Hafod Nursing Home

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – This meant people were supported and treated with dignity and respect; and involved as partners in their care.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good.

This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 65 (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 treat people with kindness, empathy and compassion, or respect their privacy and dignity.

Systems to assess, monitor and mitigate risks to people, including risks associated with the environment and support planning were not always robust and did not always demonstrate a caring and dignified approach. Audits and checks completed had not consistently enabled the provider to identify and address the on-going concerns we found during this assessment. These included shortfalls in the assessment and management of risks to people and environmental concerns such as IPC. Staff had not always been provided with up-to-date guidance on peoples increased risks and changing needs, in a timely way.

Relatives told us they felt staff were caring towards loved ones. However, 1 relative told us’ “Recently we visited at the weekend and found [Name] looking very unkempt and grubby (clothes and face). We spoke to the carer and within half an hour they were bathed, changed and spruced up again.” During our assessment we observed people to always be clean and tidy. Another relative told us how at times when they visited their loved one was often wearing someone else’s clothes. This did not demonstrate a dignified approach.

Staff had received training in relation to dignity and respect.

All people and their relatives told us they felt staff were kind and compassionate and treated them with dignity.One relative told us, “They [staff] are excellent with her. She hated being transferred, it terrified her but now with these staff, she actually jokes about it with them [staff]. I cannot give these staff enough credit.”

We observed that people’s dignity was respected by staff when offering or providing support. Where people shared rooms there was a suitable room divider in place to provide privacy during times of support

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

When decorating the communal areas of the home the needs of people using the service had been considered. Since the last assessment they had developed an activity room which had multiple items of reminiscence to suite varying needs of people using the service. This included sensory items, newspapers, games and items of interests such a people’s hobbies and interests including a planting station. We also saw that the dining room and lounge areas had been improved. The registered manager was aware of the guidance on creating a suitable environment for people living with dementia. Further work was required to develop people’s bedrooms and the garden area also still required improvements to make it safe for people to use independently.

The garden still lacked safe and independent access for those wishing to use it and the paved areas still posed a hazard. Additional work was required to develop areas of interest, stimulation and accessible seating for people to enjoy the outside space, particularly those living with dementia.

Most people we spoke with told us they were happy with their rooms, and many had pictures and personal items to make their rooms feel more homely. However, the decoration of these rooms required improvement to reflect best practice for dementia care.

People and relatives told us they felt their individual needs were respected and met. Staff recognised the importance of positive interactions and meaningful activities. Staff tried to engage with people taking into consideration their known interests to help alleviate their distress.

There was an activity co-ordinator working in the service Monday to Friday who developed an activity plan. People and relatives spoke highly about the activity co-ordinator and the work they do with people who wish to stay in their rooms. The activity co-ordinator knew people well including their interests, likes and dislikes.

The provider promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

We observed staff offering choice at mealtimes for those who found it difficult to choose verbally. We also saw staff gaining consent before putting on people’s clothing protectors. Where people required support with meals this was given in a respectful way with lots of appropriate engagement, support and prompting as required. When encouraging people to join in with activities or go to other areas of the home, if people refused then staff respected these choices.

Since our last assessment the registered manager has sourced call bell pendants to support 1 person to be able to go into the garden to smoke independently. The person told us how this has made them happier, and they felt they had regained some independence and control of when they wanted to go out to smoke rather than having to wait for staff.

Staff had received training on promoting independence, and most could explain how they supported and encouraged people to maintain independence.

We saw and were told people had access to the garden with supervision from staff. Staff supervision was required due to the lack of safe access to the garden for those with restricted mobility and uneven paving which posed a risk of falling. The registered manager told us they requested a quote from a builder to improve the paved area and accessibility however, this work to improve access had not been started. This meant people were unable to utilise this area freely to enjoy fresh air and the outside space.

We were told and saw during our visit evidence of some group and 1 to 1 activity taking place. The activity co-ordinator spent time with people on a 1 to 1 basis including in people’s own rooms, if they chose not to participate in group activities or were unable to. People appeared to be enjoying and engaged in the specific activity taking place including the visiting ‘exercise man’ who was very popular. One relative told us, “[Name] activity co-ordinator is very good, she will go to dads’ room if he hasn’t been downstairs for a while.” Another relative told us, “[Name] is always bright and alert when I visit and usually in the lounge joining in with activities, some of which are physical exercises (once a week).” And another relative told us, “[Name] activity co-ordinator is brilliant, she has brought mum out of herself. She loves the entertainment here, they have children come in, animals, the lovely exercise man. They [staff] bring mum out of her room, and she enjoys it.”

There was an activity schedule displayed for people and staff to know what activities were planned for the forth coming week.

Most people and relatives we spoke with told us they felt they were encouraged to maintain independence and were given choices. People we spoke with and were able to choose, told us there were no restrictions on what time they went to bed or got up or where they wished to spend their day.

The provider listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Although 5 relatives raised concerns with what appeared to them to be reduced staffing at night and weekends, they nor people we spoke with raised concerns that they may have to wait longer than they would have liked to receive support.The registered manager told us staff carried out checks for people cared for in the rooms and for all people during the night. This was recorded in their care plans and daily notes. However, we found that in some bedroom’s peoples call bells were not in place meaning they were unable to alert staff should they need support. Support plans and risk assessments did not demonstrate this was the persons choice or preference as confirmed by staff members.The registered manager addressed these missing call bells when we brought this to their attention.

For people who were unable to use the call bell and were able to mobilise, we found the options of pressure alarms or movement sensors had been implemented to alert staff, should they need help or support. The care plans, risk assessments, mental capacity assessments and best interest decision forms for those who lacked capacity had been completed and contained relevant information.

We saw that staff were responsive to people’s immediate needs with positive interactions between staff and the people they were supporting during the assessment. One staff member was observed to patiently, calmly and kindly use a communication tool to provide a person with the opportunity to make staff aware of what was causing them pain and distress. The staff member ensured that the person was given time and reassurance of what actions they would take once they had established the cause of their distress. This interaction was beautiful and heartwarming to observe and feedback was given to the staff member by inspectors. We then observed the follow up actions being carried out by the nurse once they had been informed by the care staff member. Again, this interaction was warm, unrushed and provided the person with reassurance that they were working to address their pain and discomfort.

Staff clearly knew people well and responded to their needs and wishes, recognising triggers which may cause distressed responses prior to them occurring and deescalating the situation.

The provider cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

The provider operated staff recognition programmes to recognise staff performance and achievements to enhance their well-being.

The registered manager told us they had sought feedback from staff members which was positive overall. Positive feedback was used to help drive further improvements in the service.

Staff told us they felt listened to and valued by the management team and they felt they could raise any concerns they had.

Staff meetings took place, and the records of these meetings demonstrated how they were used to enable staff to feel valued and included in the improvement and development of the service. Once feedback was analysed from the feedback forms completed, the actions were added to an action plan, where necessary. The most recent staff surveys in March 2025 indicated staff were very happy, particularly with the registered manager’s support. Supervisions also took place and these included discussions around staff well-being and their own development. One staff member told us how they had requested additional training and this had been provided. Since our last assessments the provider has also implemented a robust supervision programme to demonstrate meaningful and supportive supervisions take place with the registered manager. The registered manager told us they felt supported by the provider and felt positive about the monthly consultants’ visits which were supporting her to develop and monitor the service.

Staff rotas we looked at demonstrated that night staff worked very long hours each week. When this was raised with the registered manager they told us, “Staff at the service have the opportunity to pick up overtime voluntarily, and rotas are released in advance to allow adequate planning and flexibility. Overtime is offered weekly, and staff choose whether to take on additional shifts based on their own availability and preferences. Staff wellbeing is a priority, and any concerns raised are responded to promptly. Where needed, rota adjustments can and will be made to support individual staff members’ health, work–life balance, or personal circumstances.”

We found no evidence that staff working overtime has negatively impacted the quality of care, the wellbeing of residents, or the overall running of the service. Night staff members we spoke with did not raise any concerns with us about the number of hours they worked.

The maintenance officer was responsible for maintenance at Hafod Nursing Home and the providers other location. Due to the amount of work which has been required to improve the service they told us this had put some pressure on them to ensure the work was completed in a timely way and to a high standard. The registered manager told us that they were actively looking to recruit an additional maintenance officer to help improve the current workload.