Care and Social Services Inspectorate

Care Standards Act 2000

Inspection Report

Aspen House Care Home

37 Coedpenmaen Road CF37 4LP

Type of Inspection – Focussed Date of inspection – 20 February 2014 Date of publication – 11 March 2014

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

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Summary

About the service Aspen House Care Home is owned and operated by Home Limited. The company have nominated a Responsible Individual to oversee the management of the home. Aspen House is managed by Christine Davies. Mrs Davies is registered with both Care Council for Wales and Care and Social Services Inspectorate, Wales (CSSIW) to act in the role of manager. Aspen House is situated in the residential area of Trallwn on the outskirts of Pontypridd town centre. It is accessible by public transport. Aspen House Care Home is registered to accommodate up to 38 people over the age of 18, who require support with personal care or who have nursing needs.

What type of inspection was carried out? We (CSSIW) visited the home on an unannounced basis on 20 February 2014 between the hours of 9.10 am and 3.15 pm. Analysis of information held by CSSIW about the home led us to plan an inspection which concentrated on the key findings of the last inspection report dated 22 September 2012. During our inspection we considered the following:  Two service user files which were ‘case tracked’ from admission planning through to delivery of care  The home’s records relating to accidents and incidents in addition to quality assurance systems  Consideration of the home’s Statement of Purpose and Service User Guide  Files relating to two members of staff. Our evaluation focussed on recruitment and staff training  Two observations using the Short Observational Framework for Inspection (SOFI 2) tool. The SOFI 2 tool enables inspectors to observe and record life from a service user’s perspective; how they spend their time, activities, interactions with others and the type of support received  Discussions with residents, visitors and staff at the home

What does the service do well? Aspen House Care Home met the National Minimum Standard for the Older People.

What has improved since the last inspection? Care plan documentation had been developed to ensure the health and well-being of people was appropriately planned and met Appropriate references had been sought for new members of staff

What needs to be done to improve the service? No major areas for improvement were noted at this inspection.

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Quality of life

People living at Aspen House Care Home feel they are treated with respect. We spoke to several residents who told us that they felt their dignity was respected whilst they were supported with personal and intimate care. We observed that daily records completed by staff were factual and written in a sensitive manner. We also observed that when a staff member needed to contact a healthcare professional about a service user, she took the telephone into a private room to make the call so as to preserve the resident’s right to confidentiality.

People have some choice over their daily routines. This is because we observed residents choosing to have their hair done and where to spend their time. We also found that people were supported to get up at a time of their choosing. When residents chose to get up early staff told us they were given tea or coffee and biscuits if required as breakfast would not be served until 8.45. Residents who got up early told us they were happy with this arrangement. However, when we arrived at the home at 9.10am, we were struck with how noisy the home was. We could see people who had chosen to stay in bed but their bedroom doors were open. Staff made no attempt to stay quiet as trolleys were wheeled around and they loudly greeted service users and fellow staff. This limited the ability of service users to sleep later if they wished. . People have some opportunities to be positively occupied and stimulated. This is because the home has employed an activities coordinator who clearly knew the residents and what they liked to do. Several residents showed us squares they were knitting which would be made into a blanket. An activities room held puzzles and art and craft materials and artwork made by residents was displayed on the ground floor notice board. Computers were available for residents’ use in the ground floor lounge. We observed that people could choose where to spend their time and then when a resident decided they would like to have a lie down in his room, staff supported him to do this. We were concerned that all seating in lounge areas was centred around a television set and that on two floors we observed the television on but with no sound, whilst music was playing from a separate sound system. Having this conflict between what is seen and what is heard can be confusing and we brought this to the attention of the registered persons. We also brought to staff’s attention that service users should have a clear choice about what to watch on television. This is because we observed 5 service users who started to watch a film in a foreign language fall asleep. When prompted by us to check, the residents told the staff that the film was “rubbish”. Staff were then able to find another programme which the residents chose.

Residents are helped to look after themselves and can exercise some choice and control over how they are cared for. This is because residents told us that they were able to direct staff as to how they wanted their care to be provided. Care plan documentation included details of personal preferences and also highlighted what a person could do for themselves.

People can have confidence that they will be supported to remain as healthy as possible. This is because we saw that appropriate referrals had been made to relevant healthcare professionals. We also saw that care plan documentation also gave information to staff on specific medical conditions and best practice. We were concerned that the morning medication ended at 11.25am and the lunch time round started at 1pm. This presented a potential for residents to receive their medication too close together. We were assured by the registered manager that this was not usual

4 Version 1.1 07/2012 practice. She explained that the morning round had been delayed as the administering nurse had just returned from leave and was taking care to check the medication requirements of residents who had come to live at the home during her absence. The manager was able to explain how this would be managed differently in the future to avoid such delays.

Residents are supported to maintain healthy nutrition and hydration. This is because care plan documentation included details of dietary and hydration needs and preferences. When questioned, staff were knowledgeable about food and drink preferred by residents and were able to show us how intake was documented and reviewed. We observed breakfast and lunch being served during our visit. Residents had a choice of meal and portion sizes were good. Residents told us that the food was generally of a good standard.

We undertook an observation of service users using the Short Observation Framework for Inspection. This showed us that, although interaction between staff and service users mainly took place only when it was associated with a task, conservations were warm and considerate. Staff clearly knew residents well enough to maintain conversations with them.

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Quality of staffing

As this was a focussed inspection, we did not consider the quality in staffing in detail. We only considered the issues raised in the previous inspection report which were concerns regarding recruitment and staff training.

People living at Aspen House Care Home can be assured that staff have been recruited using safe and robust practices. We examined the recruitment files of two members of staff who had been employed since our last inspection. We found that all pre recruitment checks required by law had been undertaken.

Residents can be confident that staff have been trained in how to provide safe and competent care. This is because we found that staff had attended training in core areas of care, including infection control, moving and handling, first aid and how to identify and report abuse.

Comments we received about staff included “excellent across the board”, “most are very good, a couple can be a bit bossy”, and “all the staff are lovely”.

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Quality of leadership and management Aspen House Care Home is owned and operated by Cwmdare Home Limited (also known as the registered provider) and is managed by Christine Davies (known as the registered manager).

People thinking of coming to live in Aspen House Care Home are given clear information about what the home has to offer. This is because the registered persons have produced a Statement of Purpose and Service User Guide. The information given in these documents was found to be reliable and a true reflection of the service offered.

Residents of Aspen House Care Home can have confidence that the manager will respond to critical incidents. This is because we considered entries in the accident and incident book and found that appropriate action had been taken in each case. The registered person had informed CSSIW of any event affecting service users’ wellbeing as required by the Care Homes (Wales) Regulations 2002.

People living at Aspen House Care Home can be assured that the home is competently managed. This is because Mrs Davies has retained her registration with the Nursing and Midwifery Council as a fully qualified nurse. She is therefore deemed competent to assess people coming in to the home who have nursing needs. Staff told us that they found Mrs Davies to be approachable and supportive.

Residents experience an improving service. This is because staff told us that, since the manager had come to the home in October 2012, there had “been many changes – all for the better”. We also found that the registered persons had conducted an annual quality assurance exercise. The resulting report highlighted areas that residents were happy with and also areas for improvement which had been acted upon. To fully meet the requirements of the regulations, views from stakeholders and staff must also be sought when considering the quality of service provision. The registered manager agreed to include these in her next quality assurance exercise and this will be examined at our next inspection.

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Quality of environment People living at Aspen House can feel a sense of familiarity and belonging. This is because we noted that service users’ bedrooms were highly personalised in terms of furnishing and décor. Some residents had also chosen to bring some of their furniture into their rooms to make it more individual for them. People had been encouraged to bring in photographs of family members and friends in an effort to make bedrooms more homely.

Residents benefit from a home that is light, airy and clean. We found the home to be well maintained and good infection control measures were in place. Hand sanitizer was freely available throughout the home. Soap, paper towels and guidance on good hand hygiene was available in each toilet room. The most was made of the natural light coming into the home through the windows.

People’s wellbeing is promoted because the home had a range of facilities and equipment. We found that residents could choose to shower or bath and that there was sufficient moving and handling equipment to move residents safely and appropriately. Each floor had a lounge area where they could watch television or talk with other residents. We observed that some people chose to spend their time on differing floors for “a change of scenery”.

Residents can feel safe whilst living at Aspen House. This is because during our inspection a new door intercom was fitted. This enabled staff to see who was coming into and leaving the home and therefore residents were protected from strangers entering the premises. We also found that significant improvements had been made to evacuation plans following recommendations made by South Wales Fire and Rescue Service.

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How we inspect and report on services We conduct two types of inspection; baseline and focussed. Both consider the experience of people using services.

 Baseline inspections assess whether the registration of a service is justified and whether the conditions of registration are appropriate. For most services, we carry out these inspections every three years. Exceptions are registered child minders, out of school care, sessional care, crèches and open access provision, which are every four years.

At these inspections we check whether the service has a clear, effective Statement of Purpose and whether the service delivers on the commitments set out in its Statement of Purpose. In assessing whether registration is justified inspectors check that the service can demonstrate a history of compliance with regulations.

 Focussed inspections consider the experience of people using services and we will look at compliance with regulations when poor outcomes for people using services are identified. We carry out these inspections in between baseline inspections. Focussed inspections will always consider the quality of life of people using services and may look at other areas.

Baseline and focussed inspections may be scheduled or carried out in response to concerns.

Inspectors use a variety of methods to gather information during inspections. These may include;

 Talking with people who use services and their representatives  Talking to staff and the manager  Looking at documentation  Observation of staff interactions with people and of the environment  Comments made within questionnaires returned from people who use services, staff and health and social care professionals

We inspect and report our findings under ‘Quality Themes’. Those relevant to each type of service are referred to within our inspection reports.

Further information about what we do can be found in our leaflet ‘Improving Care and Social Services in Wales’. You can download this from our website, Improving Care and Social Services in Wales or ask us to send you a copy by telephoning your local CSSIW regional office.

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