Hill View Care Home
Commercial Street, Aberbargoed, Bargoed, CF81 9BU.
Tel: 01443 803493
Email: admin@hillviewcarehome.co.uk
Contract Monitoring Report
- Name Of Provider: Hill View Care Home, Aberbargoed
- Date(s) of Visit: Tuesday 26 March, 2024, 10.00 a.m. – 3.00 p.m. / Tuesday 4 June, 2024, 11.00 a.m. – 3.40 p.m
- Visiting Officer: Andrea Crahart, Contract Monitoring Officer, Caerphilly Commissioning Team
- Present: Sarah Roach, Registered Manager
Background
Hill View Care Home is situated in Aberbargoed and is close to local amenities (shops, schools, church etc.). The Home is able to provide care and support to 34 people who have dementia residential needs and at the time of the visit the home had 1 bed vacancy.
The Home is large and split on 3 levels. People are carefully matched to live on floors at a similar point in their experience of living with a dementia, in order to reduce any stress experienced and encourage a sense of well being. There are 3 dining areas and 3 communal areas for residents to use.
Staffing levels consist of 7 carers, a deputy manager and registered manager, housemother and 2 cleaners during the day time, and at night time there are 6 carers during twilight hours, 4 carers between 10.00 p.m. and 6.00 a.m. Two kitchen staff, 1 laundry and 1 handyman (employed 2 days a week) work during the day time.
The manager is registered with Social Care Wales (workforce regulatory body).
The manager of the home regularly communicates any issues to the Caerphilly Commissioning Team in terms of any concerns (including safeguarding concerns, infectious outbreaks, concerns with residents, the building etc.) and informs the Care Inspectorate Wales (CIW) also.
The CIW (Care Inspectorate Wales) undertook an inspection in April 2024 where no issues were reported, and the final report is due to be published very soon.
The Home have received a food hygiene rating of 5, which is very good and awarded in March this year.
Dependent on the findings within the report, corrective and developmental actions will be given to the provider to complete. Corrective actions are those that must be completed (as governed by legislation); developmental actions are good practice recommendations.
Previous monitoring visit
Corrective Actions
Quality Assurance (Quality of Care Review) to include further analysis of the Home (e.g. lessons learnt, outcomes of inspection reports etc.) Timescale: Immediately and ongoing. (RISCA Reg. 80). To be monitored further. (Action from visit in 2019). Action met.
Policies/Procedures which are currently un-dated to have a review date added plus a future date for review. Timescale: Within 1 month. (RISCA Regulation 12). Action met.
Staff references to always be verified with the referee (signed, dated and any relevant comments documented). Timescale: Immediately and ongoing. (RISCA Regulation 35. Action met.
Appraisals to be focussed upon for all staff. Timescale: Within a year. (RISCA Regulation 36). Action met.
Developmental
Personal Care checklist to be developed to include space for carers to record when oral care is being undertaken more than once a day. Alternatively, ABuHB Oral Care Monitoring forms to be used to capture this information. Timescale: Within 2 months. To be checked. ABuHB monitoring forms will be used going forward.
Records to be maintained of each shower head that has been cleaned within the Home so that it is easily identifiable which have been cleaned. Timescale: Within 2 months and ongoing. To be checked.
Responsible Individual
The Responsible Individual (RI) continues to provide good support to the manager/ staff team and has an oversight of the service and its quality on an ongoing basis. The RI had undertaken regular quarterly visits, the most recent being done virtually due to not being in the area to conduct this face to face. However, a conversation was held with a resident during this visit and other issues were discussed at the time, with reference to planning to repair and replace various items etc. It was evident that actions identified in the RI reports had been followed through and that staff’s opinions on what was needed were listened to.
The RI’s Quality of Care Review (dated September 2023) was comprehensive and referred to areas for development in terms of recruitment of staff, the environment (both inside and outside), non-mandatory training for staff (vital signs, Advanced Care Planning etc.). Quality of Care reviews are required to be completed on a 6 monthly basis.
The Home’s Statement of Purpose had been revised in March 2024 so was up to date and provides a comprehensive overview of what the Care Home delivers. One of the areas the document made reference to was ‘The Active Offer – More than Just Words’ (revised Welsh Language Act) which requires providers of social care to provide communication in Welsh without the person asking for this. Hill View have indicated that they can provide information in Welsh and will be responsive to the needs of Welsh speakers within the Home.
The Home’s Service User’s Guide was provided as part of the monitoring process.
If the RI and manager are unavailable to manage the service, the contingency plan would be for the deputy manager to cover in their absence.
The Home’s mandatory policies/procedures were viewed and had been reviewed in 2023. Some slight amendments were noted to be needed to some policies which were communicated to the manager and 1 policy was not present which would be considered whether necessary, with guidance from CIW. The Home’s Social Media policy was requested and supplied.
Registered Manager
The Care Home operates a CCTV system (surveillance system) which covers all communal areas (lounges, hallways) only. The manager has sought to gain consent from relatives through signed consent forms.
The temperature in individual bedrooms is able to be adjusted via the radiator thermostats to ensure that people do not become too warm or too cold. In addition, during times of hot weather electric fans and air conditioning units are used although during periods of heat waves the building can be difficult to keep cool.
The manager continues to submit Regulation 60 notifications in a prompt manner which are a mechanism to report incidences that have occurred e.g. outbreaks of infectious diseases, falls experienced etc., and these are submitted in a timely way to the relevant professionals e.g. Care Inspectorate Wales (CIW), Caerphilly Commissioning Team, Environmental Health, Public Health Wales etc.
The Home continues to request and receive good support from numerous health professionals i.e. GP, Community Psychiatric Nurses, District Nursing Team, who ensure people’s health needs are met.
Training
Hill View Care Home continues to ensure staff receive training in key areas and where these are required the manager regularly liaises with training providers. The training providers who are utilised include Langford’s, New Directions, Aneurin Bevan University Health Board (ABuHB) and the Caerphilly Mental Health Team and Blaenau Gwent/Caerphilly Workforce Development Team.
The manager has a training matrix to record all the training being delivered which was produced in a way that was clear to understand. It was evident that many staff were up to date with mandatory/key training, such as manual handling, first aid/CPR/stroke awareness, fire safety, dementia, safeguarding/deprivation of liberty safeguards/mental capacity act, health and safety/COSHH. Although there were some gaps in respect of infection control and food safety and many gaps relating to end of life care, advance care planning, I stumble (falls training) and sensory impairments the Home has ‘planned training’ arranged so that staff can benefit from these training courses.
A large number of staff have either achieved an NVQ/QCF level 2, 3 or 5 in Health and Social Care, or are in the process of working towards their qualification.
Staffing
Staffing levels appeared sufficient during the visits and staff did not appear rushed undertaking their duties. The staff were very friendly and showed patience and empathy at all times, making a point of speaking to residents. The service continues to have difficulties in recruiting and retaining staff due to the shortages of carers in the care sector and any absences are covered by the existing staff team as far as possible, although bank staff are utilised when required.
Two staff member files were examined to determine if robust recruitment processes are in place. The staff files were very organised and included a file checklist and sections. The information held consisted of a detailed application form, job descriptions, 2 references which had been verified (although it was unclear who the 1 reference had been received from, in the absence of another not being responded to), interview records, a photograph of the staff member, identification, signed Contracts of Employment. Other information consisted of a certificate of sponsorship, DBS (Disclosure and Barring Service) clearance and training certificates.
Hill View Care Home employ staff from overseas and an appropriate Sponsorship licence is in place to recruit suitable individuals to work.
A supervision matrix confirmed that supervision sessions were being held on a quarterly basis and appraisals had been held in May 2023 for all staff.
File and Documentation Audit
Two files were viewed which were contained appropriate documentation to support the people concerned as well as possible e.g. Caerphilly Social Services Support Plans, pre-admission information which are referred to in order to inform the Home’s Personal Plans (Care and Support Plans) for each area of need. There was a ‘This is me’ document which enables the Home to gather as much information that is personal to them e.g. likes/dislikes, past hobbies etc. This document was produced by the Alzheimer’s Society and includes information such as, the person’s family background, important life events, people/places, preferences, routines and personality; the aim of which is to aid staff in supporting people to reduce any distress and meet their needs.
Personal Plans (Care and Support Plans) had been written in a detailed way and in a person centred manner to reflect the person’s needs and wishes. The plans typically included e.g. personal care, oral care needs, foot care, skin integrity, mobility/transfers, meals/drinks, wishes upon death etc. There were also risk assessments in place relating to falls, the need for bed rails etc.
Daily Records which are used to record the care and support given were detailed and had been signed/dated by the staff members.
The Professional visit logs indicated that visiting professionals were involved in the people’s care from the time of their admission to the Home e.g. district nurses, community mental health team, GP, chiropody etc.
The contract monitoring officer is aware that the provider regularly submits Deprivation of Liberty Safeguarding (DoLs) documentation and informs the Commissioning Team and CIW when these are submitted.
Quality Assurance
The RI had completed quarterly visits to the Home and has a thorough oversight of the service. The most recent quarterly report had been written in February 2024, which was a ‘virtual’ visit due to the RI being overseas at the time and there were previous quarterly reports available also. It was evident from the information provided that the RI had listened to the requests that were communicated to him and that repairs/refurbishments etc. have been acted upon in the interests of the staff and residents.
The RI is required also to write 6 monthly quality of care reviews. This had been written in September 2023, therefore a more up to date report is due. This review provided an overview of the service, what had been achieved and areas for development were highlighted.
Staff and resident meetings take place to gather feedback from individuals at the service. Two recent resident meeting minutes were viewed where it was evident that feedback had been received by each resident in attendance. People shared that they were happy living at Hill View, some suggested some new activities they would like to do and a few people indicated they would like to go out more. The deputy manager confirmed that arrangements are being made to hire a bus so that people can visit a local park. A recent staff meeting was well attended and areas covered included e.g. feedback from the previous contract monitoring visit, new team leaders were introduced, reporting of sickness levels, staff engagement in activities (music) etc.
Home Maintenance
The RI employs a caretaker who undertakes regular checks throughout the Home.
The Fire Service had recommended that new fire doors are fitted throughout and this continues to be undertaken on a phased approach. Other work carried out has included additional work to the roof and the telephone system.
Other improvements that are due include replacement kitchen flooring and new flooring for some bedrooms. Hill View have had their CCTV system renewed and the glass ‘dome’ that is in the lounge area is being removed due to issues with water leaks and will be replaced by a flat roof.
Fire Safety/Health and Safety
The Home’s most recent Fire Risk Assessment was undertaken in April 2024 by the Tower Fire Group. There were some areas identified for rectifying/improvement which had been prioritised from priority 1 to 4 and it was confirmed that the Home is acting upon the recommendations with a quote for work being sourced.
Fire drills continue to be held on a regular basis with the most recent being held in May, February, January 2024 and throughout 2023. The records captured the detail of the drill e.g. the staff who have attended, where and how the drill was carried out, a de-brief on the performance of the drill and any actions required to be imrpoved upon.
Accidents/Incidents were viewed for recent months which showed that in May 2024 1 resident had sustained a fall and in April there were 12 incidences. The reports for each incident were noted to be detailed and each month an analysis of the accidents/incidences took place to see when and where they took place, what was happening at the time, whether it was observed or not and any possible causes, so that any themes can be identified.
Managing people’s money
The records for some people were viewed, which illustrated that the person’s income and expenditure had been recorded and two signatures had always been obtained for these transactions. An accounting error was noted during the visit for one of the records which was brought to the attention of the manager at the time. The Home manage the funds on behalf of all residents living at Hill View.
Observations (interactions, activities, environment)
Areas of the Home were seen to be clean, fresh and were tidy.
Interactions between staff and people cared for were warm and friendly. Staff were happy to talk about their roles and what they enjoyed about them. People looked very well cared for, a lady said how she liked having her hair done in the Home’s salon and people’s footwear looked comfortable and secure.
Communal areas and people’s bedrooms are very pleasant rooms which are well decorated and look clean. There was much evidence of personalisation where people had brought their own belongings into the Home and the hallways have memorabilia on the walls that are interesting to see and stimulating. Some bathrooms viewed were very inviting spaces and were very clean and tidy. The Home has a dedicated hair salon which is a pleasant space for people to enjoy having their hair and nails done.
Visitors are made to feel welcome when they visit and are invited to be part of the Home by sharing meal times and being part of the activities that are on offer. During one of the visits there was a visiting poet who visited every floor of the Home to delivery some poetry which visitors benefitted from also.
There is an Events page that is made available in the foyer at the start of each month so that residents, relatives/friends can see what is taking place.
The Home has links with the local church, library and local primary/nursery schools which is hugely beneficial to the residents at Hill View. The manager recently took up the opportunity to have music sessions, a ‘silent disco’, arts/crafts sessions and poetry which were enjoyed by the residents. Other singers visit also and during one of the monitoring visits people were seen to be enjoying singing along to a visiting artist.
Hill View have taken up the offer to be part of the ‘Meaningful engagement project’ set up by the ABuHB, which will provide support and guidance to staff in knowing how to make activities meaningful and will include a resource box.
There is a small outside veranda area for people to use which has a seating area, and is decorated with gardening items. The monitoring officer was made aware that further work is ongoing in this area which would include new furniture, a herb garden and a designated area for people to smoke, if they wish.
Mealtime observations
The contract monitoring officer observed the lunch time meal in one of the lounges and it was evident that people were enjoying a leisurely lunch which was unhurried. There were sufficient staff available to assist where required and residents were supported with serviettes and given drinks etc. Tables were laid with place mats, a table cloth, cutlery and serviettes.
Resident’s/Relatives feedback
A resident, who was recently admitted to the Home was spoken to said how she liked being at Hill View. She felt comfortable because her husband was living there also, she had family visiting frequently and said that the staff care for her well.
A family member relayed that they had no issues with Hill View care home and that “they felt like one of the family”. They were complimentary about the staff team, and said they knew their relatives are happy living their, they are clean, well fed and looked after. Any incidences are communicated to them promptly so they are kept informed about how their relatives are.
The Green agenda
Hill View have put some measures in place to help reduce their carbon emissions by installing LED lighting, planting flowers, recycling via individual bins and the Home has plans to create a herb garden.
The manager was invited to try to identify someone within the staff team who may have an interest in this subject to be able to drive the green agenda forward.
Actions
Corrective Actions
RI Quality of Care Review (6 monthly) due for first quarter of 2024. Timescale: Within 1 month. RISCA Regulation 80.
Policy relating to restraint to be written (as per guidance from CIW). Timescale: Within 2 months. RISCA Regulation 29.
Developmental Actions
None.
Conclusion
Residents continue to live in an environment that is comfortable, nurturing and provides the opportunity for people to thrive. The home environment is bright, airy, welcoming and inviting. People look well cared for, there are activities on offer to provide stimulation and staff are attentive and pleasant.
The Home is well furnished and maintained and it is evident that repairs are acted upon and ways of improving the environment are explored.
Documentation is robust in terms of residents’ files with information being detailed and person centred and staff files show a robust recruitment process has taken place also.
The RI continues to support the Home, gather feedback from key stakeholders, listen and act on what is communicated.
The monitoring officer would like to thank the manager and staff team for their time and hospitality during the monitoring visit.
- Author: Andrea Crahart
- Designation: Contract Monitoring Officer, Commissioning Team
- Date: June 2024