Inspection on 24/02/09 for Beaufort House

This inspection was carried out on 24th February 2009.

CSCI found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Beaufort House 28/02/07

Beaufort House 14/03/06

Beaufort House 25/05/05

Beaufort House 25/01/05

Beaufort House 24/06/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Beaufort House Rectory Road Burnham-on-sea Somerset TA8 2BY     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: kathy McCluskey     Date: 2 4 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Beaufort House Rectory Road Burnham-on-sea Somerset TA8 2BY 01278786320 01278786320 beauforthouse@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Royal Agricultural Benevolent Institution care home 32 Number of places (if applicable): Under 65 Over 65 32 0 old age, not falling within any other category physical disability Additional conditions: 0 32 The maximum number of service users who can be accommodated is 32. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are qithin the following categories: Old age, not falling within any other category (Code OP) Physical disability (Code PD) Date of last inspection Brief description of the care home Beaufort House is situated in a pleasant residential area of Burnham-on-Sea. It is set in its own grounds and is surrounded by large and attractive gardens with ample car parking spaces to the front and side. The home is registered with the Commission for Social Care Inspection to provide personal care to up to 32 older people. The home is not registered to provide nursing care nor is it registered to provide care to people with dementia or other mental health problems. Care Homes for Older People Page 4 of 31 Brief description of the care home Beaufort House is owned and run by the Royal Agricultural Benevolent Institution for its patrons. The registered manager is Mrs Susan Lock. The main care home is a large Victorian building that has been converted into single room accommodation. The accommodation is of a high standard, comfortable and very well maintained. There are four large sitting rooms (one with bar facilities) and a spacious dining room. All bedrooms have en-suite facilities and call bells. There is a passenger lift and facilities for assisted bathing. The home benefits from experienced staff, who have been at the home for many years. The management and staff at the home assist service users to live as independently as possible. There is an interesting range of activities within the home and links to the wider community. The current fees are between 450 pounds to 650 pounds a week. Extra charges include newspapers, hairdressing and personal items. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was conducted over one day (6.5hrs) by CSCI Regulation Inspector Kathy McCluskey. The registered manager and other members of the management team were available throughout the inspection. We were given unrestricted access to all parts of the home and all records required for the inspection were made available to us. At the time of this inspection 25 people were living at the home. We were informed that beds were remaining empty to ensure that current refurbishment works did not have an impact on the people living there. We met with many people living at the home and with staff members working there. Care Homes for Older People Page 6 of 31 The home completed its Annual Quality Assurance Assessment and returned this to the Commission within agreed timescales. The AQAA is a self assessment which focuses on how well outcomes are being met for people using the service. It also provides us with some numerical information. We would like to thank everybody involved for their time and cooperation with the inspection process. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report. What the care home does well: What has improved since the last inspection? What they could do better: No statutory requirements were raised at this inspection. We have recommended that the home ensures that the person centred care being delivered is reflected in the individuals plan of care. We have also recommended that care plans reflect any input Care Homes for Older People Page 8 of 31 an individual is receiving from a health care professional. The home needs to ensure that the induction programme for newly appointed staff is reviewed in line with the Skills for care common induction standards so that staff follow a more detailed programme and that their competency is confirmed. Health and safety procedures were generally good but we have recommended that bath and shower hot water outlets are checked on a monthly basis as the home currently make checks every six months. We have also recommended that unrestricted windows above ground floor level are risk assessed to ensure that people remain safe. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 31 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with the information they need to allow them to make an informed decision about moving to the home. The home has procedures in place to ensure that peoples needs and aspirations can be met before a placement is offered. People are given the opportunity to test drive the home. Evidence: The home have produced a Statement of Purpose and Service User Guide which detail information about the home and services offered. These documents are made available to people living at the home and to anybody who is thinking about using the service. We were informed that the home encourages people to visit the home, and stay for lunch if they wish, so that they can meet the people that live there and the staff. It Care Homes for Older People Page 11 of 31 Evidence: also gives people the opportunity to see what life is like at the home. The registered manager has recently revised the homes contract so that it provides people with clearer information about the terms and conditions of occupancy and the fees to be charged. The home has procedures in place to ensure that anybody thinking about using the service is appropriately assessed. We were informed that all pre-admission assessments are carried out by the homes care manager. Documented pre-admission assessments are maintained and these are used to formulate a plan of care. People move to the home on a one month trial period. This gives the opportunity for all parties to be sure that the home can meet the individuals assessed needs and aspirations. Care Homes for Older People Page 12 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive the care they need which is in line with their preferences and aspirations. Care plan documentation could be improved to reflect this. People have access to a range of appropriate health care professionals. The homes procedures for the management and administration of peoples medication have improved and now offer better protection for the people living there. People are supported to remain at the home during their final days and facilities are available for relatives to be with them. Evidence: Each person has a plan of care which sets out their assessed needs and how these should be met by staff. We were able to see evidence that people using the service or their representative had been involved in this process. Care Homes for Older People Page 13 of 31 Evidence: During this inspection we examined three care plans and were able to speak to a number of people living at the home. Care plans were found to be up to date and contained clear information about individuals assessed needs. Instructions for staff provided clear instructions as to how the assessed needs should be met. Care plans could be further improved if more emphasis was given to including peoples preferences as this would promote a more person centred approach to care. Social historys should also be obtained wherever possible. It should be said that when we spoke to people using the service, they were very positive about the care they received and confirmed that staff know just how I like things done. During observations throughout the day, we noted that staff had a very good understanding as to the preferences of people living at the home. It was apparent that people were treated as individuals. Care plans contained evidence that people have access to appropriate health care professionals. The registered manager confirmed that the home had excellent links and support from GPs and district nurses. People living at the home told us that arrangements were made for them to see a GP whenever requested or required. During the inspection the registered manager was heard to offer a GP visit to two people who were feeling unwell. We were informed that there was nobody at the home currently suffering with pressure sores. District nurses are currently visiting two people who require leg dressings. Wound care plans are maintained by the district nurses and are held at the home. We have recommended that the home makes reference to this in the individuals plan of care. We were able to see that the home had sought appropriate health care input for an individual whose mental health had deteriorated. Care plans contained evidence that peoples weights are monitored on a monthly basis so that any concerns can be identified. We examined the homes procedures for the management and administration of peoples medication. We were informed that medicines are only administered by senior staff who have been appropriately trained. All medicines were found to be securely stored. We examined available medication administration records (MAR) and found these to be appropriately completed. We checked the homes procedures relating to controlled drugs and found these to have improved since the last inspection when a requirement was raised. Risk assessments were in place for those people who self medicate and these included a record of the number of medicines given to the individual and the date given. It has been recommended that the home obtains a signature from the individual confirming that they have received the medicines as recorded. Throughout the day we were able to observe staff interacting with people living at the Care Homes for Older People Page 14 of 31 Evidence: home. We noted that staff communicated with people in a very warm and professional manner. We heard staff using the individuals preferred form of address. People living at the home told us that the staff were very kind and that they felt that they were treated with respect. They also confirmed that this was the case during staff assistance with personal care; They are so very respectful when they help me with my bath. The home has a pay phone in the reception area of the home. Many people have had their own private lines installed in their bedrooms. The home has policies and procedures in place for staff relating to death and dying. We were informed that unless an individuals assessed needs cannot be met by the home, people will always be supported to spend their final days at the home. The registered manager informed us that self contained accommodation is made available to relatives who want to stay with their relative during their final days. Care Homes for Older People Page 15 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with very good opportunities for social interactions. The homes arrangements for ensuring people can make choices about their lives and for enabling people to maintain Independence are very good. The home ensures that people are provided with a wholesome and varied menu and that preferences are respected. Evidence: The home offers a range of social activities which include external entertainers and trips out. A full programme of activities is displayed for people each month. We were provided with the activity programmes for February and March and these included bingo sessions, communion, musical afternoons and art classes. We were also informed that regular shopping trips and mini bus trips also take place. On the afternoon of the inspection, many people were enjoying entertainment from a visiting choir. When we examined minutes from meetings, we were able to see evidence that people are encouraged to express their preferences with regard to activities. Care Homes for Older People Page 16 of 31 Evidence: The home has a therapy room which is equipped with a large jacuzzi bath and treatment bed. Soothing music and lighting add to the ambiance. We were informed that an aromatherapist and a beautician visit the home on a regular basis. A hairdresser visits the home weekly. The home also has a small shop where people can purchase a range of items. Newspapers are delivered to the home and there is a free bar available to people living at the home. People living at the home were very positive about the range of social activities available to them; There is always something going on if you want to join in. They also told us you are never put under any pressure and you can do as you please. People told us that their visitors are made to feel very welcome. To comply with fire regulations, all visitors to the home are required to sign in and out. Refreshments are made available to visitors and visitors can stay for meals at a small cost. The home support people to remain as independent as possible. Kitchenette facilities are available for people to use as they wish. A laundry room is available specifically for people who wish to continue to launder their own clothes. We spoke with one person who used this facility; It is very good as I want to do my own laundry for as long as I can. Through discussion with people using the service and through observations throughout the day, it was very apparent that people choose how and where to spend their day. People also told us that they decide when to retire at night and when to get up. I feel completely in control of my life. All meals are freshly prepared at the home by the homes catering staff. The home has recently been awarded a five star excellent rating from environmental health for its food hygiene standards. We viewed a five week menu and this included a varied range of meals. Choices are available for each meal. People are provided with the days menu each morning and are able to make their meal choices each day. The catering staff have information about peoples preferences/dislikes and any special dietary requirements. People are able to choose where to have their meals and trays are provided in bedrooms as requested. During this inspection most people had their lunch in the dining room. The dining room is a very spacious room which has be beautifully decorated and furnished. Tables had been attractively laid. Cloth napkins and condiments were available and people could choose from a selection of refreshments. People were able to help themselves to potatoes and vegetables from serving dishes which had been placed on each table. The atmosphere during lunch was very relaxed and unhurried. Care Homes for Older People Page 17 of 31 Evidence: People told us that the food was very good and that there is always plenty to eat. We were also informed that snacks are always made available as requested. Care Homes for Older People Page 18 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an effective complaints procedure in place though this should be displayed in a prominent position within the home. The home has procedures in place which reduce the risk of harm or abuse to the people living there. Evidence: The home has a clear complaints procedure in place. It has been recommended that this is displayed in a prominent position in the home. The home have received one complaint since the last inspection and we were able to see evidence that appropriate action had been taken by the management team to resolve the issues raised. The concerns had been raised by a number of people using service who felt that the new chairs purchased for the dining room were a little hard. We asked a number of people living at the home if they knew how to make a complaint and if they would feel confident in doing so. All confirmed that they did and that they would not hesitate in raising concerns if they had any. All confirmed that they found the management team and staff at the home very approachable. Nobody raised any concerns with us during this inspection. The Commission have not received any concerns about the service in the last twelve Care Homes for Older People Page 19 of 31 Evidence: months. The home has procedures in place to reduce the risk of harm or abuse to the people living there. A range of policies and procedures are in place for staff and the home follows robust staff recruitment procedures. Training records examined confirmed that all staff had received training in the protection of vulnerable adults. Staff spoken with demonstrated a good knowledge of action to be taken should they suspect abuse. It has been recommended that the home obtains a copy of Somersets policy on Safeguarding Adults as this provides information about the local procedures to be followed. Care Homes for Older People Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a very comfortable home which is well maintained. Furnishings and decor are of a very high standard. People can choose from a number of very spacious communal areas and people have their own bedrooms which they can personalise. The large beautifully landscaped gardens are easily accessible to people with mobility difficulties. The standard of cleanliness is high and appropriate procedures are in place to reduce the risk of the spread of infection. Evidence: The home has been maintained and furnished to a very high standard and this gives a grand though very homely feel to the home. There are several very large communal areas for people to choose from. All bedrooms are currently used for single occupancy though, given the size of some rooms, couples can be accommodated if they choose to share a room. Bedrooms are furnished by the home though people furnish their own rooms if they wish. A Care Homes for Older People Page 21 of 31 Evidence: programme of refurbishment is on-going.Bedrooms are fitted with en-suite shower facilities. The home currently have three apartments which consist of a sitting room, bedroom and en-suite shower room. All bedrooms seen at this inspection were very personalised and comfortable. People spoken with told us how happy they were with their rooms. As previously mentioned, the standard of furnishings including soft furnishings and decor are of a very high standard. we were informed that people are able to choose a colour scheme for their rooms. This was confirmed by a person living at the home. Bedrooms are fitted with a lock which can be overridden by staff in the event of an emergency. There are assisted bathing facilities and work is currently on-going to add the provision of a wet room. The home employs a full time health and safety manager who is also responsible for general repairs and the management of the homes maintenance and refurbishment programme. As previously mentioned in this report, the home have a very well equipped therapy room where people can relax in the large jacuzzi bath or enjoy a range of treatments from a visiting aromatherapist and beautician. A call bell system is installed throughout the home and people told us that staff respond to call bells promptly. Ramps and grab rails are appropriately sited to assist people and a shaft lift gives access to the first and second floor accommodation. Mobile hoists are available to assist those with mobility difficulties. The home has very large landscaped gardens which are beautifully maintained. There are several different areas for people to enjoy. The home have recently purchased a summer house and comfortable furniture. A full time gardener is employed. Staff hand washing facilities are appropriately sited and staff are issued with sanitising hand gel. The home employs domestic staff. Two domestics are on duty Monday - Friday. On the day of this inspection, the standard of cleanliness in the home was noted to be very high and there were no malodours noted in the home. Care Homes for Older People Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensures that appropriate numbers of staff are on duty to meet peoples needs. Staff morale is good and people benefit from a stable staff team. The homes recruitment procedures reduce the risk of harm or abuse to the people living there. Staff are appropriately trained though the induction programme for newly appointed staff could be improved. Evidence: At the time of this inspection, 25 people were living at the home. The registered manager informed us that minimum care staffing levels were currently 4 in the morning, 3 in the afternoon and 4 in the evening. Nights are covered by 2 waking carers and 1 on-call. The registered manager and care manager work weekdays in addition to the care staff. The care manager also works along side carers and provides shift cover as required. An on-call system is in place. People using the service told us that the staff are always available when you need Care Homes for Older People Page 23 of 31 Evidence: them. Staff spoken with did not raise any concerns about being able to meet peoples needs with the number of staff on duty. The registered manager informed us that she increases staffing levels as required to ensure that peoples needs are met. The home has a very stable staff team and no agency staff have been used. In addition to care staff, the home employs catering staff, laundry and domestic staff, a full time health & safety manager/maintenance and a full time gardener. An administrator is also employed. An activities coordinator is employed for two afternoons a week. NVQ training is promoted. The homes completed AQAA told us that of the 23 care staff employed, 21 have achieved a minimum of an NVQ level 2 in Care. This equates to 91 which far exceeds the recommended 50 of the National Minimum Standards. Training records examined confirmed that staff had received up to date mandatory training. Some staff have first aid training. Staff have also received training in the protection of vulnerable adults. We examined the homes procedures for staff recruitment. Three staff recruitment files were examined and we were able to see that all required documentation had been obtained prior to the staff member commencing employment. This included an enhanced criminal record check (CRB) and checks against the protection of vulnerable adults register (POVA). It has been recommended that the application for employment form is updated to included a statement informing applicants that the post is exempt from the Rehabilitation of Offenders Act 1974 and of their requirement to confirm and sign the declaration. Newly appointed staff undertake a period of induction. On examination we noted that the homes current induction programme was basic and did not cover specific topics relating to care nor did it confirm the individuals competency. Our findings were discussed with the registered manager at the time of the inspection and she had already identified this as an area for improvement. We have recommended that the home revises its staff induction programme so that it meets with the Skills for Care Common Induction Standards. Care Homes for Older People Page 24 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a management team who promote an open and inclusive style of management. Systems are in place to seek the views of people using the service though quality assurance procedures could be further improved by introducing a more formal system. Peoples finances are safely and securely managed. People benefit from a staff team who are appropriately supervised and supported. The homes procedures for health and safety are generally good. Evidence: The registered manager is Mrs Susan Luck. The Commission approved an application for Mrs Luck to be registered manager of the home in January 2008. Mrs Luck is Care Homes for Older People Page 25 of 31 Evidence: currently working towards a registered managers award. Since the last inspection the home have made changes to its management structure to ensure the smooth running of the home. The registered manager is supported by a care manager who oversees the care of people living at the home. The home also has a health and safety manager who takes responsibility for mandatory training for staff. He is a moving and handling trainer. People living at the home and staff confirmed that they found the management team very approachable. Throughout the day we noted that people were very relaxed in the presence of the management team and it was apparent that they had a good understanding of peoples needs and preferences. We were informed that formal meetings are held for people using the service twice yearly though meetings are arranged more frequently if requested by the people living at the home. Minutes of meetings are maintained and these evidenced that peoples views were regularly being sought. People told us that they found the frequency of meetings sufficient, we can discuss any issues we have at any time and they always get sorted out. Regular meetings are also held for staff. The registered manager told us that there was currently no formal quality assurance programme in place to seek the views of people living at the home, relatives/visitors and health care professionals. The registered manager indicated that this is something that she would see as beneficial. It has been recommended that a formal quality assurance programme is introduced so that the home can seek feedback on the quality of the service provided. We were able to see evidence that, as required under Regulation 26 of the Care Homes Regulations 2001, monthly visits to the home were being conducted by the responsible individual and appropriate reports produced. We were informed that the home currently assists seven people to manage their pocket money. We examined records relating to two people. Clear records are maintained and receipts are obtained. We noted that only one staff member is signing to confirm transactions. To reduce the risk of abuse and to offer better protection to the staff member, it has been recommended, where the individual is unable to sign, that two staff sign records to confirm the transactions. As appropriate, relatives are encouraged to regularly check transactions and balances. We were informed by the care manager that a programme is in place which ensures that all staff receive formal supervision at least six times a year. Staff records examined confirmed that they were receiving appropriate supervision sessions. This was also confirmed by staff spoken with. Staff also receive regular appraisals. Care Homes for Older People Page 26 of 31 Evidence: We examined the homes procedures relating to health and safety. This included a tour of the premises and viewing a selection of records. Fire safety records were found to be up to date and there was evidence that staff received regular training in fire safety. There was evidence that appropriate checks had been made on portable electrical appliances and the home has an up to date electrical hardwiring certificate and gas safety certificate. Servicing records for the homes mobile and bath hoists and shaft lift were up to date. To reduce the risk of scalding, hot water outlets are fitted with thermostatic controls. The home currently checks the temperatures of outlets every six months. As these devises are not failsafe and in line with Health and Safety Executive guidelines, checks on bath and shower hot water outlets should be carried out monthly to ensure that temperatures do not exceed safe upper limits of 42c for showers and 44c for baths. Risk assessments should be completed for unrestricted windows above ground floor level to ensure that people at the home are not place at unnecessary risk. Care Homes for Older People Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 The registered person should ensure that care plans contain reference to individuals preferences for care giving and activities of daily living and that social historys are obtained wherever possible. The registered person should ensure that individuals care plans include information to alert staff of any care plan being maintained by other heath care professionals. This refers to the wound care plans managed by district nurses. The registered person should ensure that people who are self medicating, sign to confirm receipt of all medicines given to them. The homes complaints procedure should be displayed within the home. The home should obtain a copy of Somersets policy on Safeguarding Adults. The registered person should give consideration to introducing a formal quality assurance programme which will seek the views of people using the service, their representatives and health care professionals. The registered person should ensure, where an individual is unable to sign to confirm a financial transaction, that a Page 29 of 31 2 8 3 9 4 5 6 16 18 33 7 35 Care Homes for Older People second staff signature is obtained. 8 38 To ensure the safety of persons at the home, the registered manager should ensure that appropriate risk assessments are completed in relation to all unrestricted windows above ground floor level and that action is taken to address any risk identified. To reduce the risk of injury to people using the service, the registered person should ensure that bath and shower hot water outlets are checked monthly. 9 38 Care Homes for Older People Page 30 of 31 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!