Hafod Nursing Home

Updated 6 November 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team comprised of one inspector, an assistant inspector and a specialist advisor with experience of nursing care.

Service and service type

Hafod Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. A registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

The inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We reviewed feedback from Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service and two relatives. We spoke with seven members of staff including the registered manager, clinical lead, nursing, care and domestic staff.

We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. Telephone calls were made to speak with five relatives about their experience of care provision for their family members.

Updated 6 November 2021

About the service

Hafod Nursing Home is a care home providing personal and nursing care for up to 29 people. The service cares for younger people and some people over the age of 65 and living with dementia. The service accommodates people across two floors in two adjoining buildings. At the time of the inspection 25 people were living there.

People's experience of using this service and what we found

The home environment was poorly maintained and some areas of the home were unsafe. We found multiple areas within and outside the home where ceilings, walls, paintwork and flooring was damaged. There were also issues with fire doors and window restrictors. Due to the fire safety concerns identified at the service, a referral was made to West Midlands Fire Service to conduct a fire safety visit.

The provider’s governance systems had failed to identify the concerns we found. Whilst regular checks and audits were in place, the provider was not effective at driving improvement.

The provider had failed to maintain robust oversight of the maintenance of the service. As a result, the condition of the building and state of repairs had continued to deteriorate.

The home environment had not fully supported people’s autonomy and independence. There was limited wheelchair access to the garden area and improvements to the home environment was required to meet the assessed needs of people living with dementia.

Care plans and risk assessments were in place and had been reviewed regularly.

People we spoke with told us they felt safe from the risk of abuse. Family members told us they felt their relatives were safe living at the home and spoke positively about all the staff that supported their relatives. Staff understood their responsibilities to keep people safe and safeguarding concerns were referred to the local authority.

Medicines were managed safely. Incidents and accidents were monitored for future learning.

There were enough staff on duty to meet people's needs and recruitment processes were in place to safely recruit staff. We found there was good communication with healthcare agencies. We saw kind interactions with people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff felt supported by the registered manager. Staff had received supervision to help them in their roles and training had been completed or in the process of being arranged for them.

The registered manager understood their regulatory responsibilities.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection and update

The last rating for this service was requires improvement (published 05 February 2020) and there were breaches of regulations. The enforcement action taken included issuing a warning notice. The provider submitted an action plan to tell us what they would do to comply with the warning notice. At this inspection we found the provider had complied with part of the warning notice. However, not enough improvement had been made to the governance processes and the provider was still in breach of regulations.

The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

At our previous inspection we found breaches of legal requirements. The provider completed an action plan after the last inspection to show what they would do and by when to improve to meet the breaches of regulation 11 need for consent and regulation 17 good governance.

We undertook this focused inspection to check the provider had followed their action plan, met the warning notice and to confirm they now meet legal requirements.

This report only covers our findings in relation to the Key Questions safe, effective and well-led which contain those requirements. We reviewed the information we held about the service. No areas of concern were identified in the other Key Questions. We therefore did not inspect them. The ratings from the previous comprehensive inspection for those Key Questions not looked at on this occasion, were used in calculating the overall rating at this inspection. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the safe Key Question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches with upkeep and maintenance of the building, an unsafe home environment and governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Hafod Nursing Home on our website at www.cqc.org.uk.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.