Tryfan House

Most risks to people's care were assessed and measures put in place to manage these, such as risk of falls or weight loss. However, we saw examples of documentation not always being detailed or completed when people required additional support due to displaying distressed behaviour or evidence of monitoring following an incident or physical restraint. Although there was ongoing cleaning happening, we found examples of some areas at the home or objects used by people not being clean. Most areas of recruitment were managed safely but we found examples of additional improvements required. Medicines were well managed. Staffing levels were safe.

The environment was not always dementia friendly or homely; there was an ongoing programme of redecoration at the home. Staff asked consent before supporting people with care tasks. 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. People were supported to maintain a balanced diet and had access to the relevant healthcare professionals to meet their needs.

The service was located on the same grounds as another 5 care homes owed by the same provider and we saw care documentation related to people living at Tryfan house or any of the other care homes could be accessed by any staff working in those services. This posed a risk to people's confidentiality. People were supported by staff that were caring, compassionate and respectful. People's independence was promoted.

Most care plans were centred around people's needs and preferences however, we also found inconsistencies and areas that required additional detail. People were offered a regular programme of activities tailored to their needs. People who required end of life care received the care they needed. The service had not received any complaints, but the necessary policies and procedures were in place to manage these.

Some areas of the management of the home needed improvement. Quality assurance systems were in place and happening regularly, however these had not always been effective in identifying or addressing in a timely way the issues found at this inspection. We have made a recommendation in relation to ensuring quality assurance processes are effective to ensure adequate management's oversight. We saw evidence of

good partnership work with other professionals, to meet the needs of people using the service. There were plans to continue developing the service. The management team supported this inspection, were receptive to findings and told us the actions they would take to address issues identified.