Little Trefewha Care Home

Updated 28 June 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Little Trefewha is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and we looked at both during this inspection.

Registered manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We also reviewed information that we held about the service such as notifications. We used information sent to us by the provider in their PIR. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We used all of this information to plan our inspection.

During the inspection

We reviewed 2 people's care plans and risk assessments. We reviewed staff training and supervision. We also reviewed other records relating to the management of the service. We spoke with the 8 people who lived at Little Trefewha,3 staff, the registered manager, deputy manager and the provider. We spoke with 1 relative during the inspection.

Updated 28 June 2023

About the service

Little Trefewha Care Home is a residential care home providing personal care to up to 21 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 21 people using the service.

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

People received their medicines as prescribed. Staff recorded administration on to paper Medicine Administration Records (MAR) and these were regularly audited. Some people had been prescribed pain relieving patches. Staff were not always recording on the body map where these had been place. We have made a recommendation about this in the safe section of this report.

At our last inspection we found the recruitment process was not entirely robust at our last inspection and we issued a requirement notice regarding this. At this inspection we found people had been recruited safely.

The premises were clean with no malodours. The building was in need of some re-decoration and there was a programme in progress to address this. At the time of this inspection there was a contractor building a covered area outside for people to sit in the shade.

The provider had effective safeguarding systems in place and staff knew what actions to take to help ensure people were protected from harm or abuse.

Little Trefewha had enough staff available to meet people's needs and ensure their safety. Staff were happy and many had worked at Little Trefewha for many years. People told us, “Staff are lovely, I have no complaints. Yes, there are enough staff to help me,” “There are always plenty of staff on duty and they really look after you, couldn't ask for better” and “Staff are local to the home and have been in their roles for many years, they're very efficient”.

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 worked within the principles of the MCA and sought people's consent before providing personal care and assistance. Guidance in care plans guided staff to help build independence wherever possible.

Identified risks were assessed and monitored. Care plans contained guidance and direction for staff on how to meet people’s needs.

Food was freshly cooked on the premises and looked appetising. There were staff available to support people at mealtimes where needed. People were positive about their meals.

The registered manager, deputy manager and the provider had effective oversight of the service. There was an improved audit programme in place to help identify any areas of the service that may require improvement.

People, staff and relatives were asked for their views and experiences by the registered manager and the provider. Staff meetings and residents meetings were held to share information and seek people’s views. Comments from people included, “I like living here,” “Carers do a good job, they all do their best, I’m quite happy here, I feel part of the furniture” and “I’m lucky to be here, there is plenty of choice of entertainment and food”.

Relatives' comments included, “(Person’s name) has settled in very well, staff are approachable and responsive, I’m happy that (Person’s name) is safe and happy here” and “We are kept well informed about (Person’s name) care. Any change in their condition is reported to us and external medical help is sought if necessary”.

The registered manager understood their responsibilities under the duty of candour. Relatives were kept informed of any changes in people’s needs or incidents that occurred.

The registered manager and staff worked closely with local health and social care professionals to meet people’s needs.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection:

The last rating for this service was requires improvement (30 November 2018).

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 30 November 2018. A breach of legal requirements was found in relation to recruitment processes being used at that time.

We undertook this focused inspection to check if the provider had made improvements and if they were now meeting the legal requirements. This report only covers our findings in relation to the key questions safe and well-led.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Little Trefewha on our website at www.cqc.org.uk.

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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.