Hafod Residential Home

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question Good. At this assessment the rating has changed to requires improvement. This meant people’s needs were not always met.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

People and those close to them were not always involved in planning and making shared decisions about their care and treatment. This increased a risk of their care not being centred around them and their needs. Some relatives told us they had not been involved in care plan reviews for over a year, which limited opportunities for shared decision-making.

Despite these concerns, people generally understood their condition, care and treatment options and advice given.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People received care from staff who understood their individual health and social care needs. Relatives described staff as knowledgeable about people’s preferences, routines, and personalities, and said they provided support in a way that respected these. One relative commented, “They [staff] understand my relative very well”.

Care and support were delivered in a consistent and coordinated way. Relatives reported that staff worked together effectively, ensuring continuity of care even when covering shifts or supporting multiple people.

Staff took people’s preferences into account when planning and delivering care. For example, people could choose where to eat, and whether to spend time in their rooms with doors open or closed. Relatives confirmed that staff encouraged independence while providing personalised support tailored to each person’s needs.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The service did not consistently ensure people received information in an accessible format. Communication methods were not always effective in supporting people whose first language was not English, particularly during times of distress. The service also failed to consistently identify, record, or meet the needs of people requiring accessible information. However, in most cases, accessible information standards were followed. For example, one person whose first language was not English was supported to watch television in their first language, which helped them feel more included and comfortable.

The provider did not always make it easy for people and their relatives to share feedback and ideas, or raise complaints about their care, treatment and support.

Most people knew how to share feedback about their care and support. However, several relatives were unsure whether formal processes existed or how to submit a written complaint. Some had not received quality assurance questionnaires, surveys, or information about opportunities to attend meetings or forums to share their views. When asked about involvement in decisions about the home, one relative said, “Not really, if anything we can suggest things like the food needing improving and it has.” This showed that informal feedback was sometimes acted on, but formal systems were not strong enough.

Most relatives told us they knew how to raise a concern informally with the service. However, they also said that formal documentation such as written guidance on how to raise concerns or feedback surveys, was not provided clearly enough. Relatives felt this limited their ability to access clear and consistent information through more formal channels.

Although a complaints policy was in place, it was not always clearly communicated to relatives.

People and relatives did make positive comments about sharing ideas and seeing changes as a result. For example, some told us they had raised concerns about food, and improvements were made to better reflect their preferences.

At the time of the inspection, the service was working to strengthen how it listened to and involved people and their loved ones.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

Care aligned with best practice, quality standards, and legal requirements, including those on equality and human rights. The premises and equipment were accessible to people, and staff provided support to help people overcome barriers to care. Leaders and staff remained alert to discrimination and inequality that could disadvantage different groups and acted to mitigate these where possible.

We saw positive examples of reasonable adjustments, such as a person being supported to access faith-based sessions, which helped them to feel more included and comfortable. One person told us “Going to church on a weekly basis makes me feel included” Most relatives also told us they knew how to informally raise a concern with the service.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff and leaders demonstrated awareness of the different needs within the service and worked to support people in ways that promoted fairness and respect. People generally experienced care and treatment that upheld their rights and helped reduce barriers. For example, one person who did not speak English as their first language was supported to watch television in their own language, which made their experience more inclusive and personalised.

Relatives told us they felt comfortable speaking directly to staff if they had concerns, and they valued the open, approachable culture. People also said they were treated with dignity, and staff acted promptly if they felt someone was being treated unfairly.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

The service did not consistently support people to make informed choices about their future care while they had capacity. Care planning and discussions about future needs, including end-of-life preferences, were not consistently documented or shared with other relevant services and staff. Opportunities to explore and record future choices were sometimes missed. People were not consistently supported to express their wishes about cardiopulmonary resuscitation (CPR) or to plan for greater independence or fewer care interventions.

Leaders and staff responded to requests and preferences when raised, but the service did not consistently ensure that people’s future care decisions were planned, communicated, and recorded in a timely and proactive way. As a result, some people may not have had the opportunity to fully influence decisions about their future care or end-of-life wishes. When discussing plans for the futurefor their loved one, one relative told us “Unfortunately, this discussion has not been had with me”.