Cantref Care Home - Results of Quality Assurance Questionnaires late 2018 - Aug 2019

Responsible Individual: Anthony Bailey

Manager: Joanne Pritchard

Regulation 50 of the Social Care Wales Act 2016 has re-enforced the aim of monitoring, reviewing and improving the quality of our service. It is not only an exercise to appreciate feedback, it is a key importance in highlighting and developing our relationship with individuals, families and visiting professionals and how they perceive us as a care provider and for us to work on the things we could do better.  Our aim is to continue to monitor our ideals daily and to formulate reports approximately every six months.

Do people feel their voices are heard, they have a choice about their care and support and are opportunities made available to them?

What do we do well – and how do we evidence it?

For our Quality Assurance this time, we varied our questions to ensure a more personal viewpoint and where possible, these were completed by the individuals themselves or with a little help from their families. We have made the font larger and incorporated colour so the visual aspect is considered for someone with poor eyesight.  We have also begun a “first response” questionnaire so that we have a better perspective of what individuals and their families first impression of Cantref is. Quality Assurance forms are a permanent fixture and are available to all to fill out throughout the year. Guests, relatives, staff and visiting professionals are all welcome to leave their satisfaction gradings which can remain anonymous if preferred.

From pre assessments to the completion of Individual Plans (formerly Care plans), individuals and their families are the primary source of information. They are very in depth and the Mental Health Capacity Act is the core to the process and whether the individual themselves assist with this formality, or the family or prime caregiver, the onus is very much on individual choice and consent is gained for all answers. We include the paperwork to include;

·         Choice and Control

·         Communication preference

·         Personal Care

·         Nutritional and Hydration preferences – we are very in tune to this and have been promoting hydration particularly in the warmer months

·         Social, Cultural and Leisure Activities

Questions are illustrated in the format we call “my view” and an example of the Choice and Control section is as below:

“I can make my own choices and decisions even though others may not always agree” – (Tick box)

“With some assistance I can make all the choices and decisions about my life” – (Tick box)

“I can make most day to day choices and decisions about my life” – (Tick box)

“Other people make most of the choices and decisions about my life. I need some assistance to take some control over my life” – (Tick box)

Individual Plans are a huge part of how we conduct care that is centred around an individual. They are updated regularly, and all our staff can evidence themselves with the information, so a good care rapport and trustful working relationship is embarked upon and retained. Care requirements can change quickly depending on contributing factors such as dementia, old age health decline and other health problems, however with a substantial and comprehensive Individual Plan we can adhere to the wishes and plans of that individual and tailor their needs to suit them being comfortable and well looked after. So, in terms of care expectations and changes, individuals and families are kept involved in decision making, we have meetings with families in terms of what our recommendations might be – whether it be a change of room, a different mattress, GP input for pain intervention, we are lucky to be very well supported by our health care professionals and seek opinions, discuss and try alternatives that can move us over obstacles and  in turn ensure that our ladies and gentlemen are happy and confident with the care being received.

Consent is a non-conscious effort for Cantref, as it is something we feel we have been striving for a long time already. Staff are aware of the Code of Professional Practice and their commitment to the promotion of wellbeing, voice and the control of individuals whilst supporting them to stay safe. Training is applied to incorporate Dignity and Respect, Equality and Diversion, Mental Capacity, Safeguarding and Wellbeing.

Individuals do have the opportunity to assist with our menu’s and we have on occasions asked for feedback. We have recently purchased a Panini maker and the options for the teatime menu’s and the addition of more seasonal vegetables and available fresh fruit has become more extensive. Mealtimes are so important as a social aspect to those who live here and so it is an area that we are always striving to improve and encourage variation with the inclusion of our cooks who work hard to achieve great meals and puddings.

Individuals can also choose how they decorate their room. Updating rooms and improving the environment of the home is something that is always ongoing. We have liaised with our individuals and ordered wallpaper samples etc. and some of our individuals have had 100% input with how they envisage their room to be. We always suggest personalisation from the assessment stage as it should be a place where individuals feel safe and have familiar items around them.

We have recently piloted the “Coloured Walking Frame” scheme. This has been an exceptional concept explored by our Health board and one that is very successful at this care home. Individuals who could not see or were non plussed about the silver walking frames can personalise their own, choose their own colour and we have seen great steps in the remembrance and usage of the frames and our individuals see it as something that they have had input into and are very proud owners of their new brightly coloured mobility aids.

We are very lucky with a low turnover of staff and we work hard together as a team to ensure that we retain great caring staff. We conduct supervisions quarterly, however during our office hours the door is always open for staff to come and talk. Meetings are conducted daily on a non-formal basis rather than a strict setting and we regularly chat about individuals and any noticeable points. Pain is a huge contributing factor to behaviour (for example), but with having staff on board who draw upon their knowledge of an individual, we can work together with our amazingly supportive district nurses and GP’s to ensure that we action and combat the stresses and concerns of our ladies and gents timely and hopefully with positive results.

We are currently working towards ensuring the home is more bilingual, particularly as we have, on occasion, had individuals who can speak Welsh. We will be forwarding information regarding learning some words in Welsh to all staff and we all will work harder to ensure we are more confident in using Welsh pleasantries at least. We do take seriously the Welsh Active Offer and are more aware now of who we are able to contact should we require any of our documentation to be available in Welsh and where their offices are. Having recently met the person who works for the Welsh Governance team it was a pleasure to recapture why Welsh and the Welsh language is important to retain. Our policies and procedures are very extensive, and we are all aware of our LGBTQ commitments and we welcome the inclusion of all people at our care home regardless of label. We were not part of the PRIDE event this year as it snuck upon us in terms of time, however next year we are looking forward to flying the flag for the LGBTQ community in Abergavenny and beyond.

Some of the comments that we have had through our QA forms 2019

“As a visitor, we are always made welcome and Cantref are happy to welcome the dogs”

“Cantref has provided us with the feeling of being part of a family”

“Cantref staff have provided my mother with such outstanding care that I can’t thank them enough, I have discussed my comments with professionals and friends”

“Our family member is happier here than I have seen them for a long time. If my Husband or I ever had to go into a care in the future, we would wish to come here”

What areas do we need to improve or want to develop further?

Identify areas of improvement or suggestions that we have discussed as teams

As managers, we are invited to many events to improve our knowledge in certain areas or to inform us of updated policies etc. We cannot attend them all, however we have been working quite closely with Aneurin Bevan Health Board and their Primary Care and Community Division who are a refreshing bunch who take seriously the work that residential and nursing care homes provide to our ageing community. The aim is to arm caregivers with knowledge with the aim of a decrease of ambulance call outs or hospital admissions. With their input we have embarked on the “Sepsis and Vital Sign” training, which is a recognised effort by our community GP’s and will empower care staff to formulate their knowledge of Sepsis and any other concerning health problem and embark upon taking the vital signs (BP, Oxygen Levels, Temperature and Heart Rate) prior to telephoning the healthcare professionals. This is not a mandatory section of training, however 80% of our care staff have registered interest and these training dates have now been organised.

Out of our 2018/19 responders there was a suggestion made by a relative who felt there is a lack of staff interaction on the days the activity lady is not here, namely weekends. On discussion with staff regarding this feedback, there was a feeling of genuine upset by this statement. Staff felt that families only sometimes tend to get a small snapshot of a day when they visit. Staff report that as this is a small and friendly care home, there is an abundance of interaction and families may not see this as staff would rather enable visitors to engage with their loved one in peace rather than intervene or distract. Staff also felt that perhaps family members do not comprehend the palliative aspect of a care home and that we may have individuals who are much more poorly who need to be turned and therefore their personal care is much more in depth and timely. As it has been highlighted, it is only something we can work on together, weekends can appear to be calmer as there are less visits, not only from healthcare professionals, but also family members – it is generally less busy.

The summer always brings us opportunity to enjoy the warmer weather, the outdoor areas of the home have been improved with the tidying of borders, pruning of trees and bushes and planting of flowers. For the near future, we will be changing the conservatory, as it is so greatly used and loved by those who sit in this environment – we are enlarging it slightly and enhancing the roof to be what is known in the industry as a “warm roof”. It will be fully slated with Velux windows to keep it warm in the winter months and cool in the summer. The line of bushes on the patio area will be removed as they seem to be growing wider and infringing on the space that we could use more advantageously.

Security is a factor of any care environment, although we have not tackled implementing the camera system just yet, the wires have been put in situ and it is something that we will be completing in the autumn. We also want to improve the call bell system sound. This has taken lots of input and is possibly more technical and complicated that we envisaged, however if we can have a better call bell alarm sound, it may improve the environment at night time, where the alarm bell can sound quite loud and particularly for those who suffer with dementia related cognitive impairment where sounds can cause apprehension.

Despite the availability of the complaint’s procedure in Welcome Packs (which are in rooms), it is unlikely that unless a complaint is raised then visiting professionals / visitors / individuals are not fully aware of how to go about raising an issue that is on a formal basis. This was reflected in our QA. We have a good working relationship with family members from the beginning, therefore phone calls, emails and requests to see management are responded to quickly. A family member had concerned that mail was not being delivered promptly, this was investigated with the consent of the individual concerned and an explanation provided, this was to the satisfaction of the family and particularly the individual. We always speak to our ladies and gentlemen directly to ask if they are ok or if there are any issues they wish to discuss. Individuals are familiar of who management are, and the staff they trust to discuss matters that may be niggling them, the same can be said for relatives. We do have laundry battles occasionally and an item may be misplaced, we sometimes find cardigans in blanket boxes or on the backs of chairs. Most laundry items are recovered and any items that have become damaged accidentally, we are happy to replace where we can. 

 

What specific action do we need to take to make the improvements / developments successful and how will this be measured

What are our action plans for the specific outcomes and the focussed actions that are needed to improve and the timescales?

Our aim is to focus more on Resident Meetings. In a care home environment, dynamics can change dependent on individuals. We have a high volume of individuals with capacity who would take part in a meeting. We have tried, on occasion, to delegate the responsibility to our own individuals, however they report that eyesight is problematic so in turn reading and writing of meeting communications would be an issue. We also have shyness those who would much prefer to be led though the process by staff, rather than feel apprehensive that the responsibility is on them.

·         We will aim to hold a resident meeting at least four times a year and the agenda, minutes and actions will be taken.

We already have a steadfast protocol of how our policies and procedures are reviewed. These are done six monthly and any relevant changes or additional requirements are passed on to staff as part of the course.

·         Manager Joanne Pritchard carries out the extensive work on keeping our policies and procedures to a high standard six monthly

Our aim is to enable for us and our staff to learn and appreciate the importance of Oral Health and promote this with our individuals. Our Individual Plans cover the requirements of everyone’s oral health plan and staff currently report on the system whether oral health was assisted with (in the mornings and evenings) or whether it was declined. This training may give us the tools to encourage individuals to take their oral health more seriously or to identify the problems (of someone who cannot report their discomfort) and report these to senior staff who can ensure that a dentist is contacted.

·         Oral Health training has been booked in October for all staff

Welsh and the welsh language – bilingual signage for the dining areas, toilet etc. cannot be purchased as far as we can tell. We will use our current signage and with the help of one of our Welsh speaking individuals, find out the translations and ensure that we insert the alternative information so it can be appreciated by those who are welsh speaking and to keep engagement with the language as we are in Wales after all.

·         More signage will be sought and changed soon

  

Are people happy and supported to maintain their ongoing health, development and overall well being?

What do we do well and what is the evidence for this?

The ethos of our care home is that individuals remain as in control of their own environment as they can be and to be as independent as much as they can manage. This includes the choices of outfits, what to eat and drink, whether to engage in activities, how they want to spend their day etc. As much information as we can gather is placed into our “All About Me” booklets and we work with families to ensure we know as much as we can about a person to define them as not just the person they are now, but who they were before getting older.

Are people happy and supported to maintain their ongoing health, development and overall well being?

What do we do well and what is the evidence for this?

We have activity plans, however as much as we can pre-empt and plan activities, it is very much up to the individual whether they wish to be involved or not. All the activities and who has taken part or declined in the interaction is observed and evidenced on the caredocs system by our activities coordinator. The activities which go down amazingly well are the Lindy Bopper Dancers who very kindly visit quite often and they are from Monmouth, Michael from Musicare and Zooloab was a great day with lots of involvement from intrigued individuals, the children from the nursery and the staff. We evidence much of what we do on Cantref Care Home’s Facebook page. Permissions are gained with a consent form on all individuals who are admitted and staff who wish to be photographed, or you can opt out. It has been a great way to connect with our community and for families to see what their relatives have been up to. It is a great link to pass on messages and has been a very successful way of updating our “friends” and staff on the happenings and events of Cantref.

The children from Meadowbank Nursery visit every three weeks and we embark upon activities on the topics they have been learning about, “under the sea”, “pirates”, with a little preparation we keep both generations happily entertained for 45 minutes and it proves a talking point after. Many of our ladies and gentlemen love the children visiting and it has been interesting to observe those children who would be so shy in the beginning, really come out of their shells and engage in conversation and interaction with them.

Newspapers are delivered in the morning to those who require them, and this enables more conversation about current affairs and the doom and gloom of Brexit. We also frequent the local tea dance with those who wish to attend on a Wednesday afternoon.

We embrace Holidays or Sporting Events that we can project visuals around the home that involve everyone. For Wimbledon, signage is put up along with decorations, and our menus change slightly to incorporate more strawberries and cream. We have had a real Ice Cream Van come along to Cantref and set up in the car park. Staff were successful in bringing everyone outside apart from three! This was a great success and something that we can repeat with the weather being warm. To embellish on the menu change, when it is particularly hot, we ask staff to attend in T-shirts and we make changes to the lunches should it be heavy on the oven usage. It can become dreadfully warm and for our ladies and gents, the last thing they want when they are hot is a roasting hot dinner. Plenty of salads and the offer of melon slices, lollies and ice cream and a drive to hydrate all our individuals (and staff) as much as we can and for those with intolerances or specialist food requirements, we alter the choice.

Environment – Cantref basis its environment on being bright, airy, practical but with modern elements. We have local pictures painted by local artists, rooms are as light and bright as they can be, handrails have been painted to be more visible to those with eyesight decline or dementia and have coloured walking frames. A new feature is to make the top of the stairs more visual with a wall decal and words of encouragement to keep moving. Our dining crockery is all coloured blue to enable our individuals to see a bit easier what is on their plate and these have been very successful.

For the future, we wish to embark on tiling the bathroom areas with a theme in conjunction to enable these zones to be more of a sanctuary to those having a wash. Now, whilst they are very practical, they can be improved to make the whole experience of shower and bath days one to look forward to rather than it be a standard event. Fresh flowers are arranged for the tables, very kindly by one of our individuals who keeps the water topped up and we have a lovely member of the community who pops in flowers from her garden for our individuals to display.

Individuals who have capacity, can make decisions on their health and whether they require a GP or to see their Mental Health and other Healthcare professionals. We have quite a few individuals who are able to talk about their worries and decide whether they wish to see a professional and the reasons behind them. Individuals are taken to a private area for discussion and all updates and observations are put onto our caredocs system.

From our QA responses, individuals are happy with the activities and outdoor excursions that have been offered so far. We have only been asked for more of the same and for it to continue, which is of course our aim for the wellbeing of our ladies and gentlemen.

End of life is an area we feel is as important as the life prior to becoming poorly. We have a robust advanced individual care planning system that promotes and enables us to ask the sometimes-difficult questions regarding end stage care. We try in all circumstances to look after our individuals in this environment that has become their home if we are able to do so and we cannot do that without the experience of staff and the incredible service of our district nurses and GP’s and the massive support we receive from the St David’s Palliative Care Team. A recent extract from letter (21st June 2019)

“Following the death of our family friend, we are writing to express our gratitude to you and your excellent staff for the way you cared for her. It was clear from the time you showed us around the Home, whilst she was still in hospital, that Cantref would be the right place for her and this opinion was confirmed very soon after she moved in. Although she was a resident at Cantref for a relatively short time, the care she received was always first class, and the knowledge that she was so well looked after was a great consolation and relief to us living so far away. We should be grateful if you would pass on to all members of your staff our sincere and grateful thanks for their friendliness, good humour, care, compassion, dedication and patience, and also our admiration for a difficult task extremely professionally and superbly well done. Yours sincerely, J & H Murdoch”.

Approaching our Health Service professionals for opinions and their help with our individuals is something we do quite quickly. For example, an individual (who when they came in walked unaided using the rails) has become more impaired with cognition. This firstly appeared to be dehydration and a fluid chart was set up and significant focus placed on being supervised with drinks. We placed a call however with the occupational therapy team and our plight was to ask if they could come along and see if this individual would be better with a frame, before cognition hindered the recognition or usage of such a device. The OT came out within a few days and the individual managed to walk assisted with the frame. The Individual Plan will therefore be changed to assistance of one and the mobility aid will be paramount in keeping this person mobile and exercising her limbs and deferring the risk of skin compromise from sitting down all day. Although the elderly can lack confidence and may have balance issues, we have learnt that it is much better to keep limbs moving (with an element of risk) rather than the loss of the ability and the healthcare issues that can come with that.

A QA response from our OT “Friendly and professional staff. Individuals appear happy and well looked after. Always a pleasure to be invited to Cantref – Great atmosphere” – H Spencer / OT

What areas do we need to improve or want to develop further?

Feedback from the professionals

For the year 2018/19 we have not had any recommendations from the professionals so far. Our aim is to continue to build on all our formalities that work well and to be part of the team who improve people’s outcomes from invaluable joint working arrangements. Should we have had something highlighted to be changed, we would embrace the knowledge and work towards improving the outcomes for all the people who live at Cantref.

From our own perspective, we are working through all staff receiving as much training as possible. We are currently at approximately 70% of our workforce who have their QCF levels two or three for Health and Social Care. We have four currently embarking on their level two’s and three’s. Deputy Manager has recently completed QCF level five. The topics we have for our own in-house training are as below;

Activity Planning                                                                              

·         Challenging Behavior                                                                             

·         COSHH

·         Death, Dying and Bereavement

·         Dementia

·         Dignity and Respect

·         Equality, Diversion and Inclusion

·         Falls Safety

·         Food Hygiene and Safety

·         Health and Safety

·         Infection Control

·         Mental Capacity and Deprivation of Liberty Safeguards (DoLS)

·         Person Centered Approaches

·         Safeguarding Adults

·         Wellbeing

First Aid, Fire Safety and Moving and Handling are provided by external mentors who visit Cantref to meet with all staff. Oral Health is also a mandatory sector topic as is Safeguarding. Oral Health has been booked in October 2019, safeguarding topic will be refreshed for all prior to autumn 2019.

Staffing levels had been a little concerning due to an unforeseen potentially life-threatening illness of a member of staff. It has been down to the hard-working efforts of the staff in situ at Cantref and the very amenable involvement of a relief care worker that has bypassed any concerns that we had. They have been incredible in their support and understanding during this time.

What specific action do we need to make the improvements / developments successful and how will this be measured?

Actions and Timescales

Our actions will be to continue to work with staff to highlight the importance of refresher training and absorbing any new policies or updates of policies and procedures that are pertinent to their role at Cantref, this includes management who are not averse to training. We also embark on supervisions and one key question is about training, from a few of those meetings staff have embarked on training that is not on our schedule and have carried out this training independently at home, topics such as Diabetes, Pressure Ulcer Knowledge, Assessing Needs etc.

Action: Ongoing, Deputy Manager C. Bailey

Sustainability is a key area for our focus and waste features high on our agenda. For our buffet’s we have stopped using plastic plates and cups etc. and instead use bamboo and recyclable consumables. Oil from the kitchen is taken to the refuse centre and recycled as Bio Oil. We do recycle our plastic and cardboard already, however there are always ways we are looking at to do more. We have recently decided to formulate the Individual Care Plans, but not to keep re-printing them every three months in their entirety. This will not only cut on paper use, but ink also.

Do people feel safe and protected from abuse and neglect?

What we do well and how we evidence it?

We can ask our individuals directly whether they feel safe and protected, however the responses would be different for all as we cater for many different categories of healthcare problems, speech, cognition, learning difficulties, anxiety etc. We therefore must draw upon the working relationships we have with individuals, relatives and advocates and listen to our staff who are entrusted by our individuals to look after them and to notice things that may not be quite right. We have involved safeguarding ourselves in the past on behalf of those who perhaps cannot comprehend an illicit act, and this received a successful outcome for the individual involved.  It is part of our duty as a care provider to act on any hint of an issue immediately for the safety and protection of our individuals. (One safeguarding issue involving outside agencies in the last two years)

For the protection of those who may come to harm outside of this environment and do not have the capacity to see themselves “at risk” if they were to leave, we are able to refer to the Deprivation of Liberty Safeguarding Team. At present we have one DoLS in place out of nineteen individuals. (July 19). We must work within the principles of the Mental Capacity Act and do everything possible to empower people to make as many decisions for themselves as they can.

Staff are currently at approximately 65% trained on Safeguarding. The certification lasts three years and was last completed in 2016, they are therefore due to be refreshed and our newest members of staff will embark on this topic as a matter of course. Staff are observed daily, and supervision is carried out quarterly. One of the key topics we talk about at each supervision is abuse and whether they have or have ever had a concern they wish to talk about.

GDPR has featured highly in the past year and whilst some of the guidelines remain baffling, particularly when asking for references from other agencies for recruitment for example, we have our own policies and procedures in place and a notice on our general notice board to inform visitors of the same. We only outsource information on our individuals should consent have been gained and if it is in that person’s best interest to do so.

Steps are being taken to ensure people get the oral health care they need to ensure that they are pain free and their dignity is respected. The NICE guidelines reported that not enough people in care homes are aware of the importance of mouth hygiene and this will be remedied by the organisation of training which will take place in October 2019.

We have a strict NON-ACTION IS NOT AN OPTION rule on matters of Safeguarding. The Social Services and Wellbeing Act 2014 illustrated changes that impacted changes for adult safeguarding in Wales and staff are currently refreshing their training as it was last completed in 2016. Cantref and local authorities and all parties involved in safeguarding have the aim of stopping abuse or neglect wherever possible, preventing harm and reducing the risk of abuse or neglect with any adult who requires care and support needs and to safeguard them in a wat that supports them in making choices and having control about how they want to live. Staff are aware, from the policy, of their responsibility to report a suspicion of a safeguarding concern, who they report to and are supported during the process.

We do have a robust policy on discrimination which is contained in the ground floor office.

We do have an admittance protocol and a call bell where any visitor must identify themselves, however in the autumn this will be more secure the cameras will show staff who is outside. We have a signing in book by the front door and all visitors are asked to sign in and out. Any visitor may be asked to identify themselves by the staff and should not feel upset if this happens, it is our way of keeping the home as secure as it can be..

What areas do we feel we can improve or develop further?

At present or until we are inspected or have any improvement areas identified to us through feedback, we have no identifiable areas that are problematic. We do note that on our QA’s “complaints procedure” was not an area that relatives or individuals were sure about. We do have a complaints information section contained in our Welcome Packs and our Statement of Purpose, but as one person pointed out, “unless you are wishing to make a complaint, you are not necessarily aware of the route that you go down.”

Training and knowledge are always a massive part of increasing awareness and having recruited staff who believe and understand the importance of the welfare of the people they look after when they begin their care career at Cantref and retaining this philosophy for the years they stay. This is the essential key to running a home where people do feel safe and well looked after.

The security camera system will be implemented in the autumn as mentioned prior.

Do the individuals who live at Cantref feel that it is a place that supports their well being and can they achieve their personal outcomes?

What do we do well and can we evidence it?

At Cantref we are very conscious that it can be a very big decision to come into care for both the individual and their families or advocates. We therefore always suggest that you come in and have a look around if that is possible and to try and source as much information as you can, not only from us, but from the independent professionals who you have access to such as GP’s, the Care Inspectorate Wales, Social Workers, District Nurses etc, they are the people who visit all the care homes in this area and are able to provide an insight into a facility. Individuals and families usually whittle it down to those homes they prefer, and it is at that point that we can complete an assessment on your care needs and requirements and quite how you would like to live at Cantref happily. Individual care plans are created over a period that are the bible of ones needs and requirements for everything to do with their care and these are updated regularly to incorporate changes, enhancements or recommendations.  

We want to be able to maintain your independence as much as you are able and if we can improve on matters then that is a fantastic achievement that will keep you in good stead both health and mobility wise. We call on our Occupational Therapists, Physio team, GP’s, Access for Blind and community resources to guide and advise and support us with any recommendations that could be an option for you to be as comfortable and as self-caring as you possibly can be. Our activities coordinator makes herself aware of individual requirements in terms of the levels of interaction they would like to participate in and does her best to spread her skills to keep individuals happy and motivated. It is a very difficult job, however somewhat rewarding when you know you have helped enhance an otherwise routine day.

Individuals who wish to go out, are given the option. We have wheelchairs for those who cannot walk so far, and we can assist those who can. We have some quite nice roads to walk up and a near by park and cricket green that is regularly visited. Fresh air is key and keeping those moving who are still able. We have an individual who can solely travel into town for errands and takes themselves independently off to hospital visits. They let us know when they are leaving and when they are coming back and we think it makes a marvellous example that individuals are encouraged to keep their individuality.

Individuals who have decided that this is their forever home are given the option to personalise their rooms as much as they can. We have helped individuals pick out wallpaper and colour schemes, and those who wish can have their own telephone line for calls. We have WIFI throughout for iPad’s, tablets and mobiles.

Through our most recent resident meeting, the minutes were documented and there were no complaints with the food, garden, environment. Of course, this can change periodically depending on individuals that you have living at Cantref and their expectations and demands, however we are always open to suggestions for improvement. Our residents always love people coming into Cantref with talent and interest and they particularly enjoy the schoolchildren visit every three weeks. Posters and information through conversation is always passed on to those who sit in the lounges and to those who are in their rooms.

 What areas do we need to improve or want to develop further?

We are working this year to improve the conservatory sitting area. The roof is currently Perspex and plans have been put in to alter this to a slate “warm” roof with Velux windows. Planning updates have been put on the notice board for relatives to read and individuals have been informed through our recent residents meeting and they are all looking forward to the progression. (As they like to watch the workmen and enjoy the comings and goings of people, its much more interesting than TV).