Inspection on 17/11/06 for Somerset House

This inspection was carried out on 17th November 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

Somerset House 14/05/09

Somerset House 29/08/07

Somerset House 03/01/06

Somerset House 30/06/05

Somerset House 21/12/04

Somerset House 03/08/04

Somerset House 26/03/04

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Somerset House 157 High Street Yatton North Somerset BS49 4DB Lead Inspector Paul Grey Unannounced Inspection 09:30 17 November 2006 th 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 Somerset House DS0000008057.V313898.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. Somerset House DS0000008057.V313898.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Somerset House Address 157 High Street Yatton North Somerset BS49 4DB 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) 01934 832114 NONE Mrs Wendy Rita Hiles Mrs Julie Denise Jones Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Somerset House DS0000008057.V313898.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 26 persons aged 65 years and over requiring personal care. 3rd of January 2006 Date of last inspection Brief Description of the Service: Somerset House is a pleasant period property situated off the main road through Yatton. The property has been extensively modified and extended to meet the needs of up to 26 people over 65 years of age. The premises also have a small satellite home suitable for service users who wish to use the support offered by the home but desire a more private form of accommodation. Somerset House provides residential care to a wide range of service users for between £336 and £355 a week. Somerset House DS0000008057.V313898.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspections of Somerset House took place over 2 days in the presence of the manager. During the inspection process, the Inspector conducted a tour of the premises, spoke with 8 service users, spoke with 2 staff members, and the proprietor and manager. The Inspector then audited the home’s documents. Feedback from people who live at the home was consistently positive about the care they experience and the quality of their day to day lives. The Inspector observed a happy service user group, content staff team and generally pleasant working environment. Historically, the home has had a range off issues regarding the standard of its documentation and care planning. The Inspector recognises that the home has made efforts to improve the standard of its care planning and general documentation. This has enabled the home to meet national minimum standards. However care at the home remains task orientated. The inspector has made 3 recommendations regarding this. What the service does well: What has improved since the last inspection? What they could do better: Somerset House DS0000008057.V313898.R01.S.doc Version 5.2 Page 6 The standard of care planning at the home has improved greatly. However, care planning and assessment is still very much based around service users physical needs. This results in very task orientated care environment addressing physical needs and routine. Service user feedback indicated that although staff were kind there was little time for the staff team to talk with the service users as they moved on to the next task. Using the current assessment and care planning processes this is unlikely to change. 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. Somerset House DS0000008057.V313898.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 Somerset House DS0000008057.V313898.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): 1, 3 Quality in this outcome area is adequate. The admission of new residents is process driven and not particularly personalised. The service does what it has to do to satisfy the regulator, has the right policies and procedures in place although there is evidence that the practice is not always consistent or well applied. EVIDENCE: The statement of purpose meets the requirements of National Minimum Standards. Service user spoken with could not recall having been given a service user guide. Service users felt that they understood what was involved in moving into the home. The home’s statement of purpose is clearly laid out and written in plain English. There was evidence of an assessment procedure for new service users. The assessment procedure covered aspects of the service user’s day-to-day life, and general needs such as dietary preferences, mobility and dexterity, Somerset House DS0000008057.V313898.R01.S.doc Version 5.2 Page 9 incontinence etc. The assessment was heavily biased toward measuring the service users physical needs with little emphasis on the psychological aspects of care, for example the anxieties of moving home or leaving a house. This is subject to recommendation. Somerset House DS0000008057.V313898.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 Quality in this outcome area is adequate. Each resident has a Care Plan, but practice of involving residents in the development and review of the Plan is variable. There is evidence in the Care Plan of health care treatment and intervention, and a record of general health care information including weight monitoring, and nutritional information. There are some gaps in information but staff are able to give a verbal update. EVIDENCE: The Inspector audited 3 care files. All files audited had an assessment of need that was the basis for the plan of care for the service user. The home’s plans of care set out the action required by the staff to meet the service users needs. The standard of care documentation has improved since the last inspection and meet national minimum standards. However, plans of care were still a weak area and remained biased toward physical needs. This is subject to recommendation. Service users said that the manager and staff would support them to seek national health service support should they need it. This could be in the form of GP visits or visits from the district nurse where necessary. The Inspector Somerset House DS0000008057.V313898.R01.S.doc Version 5.2 Page 11 observed from reviewing the service users notes that staff monitored the health of people in their care and reacted appropriately if the service users needed additional care or assessment. The home has policies and procedures for the safe storage and handling of medication. Medication at the home is administered by appropriately trained staff who demonstrated basic knowledge of how medicines are used and how to safely administer them. Reviewing evidence from the manager and care files, the inspector noted if staff have concerns regarding medicines, they contact the GP or pharmacist as appropriate. Somerset House DS0000008057.V313898.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 Quality in this outcome area is adequate. The home tries to be flexible and attempts to provide a service which is as individual as possible, by using its staff and resources effectively. Residents are consulted on how the home can work to provide them with a flexible lifestyle, and they have been able to make some changes which help to achieve resident’s wishes. EVIDENCE: The day-to-day routine supports service users to live as they prefer. Service users said they can choose to have their breakfast in their rooms, when to get up and generally control their lives as they wish. They told the inspector that life at the home was generally unhurried and suited their needs. Service users said staff were generally helpful ands did not interfere or overly control their lives. The home encourages service users to maintain contact with family and external friends. Visiting friends said that they were always made welcome and could visit when they liked. Service users are able to choose who they do and do not see and there are no unreasonable rules regarding visiting hours. Somerset House DS0000008057.V313898.R01.S.doc Version 5.2 Page 13 Service users handle their own financial affairs with their able to. They are entitled, and encouraged to bring personal items with them, subject to health and safety conditions. Service users said that food was pleasant and varied and generally satisfactory.Two People commented that it was “canteen food” but generally acceptable. All service users agreed that meals time were relaxed and unhurried. Somerset House DS0000008057.V313898.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 Quality in this outcome area is good. Residents and others associated with the Home demonstrate a good understanding of how to make a complaint and they are very clear of what can be expected to happen if a complaint is made. EVIDENCE: The home has a clear, simple and accessible complaints procedure. The Inspector noted documentary evidence of this and that the home has had no complaints since the previous inspection. At the time of inspection, service users were satisfied with the service and would feel comfortable to make a complaint to the manager if they were not. Service users felt that the manager would resolve any complaints quickly and efficiently. The home has robust procedures for the reporting of abuse or neglect. The manager was aware of the whistle blowing procedure and could give examples of the home’s interventions should abuse or neglect be suspected. Somerset House DS0000008057.V313898.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, 26 Quality in this outcome area is good. The home has a well-maintained environment, which provides aids and equipment to meet the care needs of the residents. The home is well lit, clean and tidy and smells fresh. EVIDENCE: The home is a pleasant older building which has been considerably extended and modified. The location and layout of the home are suitable for its purpose as a residential home. The home and grounds are kept tidy and attractive for the service users. The building complies with fire service regulations. The premises were clean and hygienic throughout. During the tour of the premises the inspector noted evidence of infection control procedures in action around the building. Somerset House DS0000008057.V313898.R01.S.doc Version 5.2 Page 16 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, 29,30 Quality in this outcome area is good. Rotas show well thought out and creative and ways of making sure that the home is staffed efficiently, with particular attention given to busy times of the day and changing needs of the residents. The service ensures that all staff receive relevant training that is focussed on improving outcomes for residents. EVIDENCE: During the inspection, the Inspector spoke with service users, the manager and reviewed the staff roster. Service users said that staff were very busy but that there were generally enough to meet their needs. They also commented that carers had little time to talk. On both visits, the Inspector noted that the home had sufficient carers on duty to meet the needs of the service user group. Care staff at the home are supported by a cook, kitchen assistant and 2 cleaners in the day. The Inspector noted a continued improvement in the home’s recruitment processes and procedures. All files audited had 2 references, Protection of Vulnerable Adults and Police checks. The Inspector recognises the improvements shown. The Inspector audited files for 2 new staff members. Both had received appropriate induction training compliant with national minimum standards. The Inspector noted that staff had received the minimum of 3 days training per Somerset House DS0000008057.V313898.R01.S.doc Version 5.2 Page 17 year. Records showed that staff received full induction training within 6 weeks of starting at the home. Somerset House DS0000008057.V313898.R01.S.doc Version 5.2 Page 18 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 Quality in this outcome area is good. The Manager has the required qualifications and experience and is competent to run the home. She works to continuously improve services and provide an increased quality of life for residents. There is a strong ethos of being open and transparent in all areas of running of the home. The manager is resident focused and leads and supports a strong staff team who have been recruited and trained to a high standard. EVIDENCE: The registered manager has in extensive experience running the care home. The manager has undertaken training to improve her knowledge and skills to manage the home. The manager is familiar with conditions associated with old age. Staff feedback, service user feedback and manager statement indicate that the home has an open, positive and inclusive atmosphere for the service users. Somerset House DS0000008057.V313898.R01.S.doc Version 5.2 Page 19 Service user spoken with, felt the manager was approachable and could be spoken to about concerns or complaints. Feedback indicated a high degree of trust in the manager from both staff and the service user group. The Inspector noted efforts by the home to assess and improve its quality assurance. This was good practice. The Inspector noted the use of questionnaires by the manager to review the quality of care. The Inspector commends the effort of the manager and notes the home meets national minimum standards for this area. The Inspector reviewed the home’s policies and procedures for its employees. These met national minimum standards. The Inspector noted that the home now meet national minimum standards by supervising staff on at least 6 occasions a year. Somerset House DS0000008057.V313898.R01.S.doc Version 5.2 Page 20 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 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 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 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x x 3 x x Somerset House DS0000008057.V313898.R01.S.doc Version 5.2 Page 21 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. 2. 3. Refer to Standard OP1 OP3 OP3 OP7 Good Practice Recommendations The inspector recommends the home consider adopting a more person centred methodology. The current assessment tool fairly is heavily biased toward physical issues. The Inspector recommends the manager consider a more holistic assessment tool. Care planning reflects the assessment process and again is heavily biased toward physical assessment. The inspector recommends the home consider a more holistic approach to care planning. Somerset House DS0000008057.V313898.R01.S.doc Version 5.2 Page 22 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 Somerset House DS0000008057.V313898.R01.S.doc Version 5.2 Page 23 - 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. 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