Responsible Individual - Mr Anthony Bailey / Manager - Mrs 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, but also 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.
We had previously obtained our feedback through producing and using a “smart survey”. Relatives and Healthcare Professionals have been used to this format to fill in risk assessments or questions regarding visits when we were at tier levels above zero in the pandemic and so we have found it useful to use this platform again. We have had substantial feedback from all the relatives which has been very positive.
Thanks to everyone for the feedback and for taking the time to complete another survey. We have not conducted any resident surveys or questionnaires again this year, but we have undertaken more resident meetings to encourage chat and to discuss openly amongst everyone what their feelings are on their care or whether they have any concerns or ideas they wish to talk about. We have found this to be beneficial for residents to feel their voice is heard and to ensure that changes are made, or relevant ideas or concepts investigated. Families have been informed of the outcomes of the residents’ meetings on their own survey’s so that they are aware of what the outcomes have been.
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?
From pre assessments to the completion of Individual 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 would usually include the following paperwork.
Choice and Control
Communication preferences
Personal Care
Nutritional and Hydration preferences – we are very in tune to this, it can be exceedingly difficult to push fluids in care, particularly in hot weather also where older adults do not feel the heat the same as staff. Our menus are continually monitored and adapted through the seasons as mealtimes in care are hugely important.
Social, Cultural and Leisure Activities
We have resumed assessments to what they were pre pandemic. We do still rely on a lot of information being provided by our healthcare support teams, that could be hospital notes or social working reports, however, we are now able to travel outside of the home and into other homes or places of stay, to carry out our paperwork. We try not to bombard our potential service users with too many questions, but their choices are very important, particularly at this very early stage. We explain who we are and ensure that service users learn as much about our care home as possible.
When you first were looking into a care environment for your family member, loved one, friend, the beginning of the process is no doubt the most difficult, do you feel your questions were answered and reassurances given?
Answer Choices / Responses
Extremely helpful - 57.14% = 8
Very helpful - 35.71% = 5
Somewhat helpful - 0.00% = 0
Professional - 7.14% = 1
Not at all helpful - 0.00% = 0
We have been fortunate enough since our last QA not to have been approached for a complaint’s form for any means. We have had frustrations that have led on from the front lounge initially being used as a visiting room during the pandemic (given the infection control elements that the situation posed), transferring back into its original state of a space for residents to sit. Simply put, we did not have a separate indoor area for visits aside from bedrooms and outside we have the care station cabin. We have now reverted the upstairs lounge back to its purpose and this is an extra indoor space that will be welcomed by relatives and residents. Initially the upstairs lounge was made into a makeshift office to separate management during the pandemic. A secondary frustration has been car parking space. This has also evolved on from the pandemic when we were not having as many visitors. Now, with visiting being on par with pre pandemic visits and with staff on site, the car park can be busy when relatives visit. We will eventually be taking out the bush in the car park which should make a little bit more space and perhaps lines on the car park would ensure everyone parked a little more practically. We should then be able to create a space permanently for visiting personnel. Many of our relatives pre pandemic would just turn up and come in and sit where their relative was sat, it was nice for our other residents to see visitors and it is nice to see a different face. We have begun doing this again, however it is only natural for some residents to want a bit more privacy. We are evolving a booking system online so that relatives do not have to telephone or email this should be implemented soon.
We ourselves have instigated one concern. This involved a lack of input from mental health or “In Reach” teams for our residents who require regular input due to the type of medication that they take, and our concern was that they were not being the supported sufficiently. The reason for this is that the In Reach nurse who was in place has been on sickness leave for a considerable period. We raised concerns and some of the other professionals of the older adult mental health team have taken some more work on themselves and kindly come to review our residents where we have needed their input.
Care plans are centred around an individual and these are updated regularly by our senior support, all updates are important. They are a source of knowledge to everyone and every snippet of information that is helpful to formulate a plan is updated as soon as possible. We still do not print a copy off every time there is an update as we are continuing efforts of taking our carbon footprint seriously to help climate change. Should staff note a change or there be a development in someone’s care, this is put onto the white board in our staff office to be transferred over to the individual care plan. These are usually adaptations to mobility changes, by way of using new equipment, or medication changes, every update we make ensures that we are looking after the individual in the best way possible and that all relevant parties in care, be it doctors, mental health teams, social workers and families are all up to speed with this valued information should they require to have access to these details. ALL care plans are computerised our highly regarded system is managed by very competent staff and in the areas where elements require updating, the system makes these prompts. Our care system has also had many updates throughout the last year or so to help evidence any Covid19 testing/results and temperature scanning and oxygen saturation levels (these are done daily) and NEWS (National Early Warning Score) which is extremely helpful in handing over vital signs to our GP’s, D/N’s and Ambulance Control or Paramedic professionals should we have a resident who falls unwell, it enables us to document more formerly vital sign results and is a welcomed addition to the care plan system.
We include the families and friends of those who live at Cantref as much as we can. We were asked from some relatives to reduce the Risk Assessment Questionnaire for taking family members out of the home and this has been done now and made much more relevant. This is what the “somewhat attentive” percentage pertains to below.
Do you feel that we keep you updated and reassured with family members health issues or any observations? Are we responsive to changing care needs for EXAMPLE, Please comment if you have any concerns.
Answer Choices / Responses
Extremely attentive - 46.67% = 7
Very attentive - 46.67% = 7
Somewhat attentive - 6.67% = 1
Not so attentive - 0.00% = 0
Not at all attentive - 0.00% = 0
“This was particularly important during lockdown and while being covered by covid restrictions, but Cantref staff went above and beyond to keep us up to date and informed. Very grateful. Thank you.”
“I think that you respond to all observations and keep relatives updated on any changes when they occur. You also check situations you are not sure about.”
We understand that families like to be kept in the loop, particularly with health and how we care for their relative or loved one. Any falls, changes in behaviour and any plans of action that we have in mind, as we often find that minor tweaks in medication or just the clarification from a doctor that someone has a UTI can reassure families that we are making the adjustments we need to ensure individuals are at their optimum health.
We include family and, for many individuals who do have capacity, they prefer this involvement as it helps with them achieving a satisfactory outcome and understanding of their healthcare needs and why we are doing what we do. With a transparent relationship with the families, it helps our care teams and provides families with the reassurance that their loved ones are being looked after to the best of our ability. We did have one questionnaire return that asked for us to contact another family member if there was no answer at their home. We have passed this on to the teams and they will do their best to telephone a secondary person. Please ensure that all your telephoned numbers are up to date, and you let us know the lead people to contact.
Are people happy and supported to maintain their ongoing health, development and overall wellbeing?
We have had a few residents’ meetings throughout 2022, our activities coordinator Alli structures these and most of our residents join in. Relatives have residents meeting via their QA questionnaires and are therefore up to date on relative’s views. There were no complaints other than too many sausages on menu We have changed the menu to winter options now and we shall see how it goes. As a compromise, those residents who do not fancy what is planned for their dinner, they can opt for an alternative favourite. We get to know each person and provide more on the plate of what they like.
Do you feel that the Cantref team enables our service users to meet their personal outcomes?
Answer Choices / Responses
Strongly agree - 40.00% = 6
Agree - 60.00% = 9
Neither agree nor disagree - 0.00% = 0
Disagree - 0.00% = 0
Strongly disagree - 0.00% = 0
Currently our activities are centred around Autumn. We have displays of Autumnal poems and there are painting and knitting crafts ongoing for décor into the Autumn and Halloween and Remembrance Day.
We have renovated room 19 with new flooring and room 20 will be done next. We have started to look at individual rooms again as there are a few upgrades that need to be done. We need to fix some wallpaper damage in some from the beds being pulled out and general wear and tear of the home. We have new décor in the lounge/dining area and the front entrance of the house. Storage has been a priority and the outside of the building has had some attention with paint and plants, we only had one questionnaire come back that we “could be doing better” in the garden, but we fail to see how when everything is being done that can be done. We had applied for a sturdier frame outside the front of the building in Oak, with a roof, however that was rejected by planning. We shall continue seeking to improve the interior and exterior of the building in 2023. There is always ongoing work in the background.
We will be speaking with Occupational Therapy to see if there can be a re-introduction of the coloured waking frames. Visually they are much better for our residents, and they are much more likely to use them if they can pick their colour and their frame is much more personalised. We are keen for individuals to try and retain as much movement as possible. Physio input is much better now that professionals can visit (evidencing negative LFD tests) we also provide encouragement for those who have declined in this area through age, hip injury or contributing health factors. With the use of the equipment that we know well, like the handling belt, we have been able to encourage a fair few to attempt in walking with their mobility aids rather than for us to utilise the steady aid too much. It has provided some with a much-needed lift or confidence boost and our individuals enjoy trying again which is particularly good for their wellbeing. One comment on the survey was that residents should be able to go outside more. We try! We tried all summer, and many would sit out or mobilise outside, however, most would want to come in after a short while, it was either to warm or too cold or too bright! So, we do encourage outdoor activity and fresh air. Plenty have visited the nearest park or had a little trip to town, and we shall continue this throughout the Autumn and give the residents the choice of participation.
Our hairdresser Linda continues to be our hairdresser and Chiropodist Glenyse is a regular visitor also.
Visitation has been a huge factor with our individual’s wellbeing. We are currently looking into a booking system for relatives to manage their own bookings and to be given the information on our current protocols of the home, at the time of booking, rather than fill in any additional paperwork. We ask that all relatives currently sign in and out on the iPad, using our e-reception software and this is also an opportunity to leave any comments and to tell us how your visit has been.
Please comment on the general atmosphere of the home.
15 - When I have visited the carers are very welcoming, residents seem happy - 03/10/2022
14 - Very friendly and homely atmosphere - 01/10/2022
13 - Extremely good. It seems a happy place and our father is contended which is the most important thing! - 26/09/2022
12 - Whenever I am their it seems fine. - 25/09/2022
11 - Friendly, relaxed, and caring. - 24/09/2022
10 - Family run and so homely. - 24/09/2022
9 - Bright, welcoming, and pleasant atmosphere. - 24/09/2022
8 - Wonderful and welcoming. There is laughter everywhere. Our relative is extremely happy. She loves all the staff and the food! 24/09/2022
7 - Cantref has a calm and homely atmosphere. The environment is clean and generally smells fresh and sanitized. I always wish there was more conversation between residents and time for friendly interaction with staff to encourage this. - 23/09/2022
6 - Cantref has a warm, caring, and happy feel. The staff are friendly and caring not only to residents but also to relatives. I have been extremely grateful for the support shown to myself during some particularly stressful times. - 23/09/2022
5 - Lovely and caring - 23/09/2022
4 - Fantastic. Always happy, friendly, and cheerful. Love the banter between carers and residents (at least mine!) - 23/09/2022
3 - The home has a very calm, friendly atmosphere. Everyone is very helpful and always have time to answer any questions. - 23/09/2022
2 - It’s friendly, happy, and caring. - 23/09/2022
1 - Very friendly, homely environment. Staff are well mannered, respectful but very friendly and professional. The Cantref Care Station is a useful addition and helpful that it also has a heater. The home is pleasantly decorated and always smells fresh and clean. 23/09/2022
Infection control is still hugely important, our objective has always been to be vigilant in this area. Staff are all up to date on current procedures and have enough PPE to cope. We have our masks and our more heavy-duty PPE wear on standby should we need this in the future. Staff commitment to Covid Vaccination and the Flu vaccination has been extremely high and we are looking at about 98% of achievement for that, the same for the residents.
It is important to continue to mention the CCTV as this is not used for constant monitoring of individuals more as back up reference should there be a requirement to have some insight into an incident of a fall for example. Whilst the CCTV is only in public areas, we are sure that our individuals and members of their families only feel more reassured, and it has certainly made sure the night staff feel more settled it is in situ.
How do you find the exterior of the home and the gardens and care station?
Answer Choices / Responses
Very satisfied - 46.67% = 7
Satisfied - 46.67% = 7
Neutral - 6.67% = 1
Very dissatisfied - 0.00% = 0
Dissatisfied - 0.00% = 0
What specific action do we need to take to make the improvements / OR 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?
Bathrooms are the priority next. We need to make sure that these areas are more aesthetically pleasing and relaxing areas for our residents to take part in their bath or shower, they are far to clinical currently and need upgrading.
Every spot of the outdoor areas has been pressure washed, even the roof. Paths have been made less slippy, the aesthetics of our staffing area has improved and will continue to be improved. Our upstairs lounge will be painted, and the flooring will be pushed back into 2023 in terms of the front entrance and hallway, so that we can concentrate more on the bedrooms to make sure they are up to scratch.
We are looking into handles being applied to some of our dining chairs at the preference of some of our residents.
How do you find the general appearance of the rooms, we know some need wallpaper attention, paint touch ups etc. Do you feel that your relative is comfortable and happy in their room?
Answer Choices / Responses
Yes - 100.00% = 15
No - 0.00% = 0
Identify areas of improvement or suggestions that we have discussed as teams… Do you feel that our team here have the knowledge, SKILLS, and competency levels to meet the needs of our service users?
Answer Choices / Responses
Far above average - 26.67% = 4
Above average - 73.33% = 11
Average - 0.00% = 0
Below average - 0.00% = 0
Far below average - 0.00% = 0
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 for all staff to be competently trained in all relevant areas of their job role. Clearly all infection control has been updated with staff understanding the processes of the prevention of contamination within the building. All our staff all have access to Redcrier training portal which they can access through their phone, laptops, or iPads to refresh and complete any training we ask them to.
With our training, we currently stand at more than 85% of our staff having completed training to their fullest capacity and 85% of our staff have either a QCF level II or QCF level III in Health and Social Care. Our newest members of staff are currently at the beginning of the process, some have come from other healthcare settings, but certificates may not be transferable and so are beginning the process again with our systems.
Supervisions are currently up to date and are done quarterly. Any observations are implemented on the Caredocs system by managers, and we tend to discuss when it is time for reviews.
All staff have successfully managed to register on Social Care Wales. Some are now continuing to finish their workbook and we have one or two who have started QCF’s that should be finished by next year to be in line with the three-year deadline.
We have completed two Fire Drill’s and evacuated residents to a “safe” area, these will continue as they have been a fantastic learning tool, even though they do cause significant upset to those who usually like peace and quiet. They have been randomised so that staff do not know when they are taking place. We have informed relatives if they have been in the building, however.
Staff speak with managers daily and if there is a concern with visits or an emergency, then protocol to manage this is deployed
Are people happy and supported to maintain their ongoing health, development and overall well being?
How do you find the general appearance and demeanours of our residents, do you have any concerns?
Answer Choices / Responses
Very satisfied - 53.33% = 8
Satisfied - 46.67% = 7
Neutral - 0.00% = 0
Dissatisfied - 0.00% = 0
Very dissatisfied - 0.00% = 0
Comments: 2
Residents participate in many interesting activities and events organised by the staff. The garden and visitor pod are attractive and comfortable for residents and visitors. Residents appear to be happy, comfortable, and well cared for. - 23/09/2022
When we visit and see some of the other residents, they all seem happy and well cared for. - 23/09/2022
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 resident meetings, our individuals are happy with the activities. Alli and all the care staff team have worked so hard in creating themes and activities around those themes and generally sit with them in the afternoon for regular chats.
Do you think that the Cantref team ensure that care and support is provided in a way that protects, promotes, and maintains the safe and well-being of individuals and that we seek support from relevant agencies and specialists where required. (We do incur delays from some outside healthcare sources unfortunately)
Answer Choices / Responses
Extremely responsive - 53.33% = 8
Very responsive - 40.00% = 6
Somewhat responsive - 6.67% = 1
Not so responsive - 0.00% = 0
Not at all responsive - 0.00% = 0
Comments: 1
Any concerns that I have raised with staff regarding health etc have been dealt with promptly and outcomes shared with myself. 23/09/2022
What has been the feedback, and do we feel could there could be improvements?
Feedback from the professionals
For the year 2021/2022 we have not had any recommendations from the professionals so far.
“Whenever I have had to contact or visit the home I have been dealt with respect and courtesy”
“I have nothing but praise for the way you look after you residents and the care given to them”
“Staff are always polite and friendly, and accommodating”
“I contact Cantref every week and visit regularly. Staff are always very courteous, professional, and polite and always complete any requests that i have regarding patient care. Residents are extremely well cared for, and always express how content and happy they are with their care”
From our questionnaires to healthcare professionals, we scored a high percentage of praise and great scores of “far above average” with our questions put forward such as: “How well do you feel that we carry out instructions in relation to your patients” or “How friendly, professional and respectful do you feel we are at Cantref”.
We were delighted with the feedback from our healthcare colleagues which included our district nursing team and GP practices and Social Workers, we are just as happy with the good working relationships we have and cannot thank them enough for their input when we call on them.
Feedback from the staff
For the year 2021/22 we have continued to work as a team and will continue to do so into 2023. Care needs for our residents still are higher than they were years back and this can pose a more challenging workday, however, as we know all our residents well, we adapt and evolve to their needs quite quickly and have found that we have a good mix of residents now who have made good friends together. It is nice that families are coming into the home, we have had some challenges with visitors when we do challenge them for LFD’s, we think this impacted some of our confidence in asking for them, however we are now all on the same page in terms of the requirements and ultimately our role of looking after the health and wellbeing of the residents inside the property far outweighs any challenges. It has been good to do some Fire Training where we can. It has indicated to us how residents cope and therefore how we would adapt our approaches if there was such an event. We will continue to do these where we can. Staff questionnaires have been sent to all staff emails, we have received 13 back so far and no concerns have been put forward. Question 12 response is below.
Q12
Do you feel valued as an employee of Cantref Care Home?
Answer Choices / Responses
Yes - 100.00% / 13
No - 0.00%
Feedback from the relatives is as below.
How do you find staff appearance and attitude?
Answer Choices / Responses
Extremely friendly - 73.33% = 11
Very friendly - 26.67% = 4
Somewhat friendly - 0.00% = 0
Not so friendly - 0.00% = 0
Not at all friendly - 0.00% = 0
From my own perspective
Staffing levels are good, we managed to navigate the rota with the support of staff when we were hit with Covid in April 2022 for the first time, and they continue to put in every effort in to filling the gaps should there be annual leave. Upgrades are continuing and will do into 2023 where we hope the bathrooms will be completed shortly which will improve the aesthetic of the home greatly and the laundry and staffing areas will be completed to a high standard. It has been nice to see relatives coming into the home more regularly and in terms of getting back to the “new normal” it has been a good step in the right direction. The booking system is being organised by the team that we work with from E-reception, which is our electronic booking in system that relatives use on the iPad, and we think this will be a welcome addition and it will finally make things simpler for relatives who have supported us greatly with filling in their visiting forms or questionnaires throughout the pandemic.
Does the home appear to be managed professionally?
Answer Choices / Responses
Extremely professional - 53.33% = 8
Very professional - 40.00% = 6
Somewhat professional - 6.67% = 1
Not so professional - 0.00% = 0
Not at all professional - 0.00% = 0
To reassure our relatives
We have not been contacted by our CIW inspector. We still notify CIW of any incidents that we are obliged to.
To date, through the QA questionnaires there have not been any concerns voiced by residents, however, our aim is to always improve, and we have adapted our procedures through the pandemic so far and will work as a team together to always ensure we achieve the highest standard of care for our individuals and provide safety and confidence for our staff.
Do people feel safe and protected from abuse and neglect?
What we do well and how we evidence it?
Do you feel that your family member, loved one or friend is looked after and feels safe in our environment of care?
Answer Choices / Responses
Strongly agree - 80.00% = 12
Agree - 20.00% = 3
Neither agree nor disagree - 0.00% = 0
Disagree - 0.00% = 0
Strongly disagree - 0.00% = 0
At our recent residents meeting, when residents have been asked if everyone feels safe and well, the response was they did feel safe, and all were happy. Some reported they would inform us if they were not. Overall, no concerning issues were raised via residents. The same question is asked at Supervision – and we ensure Safeguarding refresher training is completed annually so that we are all aware of being alert to the safety of our residents.
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. We do have several under the protection of the DoLS. 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 much as they can. If a DoLS has been highlighted as a requirement of a particular individual, we do our best to inform relatives first as it can be a bit of a shock to receive a call and not know anything about the process. We will be putting together a booklet for ease to give relatives as much information as possible.
GDPR and confidentiality is our professional responsibility, and all current protocols and procedures are up to date.
All residents are part of the ABHUB Oral Health Scheme, and we have an Oral Health Champion(s) as part of our staffing teams. The oral care champion(s) are responsible for putting systems and processes into place so that oral health care plans are followed and that residents have access to preventive and treatment services when required. It was only evidenced to us recently that our previous local dentist who looked after out residents on a community basis has now been outsourced to Blackwood. There are delays in the service and currently we do not think that waiting times have improved at all since during the pandemic which can incur confusion to our residents and sometimes discomfort.
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 all staff are currently compliant. 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. We always support them in making choices and ensure awareness that they have 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 throughout the process. We do have a robust policy on discrimination which is contained in the ground floor office.
Do the individuals who live at Cantref feel that it is a place that supports their wellbeing and can they achieve their personal outcomes? What do we do well and can we evidence it?
Independence is our main priority and ensuring someone maintains their abilities to help themselves as much as possible. Our library lady still attends the home but uses our drop off box for books and items that have been requested. Papers are delivered daily and are given to our residents. Dining times and meals are so important to everyone, it is the time associated with chat and provides some level of normality much the same as going to a café.
Our activities coordinator still does her very best at encouraging residents to take part in activities. Allison has recently attended some training in St Fagan’s and has brought elements of what she learnt with other activities personnel back to the home. Tai Chi has been a new one for us. It is a difficult job and one where you must spread yourself about and try and enhance everyone’s daily life individually. Some are not to keen to join in, but they do like watching and this is an activity as it brings something new to their day. We have singers booked in November and December and it may be that this year we are able to re-establish our connections with the Baptist church for our annual Christmas concert and curry evening.