Inspection Report on Ty Gwynno Care Home Hafod Lane Hopkinstown Pontypridd CF37 2SD Date Inspection Completed 03 July 2019 Welsh Government © Crown copyright 2019. 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 Ty Gwynno Care Home offers residential care for adults living with dementia and for those who require support with daily living. Nursing care is also offered for those with more complex medical needs who require the support of registered nurses 24 hours a day. The service can provide accommodation for a maximum of 46 individuals. Ty Gwynno Care Home is situated in Hopkinstown on the outskirts of Pontypridd within easy reach of local shops and other amenities including public transport. The registered provider is Irvine Care Limited. There is a manager in post who is registered with Social Care Wales and the Responsible Individual (RI) is Dr Claire Royston. Summary of our findings 1. Overall assessment People benefit from a service that promotes their well-being. Individuals within the home have opportunities to take part in activities of interest. People are treated with warmth and kindness by friendly staff and appear well cared for and happy. Comprehensive personal plans and risk assessment are in place which reflect individual needs. Medication administration and processes are effectively managed. We found the environment to be well maintained and homely. The manager is approachable and knowledgeable and overall staff feel well supported by the management team. 2. Improvements This was the first inspection since the service registered under the Regulation and Inspection of Social Care (Wales) Act 2016 (RISCA). Any improvements will be considered as part of the next inspection. 3. Requirements and recommendations Section five of this report sets out our recommendations to improve the quality of the service. Please refer to section five for further details. 1. Well-being Page 1 Our findings People’s physical and emotional well-being is promoted as they are treated with warmth and kindness by friendly staff. People gave positive feedback about the care provided and we saw that residents appeared generally content and occupied. We found individuals were as healthy as they could be because they received proactive care as identified in their personal plans and were referred to appropriate professionals in a timely manner. Staff were knowledgeable about the people they supported and staffing levels were sufficient to ensure that individual needs were met. We conclude that people receive good care and support which enables them to stay happy, healthy and active. The service offers a safe and suitable environment which supports individual well-being and a sense of belonging. We found people were supported to live in a pleasant and homely environment which was decorated and maintained to a good standard. Bedrooms were personalised to individual tastes and the standard of cleanliness within the home was very good. Policies and procedures were in place to ensure people’s safety was maintained through the use of appropriate security checks, fire safety measures and an ongoing programme of maintenance and repairs. Therefore we can conclude people’s well-being is enhanced by having access to a safe and pleasant space to live. People are listened to and have influence over the care they receive. We observed throughout the inspection that individuals were treated with dignity and respect and were able to contribute to decisions made in their day to day life. The policies we looked at were comprehensive and legal rights were recognised and supported. We found the service had a good understanding of people’s needs particularly those with a diagnosis of dementia. We found the service actively sought feedback from a number of different sources to ensure they continued to provide effective services. In conclusion we found individual circumstances are considered and people can contribute to decisions related to their care. People are protected from abuse and neglect. People can be confident that they are cared for by staff whose character and suitability to undertake their roles had been checked prior to the start of their employment. Staff received adequate training relevant to their role which enabled them to understand their responsibilities to safeguard and protect vulnerable adults. Up to date policies and procedures were in place to ensure the service followed national guidance and current legislation. Medical and professional advice was sought in a timely manner and the service was proactive in identifying potential risks. Effective audit tools were in place to support good managerial oversight and ensure best possible outcomes for individuals using the service. Therefore we can conclude that people are safe and protected. Page 2 2. Care and Support Our findings Care files are detailed and reviewed appropriately. We examined four resident files and saw they were well organised and provided up to date clear information on the individual needs. We found pre-admission assessments were carried out by suitably qualified staff. Personal plans in place covered areas such as personal care, diet and nutrition, communication, cognition, behaviour and mobility. We noted one file we examined lacked a behavioural and cognition plan, this was discussed with the manager who agreed to address this as a priority. In addition we found people were supported to complete a ‘living my choices’ booklet which provided an overview of people’s preferences, including how they liked to be supported and what was important to them. Risk assessments and personal plans we looked at were detailed and reviewed on a regular basis and risks were minimised through ongoing monitoring, regular observations and intervention. Best interest and deprivation of liberty decisions were documented to ensure personal plans for those individuals lacking capacity were proportionate and legal. We found that the service had a good understanding of issues related to dementia diagnosis and used specialists tools to assess potential issues around pain management and depression. Daily records we looked at were routinely completed and covered core areas such as safety, medication, diet, continence, personal care and physical well-being however we noted that some daily recordings lacked information on people’s emotional well-being. Therefore we conclude that personal plans are maintained effectively and reflect individual needs however some daily recordings would benefit from documenting peoples emotional wellbeing. Meals times are on the whole a positive experience and people’s nutritional needs are being met. We saw meals were attractively presented and people we spoke with were complimentary about the standard of food they received. Comments included; “I had a lovely breakfast,” and “The meals are lovely, plenty of it and lots of choice”. Kitchen staff told us menus were changed regularly to ensure variety and choice. Menu options were discussed during residents meetings to ensure people were happy with the quality and choice of food they received. We also saw kitchen staff had access to a file which provided information on individual food allergies and any specialist diets. We observed staff interactions through the lunch time period and saw people were supported in accordance with their personal plans. On the whole we found staff interacted with people in a sensitive manner, engaging in conversation and offering reassurance. However we also observed other individuals being supported to eat lunch with very little interaction or conversation. Therefore we can conclude people’s dietary needs are understood and met however some interactions during lunch times could be improved. People are supported to remain healthy and medication is administered and stored effectively. We examined several individual files and saw that timely referrals were made to health and social care professionals including GP’s, dieticians, opticians, advocates, physiotherapists, specialist dementia teams and social workers. We found evidence that Page 3 care staff monitored diet and fluid intake of those at risk of weight loss or dehydration and people were weighed on a monthly basis or more often if their health required. We examined medication administration records (MAR’s) and found that charts were routinely completed and controlled medication was appropriately stored and accurately recorded. Temperature checks were also carried out on a daily basis in line with regulations. This demonstrates that the service maintains safe medication system and people receive care that maintains their physical and emotional well-being. People living at the home are positively occupied and receive good quality care. During our visit we observed activities taking place. We saw a weekly activities lists displayed in the reception area of the home which informed people what activities were planned for the forthcoming week. We spoke with the homes activity coordinator who told us that activities such as yoga, tai chi, bingo, exercise classes, gardening activities, music sessions,