Care and Social Services Inspectorate Wales Care Standards Act 2000 Inspection Report Hafod Mawddach Marine Road Barmouth LL42 1NW Type of Inspection Focussed Date(s) of inspection 07/04/2013 Date of publication 19/06/2013 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: cssiw@wales.gsi.gov.uk www.cssiw.org.uk
Version 1.0 01/2012 2
Summary About the service Hafod Mawddach is registered with the Care and Social Services Inspectorate Wales to provide personal care and accommodation for 25 service users over the age of 65 years. Included in the registration is the provision to provide personal care and accommodation for 7 service users who have a diagnosis of dementia. Respite care and day care is also provided. Mrs Morwenna Edwards is the responsible individual; acting on behalf of the Council. Ms Alexandra Campbell is the registered manager and is also registered with the Care Council for Wales. Hafod Mawddach is a two storey purpose built home owned and managed by Gwynedd Council. Accommodation is provided in single bedrooms located on the ground and first floor. Access to the first floor is gained by a passenger lift or stairway. The home is located within close proximity and walking distance to all the local amenities of Barmouth. What type of inspection was carried out? This is a scheduled focussed inspection which covered the quality of life service users experience at Hafod Mawddach. An unannounced inspection visit to the home was conducted on 07/05/2013 between 11:45 and 15:10. In the course of the inspection visit we (Care and Social Services Inspectorate Wales) met with a majority of the people using the service. Discussions with people using the service were held with and without staff present. We viewed the files of 3 people using the service. The practice of staff was observed throughout the inspection visit. Discussions were held with staff on duty at the time of inspection. Alexandra Campbell, registered manager was not at the home at the time of the inspection. What does the service do well? People using the service can feel confident in the care they receive because staff are competent and confident in they way they care for people living at the home. Discussions with staff members demonstrated their knowledge of the individual social and health needs of people using the service. During the inspection process we observed staff interact in a positive manner and treated people with respect and dignity. People using the service said that they were happy living at Hafod Mawddach - praising the care staff and management at the home. What has improved since the last inspection? The registered providers have committed themselves to ensure that there is a management team in place at Hafod Mawddach. This is because the service now has a manager who is registered with CSSIW and the Care Council for Wales. 3
The registered persons are committed to the personal development and competency of the staff team for the benefit of the people using the service. This is because care staff told us that they felt valued and supported by the management. What needs to be done to improve the service? There were no issues of non compliance to report. There are areas where practice could be further developed so as to improve the service. These are:- National Minimum Standard 20 Staffing Levels Staff were observed encouraging people to take part in coordination and movement activities in the lounge. However, during the activity session the staff member was distracted to respond to the call bells and assist people with their personal needs. Staffing levels should ensure that there are sufficient staff to carry on activities and social interaction with service users and to ensure that care tasks are also completed. National Minimum Standard 36.8 Adaptations and Equipment On the day of the inspection we saw wheelchairs and wheelchair foot rests kept in the lounge area. The foot rests were close to one of the entrances to the lounge. The location of these were unsightly and could cause a risk of people tripping over them. Consideration should be given to storing equipment away from the communal areas when not in use. National Minimum Standard 9 Social Contact and Opportunities People using the service should find that their lifestyles in the home matches their expectations. Hand and bath towels were seen in bedrooms and bathrooms. Although these looked clean they were very worn and discoloured. Consideration should be given to replacing items of linen which are worn and discoloured. 4
Quality of life Overall, we found that people using the service were able to access their rights and the people s individual needs were understood and met. Service users spoke positively about living at Hafod Mawddach and how their individual choices are respected. People using the service said they can choose when to get up, when to retire and whether to remain in the privacy of their own bedroom or sit and join in the activities in one of the communal areas. One person told us that they had chosen Hafod Mawddach as they had previously experienced a positive period of respite care at the home. Care staff are committed to providing a person centred approach. This is because we heard staff speak to people in their preferred language and their personal choice with regard to whether a male or female staff member assists with personal care. People using the service benefit from having healthy and appetising meals and staff ensure that people have plenty to drink. Service users said that they enjoyed the meals served and they had choice of meals. We saw meals being served and daily menu s providing a choice of meat, vegetarian or fish option. We saw service users being served their meals in the areas of their preference including the dining areas, individual bedrooms or at a table in the main lounge area. We saw staff regularly checking with service users whether they would like a hot or cold drink and seconds following the serving of meals. A record is maintained of meals provided. People were seen to be positively occupied and stimulated. Service users said there were sufficient activities at the home. We saw that daily life in the home can be busy, but also saw that staff not only paid attention to service users personal care needs, but were also involved in social activities with service users. Photographs were displayed of various activities held at the home and we were told that the local leisure centre staff continue to visit on a weekly basis to do chair aerobics and exercises. In addition to the more organised activities, we also saw service users relaxing and watching television in one of the lounges or in the privacy of their own bedrooms. When we arrived at Hafod Mawddach people were sitting outside with staff chatting in the sunshine or reading a book or newspaper. We also saw people using the service and staff go for a short walk out of the grounds of Hafod Mawddach after lunch. The impact for service users is that they remain active, stimulated and part of the community. People using the service are helped to stay healthy or manage their health care needs because the staff and management are aware of their care needs and they have good access to specialist and/or medical support. We saw evidence of specific aids for individuals using the service, for example wheelchairs, walking frames. People using the service develop relationships and feel recognised and valued by others. This is because we were told by service users that they have developed new and old friendships with other service users since living at Hafod Mawddach. One person told us that they had rekindled a friendship with another service user when they moved to live at Hafod Mawddach. We heard how people maintained contact with their friends and family. Relatives and friends visit Hafod Mawddach on a regular basis and some service users have their own mobile telephones. We viewed the care plans of 3 people living at Hafod Mawddach. Whilst some had limited information, others had detailed information regarding the person s health and social needs. The senior carer stated that all service users care plans are being revised using the person centred planning and risk assessment processes. 5
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Quality of staffing CSSIW did not consider it necessary to look at any length at the quality of staffing on this occasion but a few aspects in relation to staffing were discussed. However, this theme will be considered in greater detail during future inspections. 7
Quality of leadership and management CSSIW did not consider it necessary to look at any length at the quality of leadership and management on this occasion. However, this theme will be considered during future inspections. 8
Quality of environment CSSIW did not consider it necessary to look at any length at the environment on this occasion but a few aspects in relation to the environment were observed. This theme will be considered in greater detail during future inspections. 9
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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. 11