About the service: Hafod Residential Home is registered to provide accommodation and personal care. The service provides care and support for up to 16 older people some who may be living with dementia.

People’s experience of using this service:

People were not all able to fully verbalise their views therefore they were not able to tell us about their experience of living there. We observed the interactions between people and the staff supporting them. There were 13 people living in the service on the days we visited.

The management team and staff knew people well and understood their likes and preferences and health needs. Staff were caring and chatting with people as they moved around the service. Relatives told us they were welcome at any time and any concerns were listened and responded to.

People and staff told us the service was well managed. People said they were treated with kindness and compassion. Staff showed a true fondness for the people they cared for and there was a friendly atmosphere. People’s wellbeing was promoted.

Staff were recruited safely in sufficient numbers to ensure people’s needs were met. People and staff said there was limited time for social interaction and activity with staff. However, the registered manager was in the process of employing an activities coordinator to improve activities provided.

The environment was safe, and people had access to equipment where needed. The jacuzzi bath was currently out of action. However, the required part had been ordered. Staff had received appropriate training and support to enable them to carry out their role safely, including the management of medicines.

There were positive working relationships with external professionals and a passion for continuous learning and improvement.

People were kept safe and protected from avoidable harm and abuse, and people had their medicines safely managed. Processes had been put into place to ensure a robust oversight. People lived in an environment which was fully assessed for safety.

People received personalised care and support, and had their human rights protected. Staff were competent in their roles and were well supported. Quality monitoring systems had been further developed.

Rating at last inspection: Good (Report published 2 November 2016). However, it was rated as Requires Improvement in Well-Led. This had now improved to Good.

Why we inspected: This was a planned inspection based on the rating at the last inspection. At this inspection, the service remained rated Good overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

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

This inspection took place on 6 and 7 September 2016 and was an unannounced comprehensive rating inspection. The location was last inspected in March 2014 and was rated as meeting all the standards.

Hafod Residential Home is a registered care home providing accommodation and personal care for up to 16 older people. At the time of our inspection 15 people living at the home.

There was an acting manager in post and the owner had submitted an application to become the registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff did not always complete risk assessment documents correctly, to ensure effective monitoring.

People were safe and secure. Relatives believed their family members were kept safe.

Staff had been recruited appropriately and had received relevant training so that they were able to support people with their individual needs.

People safely received their medicines as prescribed to them.

Staff sought people’s consent before providing care and support. Staff understood when the legal requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) should be followed.

People had a variety of food, drinks and snacks available throughout the day. They were able to choose the meals that they preferred to eat and meal times were flexible to meet people’s needs.

People were supported to stay healthy and had access to health care professionals as required. They were treated with kindness and compassion and there was positive communication and interaction between staff and the people living at the location.

People’s rights to privacy were upheld by staff that treated them with dignity and respect. People’s choices and independence were respected and promoted. Staff responded appropriately to people’s support needs.

People received care from staff that knew them well and benefitted from opportunities to take part in activities that they enjoyed.

The provider regularly consulted with stakeholders to identify how the quality of the service could be developed.

On the day of our visit there were 12 people living in the home. The provider did not know we were coming. We spoke with four relatives, nine people living in the home, four staff and the acting manager. All the people spoken with who used the service were complementary about the staff and the care they received. One person told us, "I am happy here you never go without and staff are really nice to us all''.

People’s care and health care needs were planned and met in a personalised way. All staff spoken with told us they had the information they needed to care for people safely. All four staff told us the people living in the home told them what support they wanted. One person told us, “I am old enough to make my decisions and staff respect them’’. All nine people told us that they were asked about the help they needed. This meant people were involved in the care they received.

We saw and people spoken with told us they were given a choice of what they wanted to eat. We saw that assessments of people’s dietary needs had been completed to ensure people stayed healthy. This meant people’s nutritional needs were met.

Staff spoken with told us they felt supported by the manager and had regular training opportunities. This meant staff should have the skills to care for people safely.

We carried out this inspection to check on the care and welfare of people using the service. The inspection was unannounced which meant the provider and the staff did not know we were coming. During our inspection we spoke with seven people using the service and three members of staff.

We saw that staff treated people with respect and dignity. People told us that choices had been offered and their views had been taken into consideration. One person said, “The staff have a really positive attitude. You can’t fault them and they’re very respectful.”

We found that medication systems were safe and that medication had been given to people as it had been prescribed by their doctor.

The home was clean and people told us they liked living there. The dining room, conservatory and one bedroom were being redecorated and refurbished.

We found that care records were informative and people told us their views were taken into consideration when planning their care.

There were systems in place to monitor how the home was run. Systems were being developed to ensure people using the service and their representative were able to tell staff what was important to them and influence how the service was delivered.

When we visited the home on 13 October 2011 we followed the care of two people who were or could be at risk of skin damage because their mobility was very limited. We met and spoke to one of those people and asked if they were well looked after at the home. They told us that they were. They said that staff were very kind and careful when they helped them move around and with their personal care.

We did not speak to the other person as they suffered confusion and could not easily communicate with us. We did however spend two hours in the public rooms and saw that they were not left sitting in one place for a long time. They appeared to be alert to what was going on around them and responded to chat from staff and other people.

We saw that people lived in a warm and homely environment with access to a large garden. Some of the interior looked worn and shabby including the furniture. One person had to ask us to vacate a dining chair for their use in the conservatory as it was the only one available with arms.

All of the installations and technical equipment in the home were regularly serviced and inspected as they should be to keep them working safely.

People cannot leave the home unless staff release the security lock on the front door.

There is no manager that is registered with us to run the home. This means that the provider is in breach of a condition of its registration that should have been complied with by 1 April 2011.