Care and Social Services Inspectorate Wales Care Standards Act 2000 Inspection Report Glan-yr-Afon Nursing Home Glan yr Afon Lane Fleur-de-Lys Blackwood NP12 3WA Type of Inspection Focused Date of inspection Wednesday, 20 May 2015 Date of publication Thursday, 25 June 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: psi@nationalarchives.gsi.gov.uk You must reproduce our material accurately and not use it in a misleading context. Page 1
Summary About the service Glan yr Afon care home is registered with the Care and Social Services Inspectorate Wales (CSSIW) to provide personal and nursing care for up to thirty nine older persons aged 60 years or older. This can include up to five individuals with a diagnosis of dementia. The home is a refurbished older building set in its own grounds in the village of Fleur de Lys near Blackwood. The home is owned and operated by Comfort Care Homes and there is a nominated person who represents the company. The Registered Manager is Arlene Testa. What type of inspection was carried out? We (CSSIW) visited the home on an unannounced basis on the 20 May 2015. An analysis of information held by CSSIW led us to conduct a focused inspection and considered the quality of life theme and the experience of people using the service. To inform our report we considered the following: a review of information held by CSSIW about the service a discussion with people using the service and family representatives a discussion with the Registered Manager and staff of the home examination of three service user care files examination of the providers quality assurance report 2014 examination of a local authority commissioners contract monitoring report for April 2015 an observation of daily care practice What does the service do well? The provider has won several awards from the Local Health Board (LHB) including one for a programme that uses volunteers to enhance the residents experience and the quality of their life. In addition, a nurse at the home received a Royal College of Nursing Award (RCN) for a programme that enhances the transition period from hospital to the home environment. What has improved since the last inspection? The provider has now established a dedicated member of care staff for the breakfast period which has been extended to allow people to have breakfast at a time of their choice. Review dates of service users plans are recorded clearly in the care file documentation Page 2
where care needs have changed as a result of medical interventions. In the three care files we examined these dates were clearly recorded. What needs to be done to improve the service? No non compliances notices were issued and we did not identify any areas for improvement at this inspection. Page 3
Quality Of Life People can be assured that they have a voice and are encouraged to speak up and can have choice and influence in how they are cared for and their daily living. Each resident is allocated a named nurse and a care key worker who are responsible for ensuring that health and care needs and preferences are acknowledged, known and catered for. We saw person centred care plans and care file documentation which included me and my life and think about me which detailed their past circumstances and life history and needs and preferences. Further participation in decisions on daily living were encouraged through the established residents committee. We saw evidence of a monthly meeting of the committee which decides upon aspects of daily living such as menus, entertainment and trips out. We spoke with several people using the service who feel involved in decision making and felt they had opportunities for choice. One said that she preferred to sit in the smaller of two lounges, on occasions, and was able to move from one to another. People experience wellbeing and can access opportunities to be positively occupied and stimulated. This is because the provider employs the services of a full time activities coordinator who involves people using the service in deciding upon a programme of activities. In addition, she works with residents in producing a social booklet, records the activities undertaken and organises one to one as well as group activities. Immediately following lunch we observed people participating in a reminiscence quiz which proved very popular. The activities coordinator evidently knew the individuals present as she was actively engaging people in and assisting them to think about answers based on their past experiences. We sat with one resident who informed us that there is always something going on. She also asked us to observe the atmosphere for a while as it s always like this. Another resident commented on the fact that the activity is immediately after lunch, which she preferred, as she would only fall asleep and appreciated the stimulation. We were informed by the Registered Manager that the home regularly organised fun days and activity in the garden area. We saw photographs hanging on walls, around the premises, which gave evidence to the involvement of staff in creating a positive and humorous environment. People can be assured that they will be supported in remaining as healthy as possible and that their physical wellbeing is maintained. We saw care files that documented the health needs of people using the service. The files included assessments from hospitals (if referred from there) and assessments on admission. We saw, in care files, that people have access to specialist and medical support which Page 4
included a referral to speech and language therapy and that access to opticians is provided on site; consultations for vision were being undertaken at the time of the inspection. We were informed that the home s GP is part of the local health board enhanced surgery scheme which means that a surgery is provided weekly, at the home. The registered manager informed us that the provider placed a great deal of emphasis on the sensitive care towards palliative care and have recently purchased a syringe driver. The nursing staff are being trained, in its use, by a clinical nurse specialist, provided by the local health board and all staff (carers and nurses) are undergoing training in end of life care. We noted in care file information that allergies are known and catered for in meals and the cook, when spoken with, was fully aware of the needs of individuals. The lunch provided looked appetising and substantial. A recent local authority monitoring report suggested that residents should be allowed to visually choose their meals at the time rather than beforehand. We suggested that the provider consider initiatives such as Menu Counts in Care that the local health board were implementing in other care provision. People experience warmth and belonging and can develop relationships, feel recognised and valued by others. We saw that people are treated with dignity and respect by staff who placed an emphasis on creating a welcoming and homely atmosphere. People using the service and family representatives, when spoken with during the inspection, commented on the wonderful, lovely atmosphere and carers are so nice. Comments recorded in the 2014 Quality Assurance report included staff are so caring and hard working. The provider has been successful in achieving two awards from the Local Health Board based on an initiative which aims to improve the residents experience and quality of life. We saw information that the initiative (Chat programme) uses older volunteers to visit the service and develop relationships with individuals. During the inspection we observed a positive and respectful relationship between staff and people using the service and care files included information relevant to the emotional and psychological needs of people. Bedrooms were personalised, very clean and well maintained and one person told us that she is made to feel supported because staff are always helpful and happy. Page 5
Quality Of Staffing CSSIW did not consider it necessary to look at the quality of staffing on this occasion because the focus was on the quality of life of people using the service. However, this theme will be considered during future inspections. Page 6
Quality Of Leadership and Management CSSIW did not consider it necessary to look at the quality of leadership and management on this occasion because the focus was on the quality of life of people using the service. However, this theme will be considered during future inspections. Page 7
Quality Of The Environment CSSIW did not consider it necessary to look at the quality of the environment on this occasion because the focus was on the quality of life of people using the service. However, this theme will be considered during future inspections. Page 8
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. Page 9
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