Care and Social Services Inspectorate Wales Care Standards Act 2000 Inspection Report Trebanos House Care Home Trebanos House St. Bernards, The Drive Graig Road, Trebanos Swansea SA8 4BB Type of Inspection – Baseline Date(s) of inspection – Tuesday, 9 June 2015 Date of publication – Friday, 31 July 2015 Welsh Government © Crown copyright 2015. 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. Summary About the service Trebanos House is registered with Care and Social Service Inspectorate Wales (CSSIW) to provide personal care and accommodation for up to ten people aged eighteen to sixty four years for people with a learning disability and one named person with functional mental ill-health within the ten places There were eight people living in the home on the day of the inspection. The home is situated in large grounds in a quiet residential area in Trebanos, close to Pontardawe town and approximately ten miles from the centre of Swansea city. There are ten single bedrooms and two communal lounge/dining areas. The registered provider is Care Management Group (CMG) which is a large organisation with care homes in Wales and England that provide support for people with learning disabilities and other conditions. The acting manager Jonathan Melnyk has day to day responsibility for the management of the home. What type of inspection was carried out? This was a scheduled unannounced baseline inspection focussing on all four themes – the quality of life; quality of staffing; quality of leadership and management and quality of the environment. The methodology used was:- One unannounced visit by 2 inspectors Reference to previous report Discussion with people living at the home, staff and the acting manager Discussion with care manager Inspection of 3 people’s care records Inspection of 3 staff records Sight of the Statement of Purpose Tour of the building What does the service do well? This inspection identified that there were no significant areas of outstanding practice that were over and above the regulations and national minimum standards. What has improved since the last inspection? This inspection identified that there were no areas of improvement since the last inspection. Page 2 What needs to be done to improve the service? There were no issues of non-compliance identified during the inspection. However, we discussed with the acting manager the issues which need to be addressed:- The acting manager should complete the application for registered manager for the home and forward it to CSSIW by the end of June 2015. Regulation 8 of the Care Homes (Wales) Regulations 2002. As the previous inspections have identified, the registered persons must ensure that the home is maintained to a good standard, to ensure the comfort and wellbeing of people living in the home and staff working there. Standard 37.12 of the National Minimum Standards (NMS) for Care Home for Younger Adults. Page 3 Quality Of Life People using the service can be confident that staff who support them do so with patience, sensitivity, warmth and kindness, as we observed positive interactions between the people living in the home and staff. People experience enhanced wellbeing because staff are able to recognise gestures and anticipate their needs. Staff display patience and smile at people, which results in a calm and friendly atmosphere. From listening to people at the home, people can feel confident that staff are person centred in the way care is undertaken, as they are familiar with the people living in the home. Positive comments were made about staff by people living in the home ““staff are very good”, “I’m settled here”, “we are good butties”. People are treated with dignity and respect, and choices are actively given to people. This is because during our visit we saw staff asking people whether they wished to join in a group or 1:1 activity. With the recent introduction of a new daily diary, we saw a 24 hour account of people’s activities which evidences people’s mood, and choices, all of which contributes to a person centred care plan. Staff are currently positively adapting to this way of recording. Also if required, people can benefit further from the support of a clinical mental health nurse specialist who is employed by CMG and is currently assisting with specific care plans to support people with their individual needs. People can feel confident that people living at the home are active, positively occupied and stimulated, as people are offered a wide range of different activities within and outside of the home with appropriate levels of support in place for each activity to happen. From discussion with a care manager, we are aware that one of the people living there is benefitting from “better access to the community”. People living there have access to one mini-bus and 2 cars. In the care plans, we saw person centred documents that described people’s preferred activities. On the day of the inspection, we saw that some people were accompanied to local shops as this was a preferred choice, whilst others took advantage of a trip to the Mumbles. On their return, people commented that they “had a good time”. People also told us that they had recently been to a disco and barbeque and the acting manager told us that people living in the home had been included in a recent neighbourhood party, which the home supported by offering extra parking for those attending. People living at the home are actively encouraged to make full use of the kitchen facilities and can plan and prepare meals by receiving the level of support they require. However, the acting manager feels that meal plans are currently staff led, and has plans for this to be a more inclusive activity for the people living in the home, adding more pictorial aids to ascertain preferences, yet balancing healthy options. People can feel confident that there are robust monitoring measures in place regarding administration, management and recording of medication as medication is stored appropriately and at the correct temperature and a system is in place for staff to access information provided with the medication regarding possible reactions. Also there has been a recent review by the Boots the chemist (March 2015) which indicated no issues of concern. Page 4 People can feel confident that finances are managed appropriately, as we saw clear accounting processes in place and observed that the appropriate checks were complete and correct. Due to a change in the management structure the acting manager acknowledges that a revised Statement of Purpose and Service User Guide is now required. We are informed by the acting manager that there are plans to revise the Service User Guide so that more pictorial information is available in order to aid communication for the benefit of people wishing to live at the home. Overall the outcomes for people living at Trebanos House care home are positive as staff strive to provide a good quality of life by encouraging and supporting people to be as independent as possible and treat people with courtesy, dignity and respect. Page 5 Quality Of Staffing People living at the home can feel confident in the care that they receive, as discussion with staff on duty during the inspection identified that there is a stable staff team who know each other well and also know the people living in the home well. There are adequate staff on duty to meet the needs of the people living in the home, some of whom are supported on a one to one basis. People’s social and physical needs are met because staff are competent and confident at meeting their particular needs. From discussions with the acting manager he confirms that there are robust cover arrangements to cover any staff shortages as the staff team can accommodate extra shifts; staff from other homes within the company can provide support, or the home has a robust pool of bank staff who are familiar with the people living at the home. From examination of staff files, we saw that there is a robust recruitment process in place in line with Schedule 2 of The Care Homes (Wales) Regulations 2002, and some staff have worked at the home for a number of years. However, we found that qualifications are not always present on file and would recommend that a review of staff files is undertaken to ensure that appropriate documentation is available. People receive timely support and care and feel listened to, as we observed good interactions between the staff and people living in the home, resulting in a positive atmosphere, with comments from staff such as we are “one big family” and “I love working here”. However a comment was also made regarding being “short staffed”, but following later discussion with the acting manager he confirms that the company has just agreed to recruit a further two staff members. People can be assured that their wellbeing is promoted and protected as staff receive appropriate training which is relevant and up to date to enable them to provide appropriate care and support for all people living in the home. This is because, we saw the computerised training data base which is managed by the deputy manager, and highlights what training has been undertaken and when training requires updating.