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Care Home: Hembury Fort House

  • Hembury Fort House Awliscombe Honiton Devon EX14 3LD
  • Tel: 01404841334
  • Fax:
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Hembury Fort provides accommodation and 24-hour care for up to 25 older people who may have dementia. The building is an adapted Georgian country house set on a hill within 8 acres of grounds, outside the village of Awliscombe and several miles from Honiton. Accommodation is over 3 floors with a passenger lift to all levels. All people living at the home have spacious single rooms, with high ceilings of a unique character. Many rooms have wonderful views across the Otter Valley. The home`s statement of purpose and service user guide, which includes details about the philosophy of the home and details about living at the home, is made available to all potential residents before they make a decision about living at the home. A copy of the most recent inspection report is available on request. Information received from the home indicates that the current fees are £381£430, weekly. Services not included in this fee include hairdressing, chiropody, newspapers, transport, incontinence aids and toiletries.

  • Latitude: 50.814998626709
    Longitude: -3.2579998970032
  • Manager: Mrs Agnes Olive Taylor
  • Price p/w: ~
  • UK
  • Total Capacity: 25
  • Type: Care home only
  • Provider: Mrs Caroline Valerie White,Mrs Agnes Olive Taylor
  • Ownership: Private
  • Care Home ID: 7946
Residents Needs:
Dementia, Old age, not falling within any other category

Latest Inspection

This is the latest available inspection report for this service, carried out on 7th August 2008. 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.

For extracts, read the latest CQC inspection for Hembury Fort House.

What the care home does well People who are considering moving to a care home are given good information about the Hembury Fort before any decision to move in is made. Trial visits are encouraged and a senior member of staff from the home will also carry out a careful assessment before anyone is admitted to the home to ensure their needs can be met. Not all people spoken to during this inspection were able to recall their admission to the home but all expressed complete satisfaction with the outcome.The home has drawn up detailed care plans covering all aspects of care needs. Risk assessments have also been drawn up on all aspects of health and personal care and clearly show how the home identifies potential health risks and puts preventative measures in place. The home has good links with all relevant health professionals and treatment has been provided where needed. The care staff have completed daily reports showing that the care plan has been followed and outcomes are being met. These give a clear picture of daily events for each person living at the home. Medications are stored safely and only experienced staff carries out the administration. Records of medicines administered have been well maintained. Evidence was obtained in various ways through this inspection to show that those living at the home are treated in a dignified manner and their privacy is upheld at all times. Those who were able expressed complete satisfaction in the way they are treated by the staff. The staff were calm and unhurried and assisted people in a friendly, caring and respectful manner. Care plans and daily reports showed that people could exercise choice and control of all aspects of their lives and some people talked about how they are able to lead their lives just as they want, without unnecessary rules or restrictions. The home provides a good range of activities to suit all interests. Excellent arrangements are in place to ensure family and friends are made welcome at all times and are kept informed and involved in the daily life of the home. All people we spoke to praised the standard of meals provided. The menus are balanced, varied and nutritious meals and suit all individual dietary needs. The home has an excellent range of policies and procedures that have been regularly updated and staff have been given training and instruction on the policies to ensure they are followed correctly. People living at the home and their relatives and visitors can feel confident that complaints and concerns will be addressed promptly and a satisfactory outcome reached. All areas of the home are clean, safe and hygienic. The home employs sufficient staff to meet the needs of those living there. Good recruitment practices ensure people are safeguarded from abuse. Staff are competent and deliver high quality care in a safe manner. The home is well managed. There is an open and positive atmosphere throughout the home. Excellent quality assurance procedures are in place. Excellent systems are in place to safeguard the health and safety of residents and staff. In response to questionnaires sent before this inspection staff told usHembury Fort HouseDS0000021945.V367640.R01.S.docVersion 5.2Page 7"We meet the care needs of residents well and we are good at following procedures and policies"," The owners are very dedicated and the well being of our residents is at the top of the agenda at all times. The manager has an open door policy and is very supportive of staff". In response to the question "what does the home do well" we were told " Everything"," Management listen to me"," My manager will always give time for anything which needs to be discussed or for any problem that may arise" and" Emotional and social needs are met very well" What has improved since the last inspection? No requirements were made as a result of the last inspection. Work has been undertaken to improve areas of the home that were looking tired and in need of redecoration at the last inspection. The home is now well decorated, peoples` rooms are light and bright and people living at the home are happy with this. CARE HOMES FOR OLDER PEOPLE Hembury Fort House Awliscombe Honiton Devon EX14 3LD Lead Inspector Michelle Oliver Unannounced Inspection 7th August 2008 09:15a 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 Hembury Fort House DS0000021945.V367640.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. Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hembury Fort House Address Awliscombe Honiton Devon EX14 3LD 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) 01404 841334 Mrs Agnes Olive Taylor Mrs Caroline Valerie White Mrs Agnes Olive Taylor Care Home 25 Category(ies) of Dementia (25), Old age, not falling within any registration, with number other category (25) of places Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd August 2006. Brief Description of the Service: Hembury Fort provides accommodation and 24-hour care for up to 25 older people who may have dementia. The building is an adapted Georgian country house set on a hill within 8 acres of grounds, outside the village of Awliscombe and several miles from Honiton. Accommodation is over 3 floors with a passenger lift to all levels. All people living at the home have spacious single rooms, with high ceilings of a unique character. Many rooms have wonderful views across the Otter Valley. The home’s statement of purpose and service user guide, which includes details about the philosophy of the home and details about living at the home, is made available to all potential residents before they make a decision about living at the home. A copy of the most recent inspection report is available on request. Information received from the home indicates that the current fees are £381£430, weekly. Services not included in this fee include hairdressing, chiropody, newspapers, transport, incontinence aids and toiletries. Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 stars. This means that people who use this service experience excellent quality outcomes. This inspection was undertaken over 2 days by one inspector. We spent 6 hours at the home on the first day and 2 hours on the second. We spoke with people living there and staff and also spent time observing the care and attention given to people by staff. Prior to this inspection we sent surveys to 10 people living at the home, 10 staff and 10 health care professionals. All questionnaires were completed and returned to us from people expressing their views about the service provided at the home. Their comments and views have been included in this report and helped us to make a judgement about the service provided. To help us understand the experiences of people living at this home, we looked closely at the care planned and delivered to three people. Most people living at the home were seen or spoken with during the course of our visit and three people were spoken with in depth to hear about their experience of living at the home. We also spoke with 10 staff, including the manager, deputy and ancillary staff, individually. A tour of the premises was made and we inspected a number of records including assessments and care plans and records relating to medication, recruitment and health and safety. Currently the fees of between £381 & £430 are charged. General information about fees and fair terms of contracts can be accessed from the Office of Fair Trading web site at http:/www.oft.gov.uk . Copies of the inspection report are available from the office. What the service does well: People who are considering moving to a care home are given good information about the Hembury Fort before any decision to move in is made. Trial visits are encouraged and a senior member of staff from the home will also carry out a careful assessment before anyone is admitted to the home to ensure their needs can be met. Not all people spoken to during this inspection were able to recall their admission to the home but all expressed complete satisfaction with the outcome. Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 6 The home has drawn up detailed care plans covering all aspects of care needs. Risk assessments have also been drawn up on all aspects of health and personal care and clearly show how the home identifies potential health risks and puts preventative measures in place. The home has good links with all relevant health professionals and treatment has been provided where needed. The care staff have completed daily reports showing that the care plan has been followed and outcomes are being met. These give a clear picture of daily events for each person living at the home. Medications are stored safely and only experienced staff carries out the administration. Records of medicines administered have been well maintained. Evidence was obtained in various ways through this inspection to show that those living at the home are treated in a dignified manner and their privacy is upheld at all times. Those who were able expressed complete satisfaction in the way they are treated by the staff. The staff were calm and unhurried and assisted people in a friendly, caring and respectful manner. Care plans and daily reports showed that people could exercise choice and control of all aspects of their lives and some people talked about how they are able to lead their lives just as they want, without unnecessary rules or restrictions. The home provides a good range of activities to suit all interests. Excellent arrangements are in place to ensure family and friends are made welcome at all times and are kept informed and involved in the daily life of the home. All people we spoke to praised the standard of meals provided. The menus are balanced, varied and nutritious meals and suit all individual dietary needs. The home has an excellent range of policies and procedures that have been regularly updated and staff have been given training and instruction on the policies to ensure they are followed correctly. People living at the home and their relatives and visitors can feel confident that complaints and concerns will be addressed promptly and a satisfactory outcome reached. All areas of the home are clean, safe and hygienic. The home employs sufficient staff to meet the needs of those living there. Good recruitment practices ensure people are safeguarded from abuse. Staff are competent and deliver high quality care in a safe manner. The home is well managed. There is an open and positive atmosphere throughout the home. Excellent quality assurance procedures are in place. Excellent systems are in place to safeguard the health and safety of residents and staff. In response to questionnaires sent before this inspection staff told us Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 7 “We meet the care needs of residents well and we are good at following procedures and policies”,“ The owners are very dedicated and the well being of our residents is at the top of the agenda at all times. The manager has an open door policy and is very supportive of staff”. In response to the question “what does the home do well” we were told “ Everything”,“ Management listen to me”,“ My manager will always give time for anything which needs to be discussed or for any problem that may arise” and“ Emotional and social needs are met very well” 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. The summary of this inspection report can be made available in other formats on request. Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 8 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 Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,4,5 & 6. Quality in this outcome area is excellent. The home provides clear, detailed information to people considering moving in. People can be confidant that they will receive the care and support they need if they do move into the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During this inspection we looked at the admission records of three people, one of who had moved into the home within the last three months. We talked to them about how they chose the home, about the information that was shared, and about the discussions and agreements that were reached on the care they need. Not all were able to remember their admission clearly and generally their admission had organised by relatives Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 10 We found that the manager had visited them to carry out an assessment of their health and social care needs and to give them information about Hembury Fort. The manager said that she thought it important that she should be on duty at the home when the person arrives so that someone who is familiar to them settles them in. The manager and deputy told us that the ethos of the home puts a high value on responding to people individual needs for information, reassurance and support. We saw that information had also been gathered from other sources including health care professionals such as doctors and district nurses. The assessment records were excellent and showed that comprehensive information had been gathered to form the basis of a plan of care. The assessments highlighted people strengths and focused on them achieving positive outcomes that will maintain their independence and support them to lead their lives as they wish. This means that all care staff know how the person wants to be looked after. Copies of comprehensive assessment and plans of care for people who are not privately funded and are admitted through care management are obtained. All prospective residents and/or their family or representatives are encouraged to visit the home, meet other residents and have a meal if they choose before the decision is made to make it their home. Before agreeing admission to the home the manager and staff discuss the assessed needs of individuals to make sure the home is able, in relation to staffing, staff knowledge and environment, to meet these needs. A person who had recently moved to the home said that they, and a relative, had been included in the assessment, which was carried out well and with sensitivity and understanding. All people living at the home who we spoke to, who were able to communicate, confirmed that the home had provided ample information about the home before they decided to make it their home and the home had lived up to their expectations. We sent questionnaires to 10 people living at the home and 10 staff and received responses from all. Seven people commented that they hadn’t received a contract when they moved to the home. This was checked and all people living at the home have a contract. The manager explained that many of those living at Hembury Fort have problems with memory and in many cases relatives acting on their behalf had signed contracts. Those people who are funded by Devon Adult Service have a contract with them and are given a Statement of Terms and Conditions by the home. One comment included in a questionnaire stated “ My brother arranged it as he heard good things from someone who had lived here”. Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 11 The home does not offer intermediate care. Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is excellent Care planning provides staff with the information they require to meet the needs of individuals in a safe and respectful manner, while promoting their dignity and independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is continually working towards improvement and care plans continue to improve resulting in staff being well informed about individual needs and wishes of people living at Hembury Fort. During this inspection three peoples’ files were looked at in detail and all included detailed information to ensure that staff are aware of how to meet individual daily health and social care needs. Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 13 The plans are developed with people individually and relatives are involved with the persons consent. Plans are based on an up to date assessment covering all aspects of their health welfare and social care needs. Plans focus on individual’s strengths, abilities and wishes and include information for staff to treat people as individuals rather than focusing on their illness. Information gathering include details about what situations may disturb a person, how do they feel about their health, what may embarrass them or what frustrates them. One person had responded that they might get frustrated when anyone other than herself are organising their life or making decisions for them. We looked at the care plan for this person and it was clear that they were very involved in making decisions about their life at the home. Gathering and recording this information means that staff have the information to encourage people to lead purposeful fulfilling lives as independently as possible. Plans of care were informative, very detailed, well written, clear and easy to understand. All staff said that they refer to the plans and record information to keep them up to date. There are also daily notes written by care staff that show how people’s personal and social care needs are being met. The home monitors peoples’ dental and optician checks and chiropodists are used according to people’s needs. Information relating to the involvement, and advice from health care professionals such as skin care specialists and nutritionists were included in peoples’ plans of care. This means that they benefit from the involvement of health care professionals to ensure that health care needs are met. The manager described a good relationship with health professionals such as district nurses, community psychiatric nurse, pharmacist and doctors. Assessment of potential risks to people living at the home is undertaken as part of the care planning process and kept under review. This includes the risks of falling and nutrition. We looked at comprehensive nutritional assessments, which included an assessment of the intake of vitamins, fibre and iron. The home uses a scoring system to assess that people are receiving sufficient to maintain a healthy diet and a chart of the foods that contain these is included for staff information. Care plans are reviewed regularly and appropriate changes are made to reflect changing needs and individual choice. Individuals, and relatives are encouraged and supported to be involved in this review. Clear details are recorded of any changes and this includes the persons’ perception of reasons for changes. We saw in one review a person had been told why some changes were required for their benefit and they had replied, “ Yes, I realise that”. Medication is well managed at the home; records were accurate, up to date and indicated that it is appropriately administered. Photos of individuals are kept with the administration records to reduce the risk to people, who are not always able to confirm their identity, of receiving incorrect medication. Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 14 Details of any changes to a person’s medication are recorded in their plan of care. Staff who handle medicines have received training in the safe handling of medication. This means that people are kept safe by the homes management, storage and administration of medicines at the home. The manager undertakes a monthly “in house” audit of the homes’ medication policy and procedure. For example she has recently audited medication administration records. Some deficiencies were found as a result of this which have been since been improved thereby further protecting people receiving medication by ensuring that they all receive the correct medication at the appropriate times. People felt that their privacy was respected and staff were seen to knock on doors and wait to be invited in before doing so and were also seen offering personal care in a discreet manner. All of the 10 people who responded to questionnaires felt they always or usually received the care and support they needed. One person commented“ It’s too much of an open house. I don’t like it when people here shout and won’t stop”. During this inspection a community psychiatric nurse [CPN] and a social worker visited the home at the request of the manager to assess a person who they were concerned about. We discussed the comment we had received and the manager confirmed that this comment referred to the person being visited by the CPN. We asked staff how they deal with situations when people may shout out. They described a person centred approach including checking that the person wasn’t in pain, was upset by something that was happening in the environment or wanted something. They were able to clearly discuss strategy taken in relation to the current situation and all information leading up to the referral had been recorded. The social worker commented on the quality of the home’s care plan and recorded information. All staff who responded to questionnaires confirmed that they are always given up to date info about the needs of people. Comments made in questionnaires from staff included,“ We have responsibility to also seek information for ourselves. We can’t expect to be spoon fed” and . “Care plans are very valuable, as it gives a lot of information”. Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is good. Everyone living at the home is offered good choices in all aspects of daily living. Social activities are well managed. They provide daily variation and interest for individuals and create opportunities for increasing their independence. Meals are nutritious and balanced and provide individuals with choice and variety. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During this visit we spoke to eight people who live at the home, all were very complimentary about the care and support they receive. We also spoke to the manager and deputy who confirmed that the aim of the home is to make sure that people who live there are able to enjoy a full and stimulating lifestyle with a variety of options to choose from. Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 16 Plans of care include details of individual preferences in relation to daily routines such as getting up, going to bed, social activities, interests, hobbies and contact with the community. Plans are regularly reviewed and details were made to meet peoples changing needs, choices and wishes. A record is kept of all activities people take part in. All those that we spoke to said that there is always something going on at the home that they can take part in if they wish and that their individual interests are also met. During this inspection we saw people being encouraged and supported to take part in gentle exercises, one to one games such as carpet bowls, manicures and bingo. A weekly programme of events is clearly posted in the lounge and those people who normally stay in their rooms are told of events. The programme of activities includes exercises, painting, quizzes, bingo and crafts. The home also has a “shopping trolley” that sells toiletries, papers, magazines and confectionary for people to buy if they wish. Several people spoke about how their relatives/ visitors are made to feel welcome at the home. Visitors are offered drinks and “are made to feel part of the family”. We looked at the visitors’ book and it was clear that many people received visitors and they came at different times of the day. People moving into Hembury Fort are encouraged to bring personal possessions and small items of furniture with them to make their rooms feel homely and this is agreed before admission. Most of the rooms seen during this inspection were personalised and people spoke about the pleasure having their own things around them gave them. We discussed with the manager how the interests of people who have no family, or do not wish to involve them, are met at the home. The manager was familiar with contacting outside agencies and was aware of the details of how these could be contacted if asked by a person living at the home or relatives. This helps to encourage people to exercise choice and control over their lives. Most of the people spoken to during this inspection said that the food served was very good. Some said that it was not an easy job cooking for a number of people and “ you can’t please all of them all the time”. All people who responded to questionnaires agreed that they always enjoy meals served at the home. Nine of the 10 people living at the home who responded to surveys agreed that there are “always or usually”, and one felt there were “sometimes” activities that the could take part in at the home. One person commented, “ Can’t play football yet, but have the goal” and another “ Depends what activities there are. I cannot do much. I prefer to be independent in my room with TV.” Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 17 We asked staff how they prevent people who prefer to stay in their room from the risk of social isolation. We were told that staff visit them frequently, talk to them about daily events, their interests and tell them what activities are taking place so that they may change their minds. Staff were very aware that just because someone didn’t want to take part on one day did not mean that they may never wish to be included. People who preferred to stay in their rooms confirmed this was the case when we spoke to them during this inspection. Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. There is a clear and simple complaints procedure that ensures complaints are responded to promptly with satisfactory outcomes. Staff have a good knowledge and understanding of the forms of abuse thereby ensuring that residents are protected at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a detailed, clear and simple complaints procedure, which is prominently displayed for all residents and visitors to see. The home has developed a system to maintain records of all complaints received and how they are managed. No complaints had been made to the home or to the CSCI since the last inspection. People living at the home that we spoke to during this inspection said that if they were unhappy about anything they would not hesitate to raise any matter at any time and were sure that it would be dealt with to their satisfaction. Staff said that if anyone made a complaint they would report it to either the manager or deputy manager. If it was something that they were able to sort out themselves then they would. They were confident that no issue that was raised would ever be ignored. A complaints and suggestions book is available Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 19 in the entrance to the home where comments can be made anonymously if preferred. Many of the residents would need assistance to follow the home’s complaint procedure and staff are aware of this. To ensure that residents are not unhappy staff are able to describe how they note that individual residents are not happy or concerned about anything. The home operates an “open door” policy and residents were seen during this inspection visiting the office with issues, which concerned them. At all times they were treated with patience and consideration and the manager and staff dealt with their problems efficiently and quickly. Many of the residents would need assistance to follow the home’s complaint procedure and staff are aware of this. Staff were able to tell us how they would be able to recognise that individuals are not happy or concerned about anything. Details of the information given us by staff were also clearly recorded in care plans. This means that all staff are able to access this information and people living at the home benefit from consistent care. There was nothing to suggest that residents are anything other than well cared for at the home. People spoken to said that staff were very helpful, respectful and that nothing was ever too much trouble for them. Records were seen showing that staff have received training in Adult Protection issues. A procedure for responding to abuse is available and staff were aware of this. They were able to describe differing types of abuse and gave good details of what they would do if they suspected abuse was occurring. They were aware of the home’s ‘Whistle-blowing’ policy and that it would support them in reporting bad practice. They felt confident that they would be listened to if they raised concerns about bad practice. All of the 10 people living at the home who responded to questionnaires agreed that the always or usually know who to speak to if unhappy or wanted to make a complaint. One person commented, “ I am terrifically happy here”. Nine of the 10 staff that responded to questionnaires confirmed that they always knew what to do if concerns or complaints are made to them. Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26. Quality in this outcome area is good. The standard of the environment has improved providing a comfortable, clean and safe environment for those living in, working at and visiting the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was clean, comfortable and homely at the time of this inspection. The providers and management have worked hard to improve and maintain the home since the last inspection. We saw bedrooms that were well decorated, bright and homely. The majority of them had been personalised and people living at the home told us that they were happy at the home. Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 21 Environmental risk is being well managed and decoration, fitting and fixtures such as furniture, curtains, carpets, pictures, lamps throughout the home are of a good quality. We visited the rooms for all people living at the home were visited during the inspection, and these were all well maintained. The home has a large lounge loosely divided in to two areas and a large dining room. Ample space is available for activities and for those who like to walk or have mobility problems and need the use of a wheelchair. Because of the age and design of the building some upper floors in the house slope, and there are other hazards common to period buildings such as steep stairways. Risk assessments have been undertaken for these hazards and peoples’ safety is well managed. The home was clean and fresh and people living there commented positively on the cleanliness of the home, and this was observed on the day of the inspection. In questionnaires, ten people responded that the home was always or usually clean and fresh. There is a good supply of protective clothing and hand-washing facilities at the home and the laundry has equipment, which should effectively reduce the risk of cross infection. Everybody was well dressed at the time of this visit and several said that their clothes are well looked after. Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. People benefit from having trained, skilled staff in sufficient numbers to support them, and the smooth running of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has promoted the role of key workers for each individuals with the aim that they know they get to know the resident well and support them with personal tasks. This works towards meeting the homes’ ethos of maintaining person centred care for all residents living at Hembury Fort House. People who responded to questionnaires and those spoken to during this inspection said that staff responded to their needs promptly. This was confirmed during this visit when staff responded promptly to peoples needs in a kindly manner. Throughout the day we saw staff asking people if they wanted a drink, were comfortable, reassuring people, visiting those who wished to stay in their rooms and engaging people in conversation. The manager discussed the recruitment procedure at the home and how it has been developed so that it considers the needs of people living at the home. She stressed the importance, and time taken, to make sure that only good Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 23 quality carers are recruited so that a high standard of service is offered at the home. We looked at three recently employed staff files. All included evidence that the home had conducted a robust recruitment procedure. Files included details of past employment, application form, training, evidence of identity, police checks and references. This procedure means that people living at the home are protected by the home’s recruitment procedure. All newly employed staff undergo a period of training when they start working at the home to enable them to get to know the residents, the home’s philosophy of care, safety procedure, care procedures, and the general layout of the home. The time taken to complete this training will depend on past experience and individual ability. Training is a priority at Hembury Fort. Individual staff files include confirmation of all training undertaken and all planned. This means that all staff are kept up to date with current good practice. Staff who responded to questionnaires included comments such as “ high level of training available, also the management are constantly looking at ways of improving working practices”. According to pre inspection information training undertaken in the last in last 12 month includes safe moving and handling, food hygiene, falls awareness and prevention, first aid, protection of vulnerable adults abuse and dementia awareness. Training planned to take place during the next 12 months include first aid refresher, food hygiene and dementia awareness updates. Ensuring that residents are cared for by a competent team of staff further promotes person centred care and safety. People living at the home say that staff are always or usually available when needed, that they listen and act on what is said and that they are well cared for by staff. All staff when coming on duty are given handover period when up to date information is shared. This ensures that well informed staff care for people living at the home. A meeting of staff on each shift is held when information is shared about individuals and any issues or problems that occur. This ensures that well informed staff care for people living at the home. Ensuring that people living at the home are cared for by a competent team of staff further promotes person centred care and safety that is consistent. All staff that responded to questionnaires confirmed that their induction training covered everything they needed to know when they were first employed at the home. One person commented, “I am still learning”. Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 24 All confirmed that they are given training that is relevant to their role. Comments included “updates at all times. All training is updated when necessary, sometimes monthly, sometimes yearly” another “ Training is open to all staff, with staff paid for time spent training. In house training also given, most recently pressure sores”. Five staff felt there was always enough staff on duty to meet individuals’ needs and five felt not. One commented “Often there are extra staff and especially at critical times like morning and first part of night shift” and “We meet the care needs of residents well and we are good at following procedures and policies” Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 25 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 & 38. Quality in this outcome area is excellent. People benefit from living in a well managed home that is working hard towards trying to make sure the home is run in their best interests. Health and safety is well managed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The owner is also the registered manager of the home and holds a Registered Manager’s Award. This means that people living at the home and staff benefit from good management and leadership to ensure the home runs smoothly. Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 26 Prior to this inspection the manager sent us information about the management of the home and how the home has carried out improvements based on the feedback from the last inspection. The manager and staff have worked hard to meet the requirements made at the last inspection. Records are securely stored and would be made available to people living at the home, or their representative, with their consent. Records are kept in lockable filing cabinets, and those seen were up to date. Peoples’ feedback about such things as the quality of their life at the home, staffing, meals, cleanliness and activities is sought on a daily basis. The home undertakes annual, monthly and weekly quality assurance audits and surveys to ensure that people living at the home are given a say in the home’s running. We were shown the outcomes of these audits that include number of falls, medication procedures, quality of food and cleanliness, amongst many others. An annual quality assurance survey has been undertaken by the home and the results have yet to be audited. The results of this survey will be included in the home’s statement of purpose and be made available to other interested parties. “Resident meetings” are held regularly at the home and people are encouraged to discuss any topics they wish. The result of the most recent survey will be fed back to people during the next meeting. Most people living at the home choose to have personal finances looked after by their family or legal representatives. The owners handle financial affairs for one person living at the home. These were not looked at during this inspection. Information received before this inspection indicated that all equipment is well maintained regularly all of which contributes towards ensuring that Hembury Fort is a safe place for people to live. All staff that responded to questionnaires and those spoken to during the inspection, confirmed that the manager or deputy met with them regularly to give support and discuss how you they were working? Comments included,“ I have a very good relationship with the manager who supports me and other staff well. I get regular feedback and am praised often. This gives me the motivation to aim even higher and put in even more effort” another “ The owners are very dedicated and the well being of our residents is at the top of the agenda at all times. The manager has an open door policy and is very supportive of staff” and.“ Management listen to me”. Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 27 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 4 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 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 3 3 3 3 3 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 4 4 3 X 3 X X 3 Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? N/A 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. Refer to Standard Good Practice Recommendations Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: 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 © 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 Hembury Fort House DS0000021945.V367640.R01.S.doc Version 5.2 Page 30 - 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!

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