Inspection on 09/08/06 for Cary Brook

This inspection was carried out on 9th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Cary Brook 07/08/07

Cary Brook 07/03/06

Cary Brook 16/11/05

Cary Brook 10/01/05

Cary Brook 12/07/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Cary Brook Millbrook Gardens Castle Cary Somerset BA7 7EE Lead Inspector Loli Ruiz Unannounced Inspection 9 August 2006 10:00 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cary Brook DS0000016106.V307320.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cary Brook DS0000016106.V307320.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cary Brook Address Millbrook Gardens Castle Cary Somerset BA7 7EE Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01963 350641 01963 351364 Somerset Care Limited Mrs Judith Mary Pullen Care Home 35 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0) of places Cary Brook DS0000016106.V307320.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. REGISTERED FOR 35 PERSONS IN CATEGORIES OP AND DE (E) Date of last inspection 7th March 2006 Brief Description of the Service: Cary Brook is situated close to the town of Castle Cary, at the top of a small hill overlooking a residential housing estate. Most of the rooms have views overlooking parts of the town. The home was purpose built in the 1960s and offers specialist care to older people with physical and mental frailty. The layout is simple and over two floors. This allows those individuals, who need space, the opportunity to move around the home, with lounges available on both floors and a secure garden. A quiet dining area is also available on the first floor with a small kitchenette offering additional facilities for service users and their visitors. The home offers a generally relaxed, homely atmosphere with planned activities. The manager of the home has been in post for just over one year; prior to this appointment she had been the deputy manager at Cary Brook and has worked for Somerset Care for many years. Cary Brook DS0000016106.V307320.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Unannounced inspection took place on August 9th from 9.50 am to 17:10 hours. Thirty-three service users were residing at the home. Two of these were in hospital. The last inspection was also unannounced and took place on the 7th March 2006. At that inspection two requirements and two recommendations were made. At the time of this inspection both requirements had been met and the recommendations remained outstanding. 30 of 38 national Minimum Standards (NMS) and all of the key NMS were inspected. An exception was that of the management of service users money that was fully inspected and met in March 2006. Most National Minimum Standards were met and good outcomes were being achieved. Service users spoken to during the inspection expressed their satisfaction at the care delivered, they appeared happy and well cared for. Visitors were observed and also professionals attending such as a district nurse and an optician. The inspector would like to thank the Manager Mrs Judith Pullen, and everyone in the home for their time and help during the inspection. What the service does well: The home ensures that all people are assessed prior to moving into the home, which is a safe and secure environment suitable for service user needs. Arrangements were in place to meet the health and personal needs of the service users. Care plans were inspected and of a generally good standard and those seen were detailed enough and up to date. Service user (or their relatives) involvement in the care plans was evident in a number of places. The care and support provided is mostly person-centred. An activities programme for service users has been maintained. Activities are displayed on the notice board offering a variety of opportunities. There are monthly outings in the warmer months. The home appears to be well managed and staff indicated that the manager is approachable and open. All records examined were up to date and accurate. Cary Brook DS0000016106.V307320.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cary Brook DS0000016106.V307320.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cary Brook DS0000016106.V307320.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,4,6 The quality in this outcome group is good. Appropriate procedures continue to be followed to assess individual’s suitability to the home. Service users needs are frequently reviewed in cooperation with service users and their relatives or advocates. EVIDENCE: Cary Brook DS0000016106.V307320.R01.S.doc Version 5.2 Page 9 The home uses a corporate contract format with all service users. A selection of care plans were sampled to track care and support. All files contained evidence of professional/care manager assessment prior to moving in. There was also evidence of a good preadmission assessment by the home and effort made to obtain information about the person’s background and interests. Staff evidenced that the majority of service users have close and involved relatives and that as well as being involved in the initial assessment and plan of care, they also attend the home at 6 monthly intervals to review the plan. The home takes emergency admissions occasionally. There was evidence in a recent such admission of good assessment, contact with relatives and much individualised care that had resulted in very good outcomes already for the person. Intermediate care is not a service offered by this home. Cary Brook DS0000016106.V307320.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 The quality in this outcome group is good. Plans inspected evidenced comprehensive and person-centred plans to meet health and social care needs resulting in good outcomes for service users. Observation and records showed that service users are valued and treated with dignity and respect, however this was compromised by a standard appraoch to the management of continence needs, rather than an individualised one. The medication area was well managed. EVIDENCE: Cary Brook DS0000016106.V307320.R01.S.doc Version 5.2 Page 11 Care plans continue to be well maintained with appropriate risk assessments and evidence of continuous review. Six monthly customer in-house reviews of a formal multi-disciplinary and family involvement continue and the manager would be asking staff to refer to this in the monthly review form instead of writing “N/A” under the column dedicated for service users (or their advocates) signature. Social histories have continued enabling mental health planning linking activities with past likes and interests. This personal knowledge, coupled with the gentle approach from staff had resulted in positives outcomes for the service users whose records were inspected. There was one area that Mrs Pullen, the manager, agreed to review and that was the home’s approach to continence issues. She was advised to identify more individualised methods of promoting continence than those used at present. That is to discourage ‘group toileting practices’ and the use of incosheets/kylies on all living room chairs. Staff confirmed that an individual record sheet of activities carried out by each service user has been maintained. Photographs evidenced that a good number of service users took part on outings. Staff evidenced that these take place every month during the summer. Records evidenced that NHS, private and social care professionals continue to be accessed. An optician was visiting the home providing checks and follow up services for some service users, and a district nurse was also observed visiting. The medication area was well managed and recommendations from the pharmacist followed. Supervisory staff deal with medication and have their competencies reviewed. Staff were observed treating all service users sensitively when assisting them. Personal care was given in private. There are quiet areas upstairs and a small dining area where service users can entertain their visitors and eat with them. Some bedrooms are locked during the day to protect belongings and staff are guided by service users preferences. A wander mat alarm was observed in a room. The previous inspection has evidenced that these equipment is risk assessed and written permission obtained when used. The inspector did not look at this during this visit. Cary Brook DS0000016106.V307320.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 The quality in this outcome group is good. Service users are assisted to maintain control of their daily life activities. Daily activities, care and support are organised for each person according with a person-centred approach from staff seeking to find and respond to service users preferences. Service users have contact with their relatives and the home facilitates visits and works in cooperation with service users and their relatives. Nutritious and varied meals are provided in pleasant surroundings, in a relaxed manner and assistance is forwarded as required. EVIDENCE: Cary Brook DS0000016106.V307320.R01.S.doc Version 5.2 Page 13 Flexibility continued to be observed around times of getting up and service users chose where to be and what to do. This was not only observed but also confirmed with service users spoken with, some of which chose to sit in quiet areas on either floor, or to spend some time in their rooms. Service users were observed using the lift and accessing both floors freely. There was recorded evidence of proactive work to get to know each service user’s background, likes and dislikes so that they could be supported in the manner that they preferred. This included what staff key-worked them leading to contented service users. The activities organiser continues to work most days, although she was off duty on the day of the inspection. A student who helps with social care assisted service users with activities they chose. Group and individual activities were observed. A large colourful chart is displayed that lists some of the things service users can choose from. A record is maintained of the activities engaged by each person each day. Outings are organised at monthly intervals during the summer. There was photographic evidence of the last outings, service users and staff testimonies. The last trip took service users to Weymouth and the following week service users were visiting Longleat. Visits were observed during the inspection. Service users and staff evidenced having contact and going out with their relatives. The home invites relatives to formal care reviews with the service users at 6 monthly intervals. There are private areas for entertaining visitors. The menu was displayed in the dining room. Lunch was a choice of two home cooked main courses, and a selection of sweets and fresh fruit. Special diets are available are catered for as evidenced by the cook and prepared meals. The cook was undertaking NVQ3 in catering. Service users are encouraged to go the dinning room for their meals, so that they can socialise, be supported and food intake monitored. However meals can be taken in other locations also. The lunch meal was observed. This was served on nicely laid tables with sufficient staff to support service users. The meal was well presented and provided in a relaxed and unhurried manner. All service users spoken with indicated their approval with the meals provided. Cary Brook DS0000016106.V307320.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The quality in this outcome group is good. Service users are protected from potential poor practices through the complaints procedure and staff understanding of abuse awareness. EVIDENCE: The home has a complaints procedure. The ‘Seeking Your Views’ leaflet is displayed. CSCI had received positive feedback from relatives about the home. However they indicated that they did not know what to do in the event of a complaint and did not know how to access the inspection report in the home. This was discussed with the manager who indicated that she would consider how to inform people better. Suggest making the leaflet and inspection report more obvious at the entrance of the home. There have been no complaints since the last inspection. Staff seen indicated that they would refer any complaints they received to the person in charge. They were aware of their responsibilities under the POVA and whistle Blowing policies. Staff were observed orienting and supporting service users in gentle, unhurried and caring ways. POVA, CRB and ID checks were evident in the files of new staff inspected. The inspector did not look at service users accounts in this occasion. This was found well managed in March 2006. The area manager carries out monthly audits of all areas in the home. Cary Brook DS0000016106.V307320.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,22,24,25,26 The quality in this outcome group is good. Communal rooms are safe and had recently been attractively refurbished. The extended main living room has access to a safe and level garden area. Use of inco-sheets/ padded seat covers on all soft furnishing in the main living rooms has continued giving these rooms an institutionalised feel. Two bathrooms had been fully refurbished and plans remain to bring remaining bathrooms to a similar modern standard. Private areas seen were comfortably furnished and personalised. The loud noise created by call bells, described by the last inspector was, during this visit also compounded by an unnecessary loud telephone bell. These institutionalised systems do not assist the home’s good efforts to create a calm and relaxed atmosphere for service users. All areas of the home seen were clean and free from odours. Cary Brook DS0000016106.V307320.R01.S.doc Version 5.2 Page 16 EVIDENCE: As part of the general upgrade of the home, all carpets in communal areas have recently been replaced and the home looks bright and attractive. The main living room has been extended to about double its size and patio doors give level access to a safe garden area equipped with garden furniture, flower bed and potted plants. Service users have safe access to both floors of the home. Bathrooms are adapted and two have been completely refurbished. There are plans to continue to bring other bathrooms to this very good standard. Doors have been colour coded. The toilet seats should also carry the colour displayed on the orienting pictures on the doors. A few bedrooms were seen. These were clean and tidy, appropriately furnished and personalised. The home was clean and tidy and free from unpleasant odours. The home has a control of infection policy and hand-washing facilities are available in all communal areas. Materials and equipment were provided for the control of infection and staff encouraged to work according to the policy and good hygiene practices. Staff were observed wearing protective clothing when serving food. When domestic staff are not on duty, care staff are expected to shampoo carpets to clean spillages as necessary. The cook informed the inspector that the kitchen is also due to be decorated and for a professional deep-clean. Cary Brook DS0000016106.V307320.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The quality in this outcome group is good. Staffing levels were generally adequate although some problems had been experienced by the night shift. The staff team has a good level of expertise, have good understanding of their duties and have received training in dementia care. Good staff support systems are in place. There are appropriate recruitment and vetting procedures in operation. New staff members receive good induction into their work and in areas of health and safety. New staff are given ample time to work-shadow experienced staff and are not given key-worker responsibilities until they are ready. Training needs are identified during annual appraisal meetings taking place at the time of this inspection. EVIDENCE: Staffing levels were generally adequate although some difficulties had been experienced on the night shift leading to a movement of staff hours providing 3 staff until 10 p.m. The adequacy of 2 night staff from 10 p.m. for the rest of the night should be maintained under review. Cary Brook DS0000016106.V307320.R01.S.doc Version 5.2 Page 18 The home has some care and catering support vacancies and are recruiting to fill these posts. Agency staff continue to be used and staff say that covering absences has improved of late. There are supervisory staff in all shifts. Three staff files of the newest staff were inspected and evidenced appropriate recruitment and vetting procedures. They also evidenced training and on-going support. Staff confirmed that all have now received dementia training except for foreign staff members who had been recruited by the company in their country of origin and had received the general company induction. The manager was in the process of arranging annual appraisals with these staff members and would enter them for the necessary training. Discussion with staff working during the academic holiday, and their file evidenced that a full induction and frequent supervision had been provided. Staff evidenced to being well supported and also to good knowledge of their roles. All care staff are required by the company to register for NVQ training following their induction. This is facilitated by the company’s own training organisation and the manager confirmed that over 50 of the staff team had NVQ qualifications. Cary Brook DS0000016106.V307320.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,36,37,38 The quality in this outcome group is good. The home is well managed by an able and qualified manager. The management style is open and approachable and leads the team to secure positive outcomes for service users. Staff members are well supervised and supported in their roles. Records are well maintained and up-to-date. The health and safety policy and practices in the home protect service users and staff. EVIDENCE: Cary Brook DS0000016106.V307320.R01.S.doc Version 5.2 Page 20 Mrs Pullen has managed the home since May 2004. Mrs. Pullen was the deputy manager for 18 months at Cary Brook prior to this appointment. She holds an NVQ level 3 in Management, D32 NVQ assessors award, NEBS supervisors certificate and company health & safety trainers certificate. She is currently working towards the NVQ level 4 in Care and the Registered Managers’ award. Mrs Pullen has an open door policy and an approachable style. She is assisted by two deputy managers and has delegated areas of responsibilities to senior staff. The inspector was very pleased observing the efforts made by staff to understand service users and respond to their preferences, with some very positive outcomes achieved, as evidenced by records and discussions with all concerned. This was led by Mrs Pullen to the team and further reinforced by appropriate specialist training. The home hold the quality rating status awarded by Somerset County Council and is an ‘Investor in People’ as part of the Somerset Care Group. (Awarded October 2003). The area manager carries out audits during the monthly provider visits and the company has corporate audits carried out annually. Files seen evidenced that staff were provided with a range of health and safety training in all mandatory topics. The H&S green training chart used does not have columns for all of the essential training though evidenced that for fire and Safe Handling well and was up-to-date. The manager was asked to provide a full record to ensure that all staff receive all mandatory training and advised to have at hand a, “at a glance” training chart, that covered all H&S training. This is stored in the PC but hard copies were not available at the time. These would be forwarded to CSCI. Mrs Pullen confirmed that all senior staff have medication training with updates and competencies reviewed. They all have Appointed Persons status. The home’s continues to record and analyse accidents. Health and safety records seen included those for water safety, LOLER regulations and fire safety. They were all well maintained and up-to-date. All fire checks had been appropriately carried out and all staff had received fire training twice a year as the signature of staff in the training chart showed. One signature was missing of a student who evidenced receiving fire training during induction but had not signed the chart. Mrs Pullen understands that fire training twice a year is a minimum and that if anyone misses any of the sessions, then training has to be provided on their return to work after the last training session. The home has appropriate health and safety policy documents. Cary Brook DS0000016106.V307320.R01.S.doc Version 5.2 Page 21 Policies are reviewed by the company at annual intervals. Issues arising in the home are discussed with staff and brought to senior meetings and area meetings so that policies are reviewed accordingly. The manager was advised to do this in a proactive way- not just reacting to issues- so that all policies become working documents, are discussed with staff at annual intervals to ensure relevance, and to indicate that this had been done in the policy documents by dating and signing the d ate she had discussed/ reviewed them. Cary Brook DS0000016106.V307320.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 X 2 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 3 3 Cary Brook DS0000016106.V307320.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. OP10 Refer to Standard Good Practice Recommendations The manager was advised to find more individualised ways to meet the continence needs of service users, that is that the practice of general use of inco-sheets/kylies on all chairs in living rooms should be minimised (as recommended at the last inspection), and that the ‘blocktoileting practices’ observed during the inspection should give way to a more person-centred and discreet manner of promoting continence. It is recommended that the complaints procedure and the inspection report be more effectively displayed for ease of reference by visitors. It is recommended that the toilet seats be colour coded to match the picture on the WC doors and that downstairs WCs by the dining room made more homely. DS0000016106.V307320.R01.S.doc Version 5.2 Page 24 2. OP16 3. OP22 Cary Brook 4. OP24 The high level of noise in the home from call-bells, highlighted during the last inspection, was also observed during this visit. This should be dealt with, and the loud telephone bell should also be reduced. It is recommended that the night staff levels be maintained under review in connection with the mental frailty and personal care needs of residents in the home. 5. OP27 Cary Brook DS0000016106.V307320.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Cary Brook DS0000016106.V307320.R01.S.doc Version 5.2 Page 26 - 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!