Care and Social Services Inspectorate Wales
Care Standards Act 2000
Inspection Report
Bridgend County Borough Council Glyn Cynffig
Kenfig Hill
Type of Inspection – Focused Date of inspection – Tuesday, 29 November 2016 Date of publication – Friday, 30 December 2016
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Summary
About the service Glyn Cynffig is registered as a domiciliary care service with Care and Social Services Inspectorate Wales (CSSIW) to provide a rehabilitation service for up to 16 people who have mental health problems or a dual diagnosis of mental health and substance or alcohol misuse. The service aims to maximise independence and community integration, prevent unnecessary admissions to hospital and to provide a respite service.
Glyn Cynffig is located in Kenfig Hill with good access to community facilities and local transport links. The accommodation consists of a single person flat, bedsits and shared flats. There were eleven people being supported by the service at the time of the inspection.
The registered provider is Bridgend County Borough Council (BCBC). There is no registered manager, but we (CSSIW) have received an application from the acting manager which is currently being processed.
What type of inspection was carried out? An unannounced, scheduled focused inspection was carried out which looked at the Quality of Life for people receiving support at Glyn Cynffig.
The following methodology was used:
Visit to the premises on 29 November 2016;
Random examination of two people’s care records;
Discussion with people accessing the service;
Discussion with some staff on duty including the acting manager;
Discussion with 2 professionals – care manager and worker from Community Drug and Alcohol team;
Reference to the Statement of Purpose;
Reference to the last inspection report dated 7 December 2015.
What does the service do well? The inspection identified that there were no areas of outstanding practice. The matters reported here are those which exceed CSSIW’s expectations that conditions of registration, regulations and national minimum standards are adhered to at all times within the care provided.
What has improved since the last inspection? Since the last inspection the acting manager has completed an application to become
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registered manager which is currently being processed.
What needs to be done to improve the service? There were no non compliance notices issued. However the following recommendations have been made:
The provider needs to ensure there is a quality monitoring system in place; Policies and procedures need to be reviewed on an annual basis to ensure they are fit for purpose.
Since the inspection visit the responsible individual has confirmed that quality monitoring will be undertaken.
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Quality Of Life
People receive appropriate, responsive care from staff who have an up to date understanding of their individual needs and preferences. From our examination of two people’s care records we found that the documentation was very detailed. There was evidence of pre-admission information, mental health care and treatment plans completed by the community health team and support plans completed by staff at Glyn Cynffig were person centred, indicating people’s likes and dislikes. Risk assessments were detailed and reviewed regularly in keeping with each person’s individual needs. Care records also demonstrated multi-agency working, in particular close liaison with the community mental health team and community drug and alcohol team. Staff told us that the documentation provided was “fine and risk assessments are individual and detailed”. From our observations and discussions with staff, they were very knowledgeable about people’s needs at Glyn Cynffig. We also saw the daily communication logs, which are used as part of the staff handover. From speaking with two professionals (care manager and worker within the Community Drug and Alcohol team), both were complimentary about the staff team and care provided – “Staff are absolutely brilliant with (x) service user. Superb job managing things and do their very best for (x)”. “Staff are very caring in their approach and want what’s best”.
People are able to access opportunities to learn, follow their interests and develop skills with access to wide ranging opportunities, such as educational courses at the local library; attendance at the local gym and swimming pool. The acting manager told us that five people currently attended a local farm project where they helped out with gardening, outdoor activities and craft making. Some people also accessed a local drop in centre operated by Mental Health Matters which offers a social opportunity, in addition to providing advice and support. People were supported by staff from Assisting Recovery in the Community (ARC) team, to access their activities and interests. Within Glyn Cynffig people made use of the arts and crafts room and we saw some of the art work on display. There was also a “chill-out” room for those who wanted some quiet space. People were encouraged to undertake their own laundry via a rota system either independently or with the support of staff, in addition to domestic chores to ensure their rooms were kept clean and tidy.
Meal times were flexible, with people either independently making meals for themselves or with assistance from staff. Some of the people we spoke with told us they had meals provided at particular projects, whilst others visited local cafes. There was a tea making rota in place, which provided an opportunity for people to get together during the day.
Customer service satisfaction questionnaires had been completed as part of an annual review of the quality of the service. Overall the responses were very positive with comments such as “Very happy with stay”. “Staff are approachable and helpful”; “staff are wonderful” and “very thorough regarding advice”. We also looked at the quality of care report for 2016 which was very detailed. One person told us “They are awesome here. Love it here. Eating much healthier and out a lot more – achieving well”.
We (CSSIW) have not received any notifications, although we saw a high number of incidents recorded for 2016. There was one safeguarding matter which was reported and
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dealt with appropriately and we informed the acting manager that we (CSSIW) should also receive a notification form, as required by Regulation 26 of The Domiciliary Care Agencies (Wales) Regulations 2004. From discussion with two professionals, both commented positively on the levels of communication from the staff team and acting manager – “Staff are always very accessible and on hand – they know what’s going on. Good communication” and “Staff are very responsive – always open to having conversations about people and respond to telephone calls. Good lines of communication.” From discussion with the safeguarding manager at BCBC, bespoke training will be delivered to the staff team in respect of mental health and safeguarding. Training has also been sought from the Community Drug and Alcohol Team, which they have agreed to provide to the staff team. This supports to the ethos of multi-agency working.
We did not observe medication administration during this inspection. However, in discussion with staff they told us that the system was very robust, with two staff administering medication daily and audit checks being undertaken after each round. One staff member told us that the medication training she had attended was “marvellous” and that the practice undertaken within the home mirrored that detailed in the training. We (CSSIW) have also not been notified of any medication errors.
We found that the people using the service received good quality person centred care from dedicated and competent staff. People’s well-being is supported by providing opportunities to acquire daily living skills in order to equip them in their transition back into the community.
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Quality Of Staffing
This inspection focused on the quality of life of the people using the service. We did not consider it necessary to look at the quality of staffing on this occasion. However, we noted that from discussions with the staff team, all were positive about the support they received and gave each other. The staff team is stable and all staff were very committed and enthusiastic about their role.
We found that staff were caring, passionate and committed to supporting the people at Glyn Cynffig and were supported by the seniors and acting manager.
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Quality Of Leadership and Management
This inspection focused on the quality of life of the people using the service. We did not consider it necessary to look at the quality of leadership and management on this occasion, as no concerns have been noted since the last inspection. However at the last inspection we notified the provider that they were non compliant with Regulation 9, 1 (a) and (b) as there was no registered manager in post. The acting manager has now submitted an application which is currently being processed by us (CSSIW).
The acting manager told us that her previous line manager completed regular quality of care monitoring reports, which we saw, but this was not currently being undertaken. However, a detailed annual quality of care report had been completed in June 2016. We have therefore recommended that a system needs to be in place to ensure that the service is monitored, which has been confirmed by the provider.
We looked at policies and discussed with the acting manager that these need to be reviewed on an annual basis to ensure they remain fit for purpose.
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Quality Of The Environment
The quality of the environment is not relevant in relation to domiciliary care other than that there are appropriate office facilities. We can confirm that the registered office is appropriate for the needs of the service and that there are lockable cabinets for the safe and confidential storage of care files and staff information.
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How we inspect and report on services We conduct two types of inspection; baseline and focused. 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.
Focused 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. Focused inspections will always consider the quality of life of people using services and may look at other areas.
Baseline and focused 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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