discussed improvements, changes or any other business, all of which involved better outcomes for the people at the home. Minutes of these meetings were readily available. A keyworker system was in place which allowed staff to get to know people and their families. We spoke with a relative who told us that it was very good to know that their relative had a keyworker who they could approach. However, they also said that all staff were approachable and knowledgeable. We saw care records were written in a way that clearly identified people’s likes and dislikes and the way and time they preferred to have their care provided. We saw that people, or their relatives, had signed to say that they had been involved in discussions about their care plans and people told us that they were able to talk about their care with staff if they wished. People told us “I like everything here”, “I’m very happy here” and “nothing could be improved”. People also told us that the manager is very understanding and approachable. We saw that people are also supported to access activities and shops in the community. People are provided with opportunities to express their views and opinions and are encouraged to make decisions about their care and contributions to the home. 2. Care and Support

Summary

Individual needs and preferences are understood and anticipated and people are involved in making decisions that affect their life whilst being supported to be as healthy as they can. Overall the outcomes for people living at Bronllwyn are positive as they were seen being cared for by staff who treat people with courtesy, dignity and who respect people’s privacy.

Our findings

People receive proactive, preventative care and support. We looked at the records for three people during the inspection. There were detailed life histories. The records indicated that health and social care professionals were involved in their care. Care plans guided staff in the care and support needs required. Care records were very well organised with an effective system in place for reviewing care plans. People living in the home told us they were very happy with the care provided, one person said “it’s really wonderful, they can’t do enough for you”. A relative told us that communication was very good and the manager was easily accessible if needed. We were also told by relatives that there were no concerns regarding the care provided at Bronllwyn. We found that the system for ordering and auditing medication was good and saw that medication charts were signed and dated appropriately and had photographic ID attached. We saw that all care staff were trained and competent in the administration of medicines. Medication was stored in a lockable trolley within the ‘handover room’. People were able to access the support of health and social care professionals appropriately including GP, district nurses and social workers. We spoke with a visiting district nurse on the day of the inspection who told us that there was a good rapport between their respective teams and that the home worked with them proactively in managing people’s health care needs. People living at Bronllwyn receive the right safe care at the right time in the right way.

People are offered a choice of food and drink and receive appropriate support from staff at mealtimes. We saw that people benefitted from a healthy diet with good attention to nutrition and hydration. Staff understood people’s individual needs and listened to their preferences. We saw that the menus were varied, healthy and with plenty of choice. The people we spoke with stated that “food is lovely”, “plenty of choice” and “there are plenty of drinks and snacks”. We observed people at lunchtime which confirmed that choice was available, people were also offered second portions. Choices of fresh hot and cold drinks were readily available and people appeared to be enjoying their meals. Menus were displayed in each lounge. We spoke with the cook who showed us the four weekly menu plans. We also saw evidence in the resident meetings minutes that people were satisfied with the meals provided. The registered maanger told us that the menus are changed 1/4ly to provide a more seasonal variety. The relatives we spoke with also confirmed that the food provided was very good. People’s health is promoted because their dietary needs are recognised and catered for. People benefit from having sufficient numbers of staff to allow them to have personalised care in a timely manner. We looked at the rota and saw that no agency staff are used and that there was a consistent staff group. The staff that we spoke with told us “I enjoy my job” and “I feel supported”. We saw staff interact with people in a positive way offering warmth, encouragement and emotional support. People were treated with kindness and compassion and staff had the time and confidence to develop meaningful relationships with the people in their care. One relative said “I’ve loved it here from the first time I came”. People therefore receive care from a staff team who are able to meet their assessed needs and respond to their individual wishes and requirements. 3. Environment

Summary People can be confident that they are able to live in a comfortable, warm and clean environment. We found that people benefit from pleasant indoor and outdoor communal areas.

Our findings

People feel included, uplifted and valued because they are supported in a personalised environment that is appropriate to individual need. We saw people were relaxed and contented whether they were in the lounges or their rooms. They told us that they liked their rooms and they also enjoyed spending time in the lounges. We saw that people’s rooms contained some of their own furniture and possessions and they were decorated to a good standard. When we arrived we felt that the premises were welcoming and homely and when we toured the home we saw that it was clean and comfortable. Relatives told us that they always felt welcome when they visited. We believe that people live in an environment which is clean, comfortable and personalised.

People are cared for in a well maintained environment. We were shown the maintenance records, these evidenced that all appropriate measures were taken to ensure equipment was suitably maintained. The CSSIW registration certificate was displayed together with the Employer Liability Insurance certificate. People could be assured of effective and efficient fire procedures, testing and training. Records showed the fire alarm was tested every week. We were shown the laundry facilities which were suitable to meet the needs of people living in the home. We saw window restrictors in place. We did not on this occasion inspect the kitchen, they had been inspected by the Environmental Health Department and held a 4* rating. People are cared for in a safe environment which is designed to ensure that people’s individual needs are met. 4. Leadership and Management

Summary

Overall, people living in Bronllwyn benefit from effective leadership and management. We spoke with people using the service, their relatives and staff, and all expressed a high regard for the registered manager. There are quality assurance measures in place which focus on views and wishes of individuals living in the home.

Our findings

People living and working at the home benefit from the stability provided by an experienced and well-established management team with a visible presence. The registered manager provided day to day management of the home. We observed that interactions between the manager and residents and staff were relaxed and friendly but respectful. We saw that residents and staff approached the manager with ease. People, staff and relatives we spoke with all stated that the manager was approachable and helpful. We concluded that the management of the home is visible and approachable.

People can access information to help them understand the care, support and opportunities available to them. This is because we saw a statement of purpose and service user guide available within the home. These documents were current and contained good representations of what the home provides. Copies of these documents were visible and available to view within the home. We found the home’s statement of purpose accurately reflected the service being provided and the values held by its staff; it outlined the range of facilities and services on offer, allowing prospective residents and their families to make an informed decision about possible placements there. The manager and staff spoke passionately about providing a high standard of care and their commitment to this was evidenced through their enthusiasm and attentiveness. We saw there were robust company policies and procedures for staff to follow. We looked at a selection of policies and noted that some but not all had been reviewed. Staff confirmed to us that they knew where to access the policies. The values and vision of the service are clear.

There are suitable procedures in place for recruiting, training and supporting staff. We examined three personnel files that demonstrated all the required checks, clearances and information had been conducted and held on the files. We saw there was training and support programmes in place. Any gaps in staff training had been identified and training booked. Staff told us that they had undertaken a lot of training recently and felt they were suitably skilled to fulfil their roles. The staff we spoke with stated they felt fully supported by the management but historically staff supervisions had not always taken place regularly. We discussed this with the manger who agreed to ensure a supervision programme is in place that meets national minimum standards. Peoples care will be enhanced by the recruitment, support and training of a consistent and motivated staff team. 5. Improvements required and recommended following this inspection

5.1 Areas of non compliance from previous inspections No areas of non compliance were identified at the previous inspection

5.2 Recommendations for improvement We recommend the following:

• A system to record when staff have had supervision and when is next due would help to ensure people have their one to one meetings in keeping with good practice as outlined in the NMS. 6. How we undertook this inspection

This inspection took place on 23 January 2018 and was unannounced as part of our inspection programme. There were no concerns at the last inspection of 31 August 2016.

This inspection which looked at the four quality themes for people living at Bronllwyn Care Home. These are Wellbeing, Care and Support, Leadership and Management and Environment.

The methodology used to conduct this inspection included:

 A tour of the home  Discussion with staff  Discussion with some people using the service  Discussion with visiting professionals and relatives  Scrutiny of three staff files  Scrutiny of the care files of three individuals  Scrutiny of other documentation, as detailed in this report

Further information about what we do can be found on our website www.cssiw.org.uk About the service

Type of care provided Adult Care Home - Older

Registered Person Rhondda Cynon Taff County Borough Council

Registered Manager Tracey Thomas

Registered maximum number of 12 places

Date of previous CSSIW inspection 31 August 2016

Dates of this Inspection visit(s) 23/01/2018

Operating Language of the service English

Does this service provide the Welsh This is a service that is working towards Language active offer? providing an 'Active Offer' of the and intends to become a bilingual service or demonstrates a significant effort to promoting the use of the Welsh language and culture.

Additional Information: