Abermill Care Home
Thomas Street, Abertridwr, Caerphilly, CF83 4AY.
Tel: 029 2083 1622
Email: abermill@hc-one.co.uk
Website:www.hc-one.co.uk
Contract Monitoring Report
Name of Provider: Abermill Care Centre, Thomas Street, Abertridwr, Caerphilly, CF83 4AY
Date / Time of Visit: Wednesday 10 January, 2024, 10.00 am – 3.00 pm / Wednesday 31 January, 2024, 10.00 am – 2.00 pm
Visiting Officer: Andrea Crahart, Contract Monitoring Officer, CCBC
Present: Christine Tipper, Registered Home Manager
Background
Abermill Care Centre is situated close to local amenities in the town of Abertridwr and residents benefit from being in a close knit community and surrounding hills. The Home is part of the HC-One group and is registered to provide accommodation to 38 people (29 people with dementia and 9 older persons). At the time of the latest monitoring visit in January the Home just had 1 vacancy.
The Home comprises of 2 large lounges and a dining area in the downstairs lounge, 2 lounges and a dining area on the top floor.
Some safeguarding referrals had been received during the year, with some meeting the threshold for further investigation and others not being progressed and therefore addressed internally.
The Care Inspectorate Wales (CIW) had carried out an inspection in February 2023 and a report was produced in March 2023 where no issues were highlighted for addressing.
The Home has achieved a Food Hygiene rating of 5, which is very good and was awarded in December, 2023.
Dependant on the findings within the report, corrective and developmental actions may be given to the provider to complete. Corrective actions are those which must be completed as governed by Care Inspectorate Wales (CIW), and developmental actions are those, which are deemed good practice.
Previous Corrective/Developmental actions
Photographs of residents to be placed on the PEEP file where these are currently missing. Timescale: a.s.a.p. Action met.
Photographs of staff to be placed on their individual files. Timescale: within 1 month. Not met to date.
Responsible Individual
The Responsible Individual’s role (RI) is to oversee the services’ quality, compliance and performance, and there is a requirement to ensure that this is being overseen and monitored. It was evident that quarterly reports had been written, with the most recent having been completed in October 2023, which was an unannounced visit and illustrated a very comprehensive overview of the service, with feedback having been sought from key stakeholders i.e. residents, families, staff etc. The Manager confirmed that the RI has a frequent presence in the Home.
The Home’s Statement of Purpose was made available and had been updated in December 2023. The document was reflective of the service and made reference to ‘The Active Offer’ – More than Just Words Welsh Language Act, and how this can be promoted in the Home.
The Home’s Service User Guide was made available in both English and Welsh versions.
The Home’s mandatory Policies/Procedures were viewed as part of the process. All policies were readily available and had been updated, included a version history of updates and included a date for reviewing. Some of these policies include e.g. safeguarding, staff development, infection control etc.
In the absence of the RI and Registered Manager, arrangements would be made for another Manager from HC-One to oversee the Home in the interim.
Registered Manager
The Manager is registered with Social Care Wales (the workforce regulatory body).
The Manager is responsible for the running of Abermill, however there is an expectation that she will cover other HC-One Homes at the request of her manager, if requested. The Registered Manager is well supported by the Regional Manager and the RI.
The Contract Monitoring Officer is aware that the home does not operate a CCTV, inside or outside the building, therefore there is no requirement for consent to be sought from people residing at the Home.
It was evident that Regulation 60 notifications are issued to CIW when there are significant events in the Home that this organisation need to be made aware of, however currently these are not shared with the Caerphilly Commissioning Team. The Manager agreed going forward for these to be sent to the Contract Monitoring Officer in the Commissioning Team as required.
In terms of people being able to regulate the temperature in their rooms via their radiators there are difficulties with this and as such the temperature is controlled by a central thermostat on each floor.
Training and Development of staff
Abermill Care Home has an electronic system, which identifies when staff training is due for renewal. These records provide a statistical analysis of the training undertaken by staff and it was evident that staff are suitably trained and qualified in social care.
The majority of training courses continue to be conducted via E-Learning which staff can undertake during their working day and staff are able to access PC terminals on the same site. These courses include e.g. food safety, dementia awareness, nutrition/hydration etc. Class room type training is also available for courses such as safer handling of people, basic life support and falls in older people. Other training accessed by staff include e.g. fire safety, medication competencies and oral care is covered during the induction phase. More recently the Home has been offered training in relation to pressure care via the Aneurin Bevan University Health Board (ABuHB), which has been welcomed and accepted. HC-One staff have opportunities to develop their careers further by having access to Open University courses, and it was pleasing to learn that a senior member of staff had taken this up.
The quality of the training on offer is assessed by the Manager by speaking to staff about what they have learnt via supervision sessions, observations of practice (e.g. manual handling practices) and walks around the home to observe practices.
Social Care Wales (the workforce regulator) requires all carers to register with them to be part of a professional workforce. All staff have registered and there is a process in place whereby this is updated on a monthly basis by the Manager and HR.
Staffing and supervision
Information was easy to locate on both files viewed as they were organised with an index and dividers.
Two staff files were examined, and both files contained all the appropriate documentation that is required for a thorough recruitment process i.e. 2 written references, a detailed application form, interview record, signed Contract of Employment, Disclosure and Barring Service (DBS) information etc. One of the references had omitted to include some information in relation to attendance/time keeping etc. and therefore it was recommended that additional information such as this should be sought where this is lacking. Files did not include an induction record to indicate what areas had been covered when the staff member was appointed, which the Manager confirmed was often difficult to retrieve from the staff member concerned, and a photograph was absent from one of the files.
The supervision matrix indicated that the staff team have supervisions planned for on a quarterly basis.
Sufficient carers, domestic and maintenance staff could be seen around the Home during the visits and staff did not appear rushed. The Statement of Purpose indicates that during the day time there are 2 senior carers and 5 carers on duty and during the night time there are 1 senior carer, 3 carers and 1 covering twilight.
Currently no staff work more than 48 hours a week.
The Home employs 2 Activities Co-ordinators who work 30 hours/16.5 hour per week which enables activities to be covered 7 days a week.
‘The Active Offer – More than Just Words’ (revised Welsh Language Act) requires providers of social care to provide communication in Welsh without the person asking for it. Abermill Care Home embrace this by ensuring the person’s language preference is asked at the time of their admission so that the person’s needs can be catered for and a link made with local community organisations to help promote conversational Welsh. This is done in addition to supporting the person to access information in Welsh on a daily basis. The Statement of Purpose reflects this provision also.
File and Documentation Audit
Two files were viewed which included an index and a resident profile at the start of the file.
A ‘This is me’ document (written by the Alzheimer’s Society) had been completed for one of the residents which provided a background as to the person’s likes, dislikes etc.
A ‘moving in assessment’ had been completed which covers areas such as the person’s personal history, communication, care needs, previous medical history etc. There was also a 7 day Care Plan which had been implemented to support the person until fuller Support Plans could be written.
Suitable risk assessments were present for areas such as choking, safer people handling (to support the person with slings/hoists/slide sheets), falls, oral care etc. These had been reviewed at regular monthly intervals.
Personal Plans (Care Plans) included areas of need, typically eating and drinking, skin integrity, falls, oral care, safer people handling, sleeping, medication, personal care etc. which had been reviewed regularly (mostly monthly, if not more frequently). Some supplementary charts (where checks and care needs are recorded) were viewed and an area for concern was highlighted.
There were relatives and professional visitors record sheets present to record pertinent communication with these individuals and it was pleasing to see that staff had persisted in trying to contact the relative when they had not responded to a telephone call to inform them of an incident that had occurred. The District Nursing Service and other health and social care professionals visit regularly and support the residents as required. The Contract Monitoring Officer is aware that residents are made comfortable when they are receiving end of life care and that there is a genuine concern from staff in caring for people at this stage of their life.
The Manager referred to an electronic recording system that is planned to be introduced by October 2024 which will replace the need for written records and alternatively information will be captured via an electronic system. The Home are using an electronic medication record which has been in place since March 2023.
Quality Systems
‘Flash meetings’ (short team meetings) continue to take place on a daily basis so that updates regarding residents’ needs/other pertinent information can take place during the day to update staff, in addition to a ‘walk around’ by a senior carer. Some recent meetings were viewed and it was evident that these meetings covered key areas such as housekeeping needs, any eating/drinking concerns (weight loss etc.), any residents showing signs of deterioration that required escalation, maintenance issues, wellbeing events, medication, colleagues (absences etc.).
‘Resident of the Day’ meetings continue to be held which is used to ensure that the person’s care file is up to date (personal plans and risk assessments), that any accidents/incidences have been captured etc. Any housekeeping actions are noted (e.g. room deep cleaned), mattress checked, laundry checks, medication etc.
Some recent staff meeting minutes were viewed which includes areas for learning identified across other HC-One Homes. The information was detailed and it was evident that there was a good attendance from staff.
Regular meetings are held with residents to seek their ideas and views about what activities they would like to do inside and outside of the Home. It was evident that people are listened to and arrangements are made to put these requests in place. People’s view of the recent refurbishment were also sought and a resident said how she had enjoyed choosing the colour scheme for the refurbishment. Many links have been forged with the community, with a local school visiting and singing for the residents including local choirs also. Abermill have introduced a newsletter which is circulated to relatives also and some have expressed an interest in being part of future residents meeting.
Staff handover meetings are held which involve all relevant care staff, senior carers and the Manager. There was reference to resident’s wellbeing, mood, how well they had slept etc. in addition to updates regarding contact with the GP, hospital admissions etc.
Fire Safety/Health & Safety
Previously the Fire Risk Assessment was undertaken in July 2022 which had identified some issues for addressing, and it was evident these had been written into an action plan and completed accordingly. The Contract Monitoring Officer was made aware that a more up to date Fire Risk Assessment was being sought via the RI and it was confirmed that this had been undertaken on 30 January, 2024.
Fire drills had taken place in 2023 at regular intervals, with good recordings of how the fire drill was undertaken/the reason, the time it took, and any areas that required improvement. There were also records of the staff who had attended each fire drill.
There are Personal Emergency Evacuation Plans (PEEP’s) for each person residing at the Home which provide guidance on how to safely evacuate each person dependent upon their individual needs. This file is regularly reviewed to ensure any changes are captured and there was evidence that this had been kept up to date, and photographs were present for each record.
Managing resident’s funds
People’s monies are managed by the Home’s administrator who ensures there is good oversight of this process. There are personal allowance sheets that are completed when money is incoming and when money is spent on items/services for the person concerned. Receipts are obtained and double signatures are captured for all transactions.
There are weekly bank reconciliations which ensure that the money held is accurate at all times and in the event that any errors occur they can quickly be rectified.
Monthly statements are also issued which are electronic records and are signed off by the Registered Manager. There are also annual audits by HC-One personnel to ensure the system is running as it should.
Relative questionnaire
A relative was contacted for their feedback regarding the care at Abermill Care Home. The relatively confirmed that they normally visit every other week and feel welcome when they do. Although the staff are very busy they are lovely and pleasant. The environment is also calm and relaxing with lots of staff around who are brilliant.
The person confirmed that they relative who resides at the Home is very settled and calmer than she had been when she lived in her own home and that she is now eating much better and she is accepting of personal care.
The relative has been informed about events that are taking place and more recently regarding the renovations work that is going on. There have been no issues/concerns that the relative has needed to convey to staff/Management.
Observations (Activities, environment, meal time experience, interaction etc.)
Abermill is under-going a large renovation where some rooms have been re-purposed, re-decorated and re-furbished. Areas of the Home are looking much fresher and are inviting spaces. The work remains ongoing, with plans to improve the outside areas of the Home and the training facility on the premises also.
The hallway areas in the Bluebell community have been freshened up and there are lovely framed pictures illustrating places of interest in Wales for people to look at.
Abermill have had an uncertain time when the Home was for sale, however are now in a position to progress with these refurbishments and develop the service further.
The Contract Monitoring Officer was made aware that there had been a problem with the heating in one of the bedrooms, but that the issue has been escalated within the maintenance team and the room has been de-commissioned until this is repaired.
The Activities Co-ordinators and care staff continue to provide a range of activities for people to enjoy and provide stimulation. During the visit people in the Bluebell community were enjoying a ‘sing a long’ and a lady was having her nails painted. There was a very relaxed atmosphere.
People have the opportunity to visit places of interest outside of the Home as they have access to a minibus, with the assistance of another carer who supports with this. The Home continues to have links with a variety of organisations e.g. Pet Therapy, the local Oasis café, vocal artists who visit the Home etc. A resident also told the Contract Monitoring Officer how she enjoyed going out in the community with her family when they visit on the weekends and another resident pointed out the local mountain which said she had climbed and how she looked forward to sitting out in the garden in the months to come. It is also evident that people are supported to find comfort to ease their anxiety.
The meal time experience was observed in both lounges (Bluebell and Ein Cartref) with more of a focus and time spent in Ein Cartref. The tables had been set with table clothes and a centre piece. The meals smelt delicious and there were a number of comments from residents saying that they enjoyed their cooked meal. There were drinks provided and people were assisted to eat their meals where this was required. The experience was unhurried and staff were attentive as a gentleman did not want to eat his dinner and an alternative was brought to him quite quickly.
A manual handling technique was observed in a lounge, where a gent was assisted to transfer from his chair into a wheelchair. This was done so very carefully and re-assurances were communicated to the gent throughout the whole of the transfer.
People looked well cared for appropriately dressed for the time of year and the Home felt warm. The Manager is currently aware of the needs of residents, and staff when temperatures are inclined to soar in the summer time as the upstairs areas of the Home can particularly be very warm to live and work in and considering ways to combat this.
Actions
Corrective Actions
Staff files to include induction information, an up to date photograph of the staff member, and additional reference information to be sought where it is lacking. Timescale: Ongoing. RISCA Regulation 35.
Supplementary charts to reflect the actual times when care has been delivered. Timescale: Immediately and ongoing. RISCA Regulation 21.
Regulation 60 notifications to be sent to the Caerphilly Commissioning Team to inform of significant events. Timescale: Immediately and ongoing. RISCA Regulation 60.
Conclusion
Residents continue to benefit from a stable staff team who are suitable trained, qualified in their roles and are caring and attentive to people’s needs.
Resident’s documentation appeared to be robust with information having been reviewed at regular intervals.
There are robust quality assurance systems in place and the RI continues to visit regularly, in addition to the Regional Manager and other colleagues to offer support and ensure standards are maintained. The RI reports indicate that a thorough overview of the service is taking place at regular intervals.
Wellbeing is a focus at Abermill care home and people benefit from lots of stimulation inside and outside of the Home.Residents and staff live and work in a newly renovated and re-furbished environment.
The Contract Monitoring Officer would like to thank the staff team at Abermill for their hospitality and time during the visits.
Signed: Andrea Crahart, Contract Monitoring Officer
Date: January 2024