Archived: Somerset

Updated 3 October 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the registered provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 10 and 14 August 2017. The first day was unannounced and we arranged with the registered manager to return on the second day. The inspection team consisted of one adult social care inspector, a specialist nurse advisor and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. In this inspection, the expert by experience had experience in relation to services for older people and those living with dementia.

Prior to the inspection we reviewed the information we held about the service, including the Provider Information Return (PIR). This is a form which we ask the provider to complete to give us some key information about the service, what the service does well and improvements they plan to make. We reviewed notifications that the provider had sent us since the last inspection. Statutory notifications are documents that the registered provider submits to the Care Quality Commission (CQC) to inform us of important events that happen in the service. We also contacted the local authority in order to gain their views about the service. They had no current concerns. We used this information to help us plan this inspection.

During our inspection we spoke with four people who used the service and with six relatives. We spoke with the manager of the home, the area manager, the quality manager, the deputy manager who was also the nurse in charge on day one of the inspection, four care workers, the maintenance person and a domestic. We used the Short Observational Framework for Inspection (SOFI) on the first day of our inspection. SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spent time observing the daily routines at the home, including the support people received with their medicines and the lunchtime experience. We looked around the care home including some people’s bedrooms with their permission. We reviewed four people’s care records, medication records, five staff recruitment files, induction and training records, and a selection of records used to monitor the quality and safety of the service.

Updated 3 October 2017

This inspection took place over two days; the 10 and 14 August 2017. The first day was unannounced and we arranged with the manager to return on day two. Somerset is registered as a care home providing care and support for up to 44 older people who may have a physical disability or be living with dementia. The property is a large detached building over three floors, ground, first and second in the centre of the village of Wheldrake which is eight miles south of York. The service was an old rectory and has well maintained mature gardens. There is a shared lounge, conservatory and dining room. All bedrooms are for single occupancy.

At the last inspection on 2 February 2017 we asked the provider to take action to make improvements to medicines management, staffing and the environment and this action has been completed.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There were systems and processes in place to protect people from the risk of harm. Staff were able to tell us about different types of abuse and were aware of action they should take if abuse was suspected. We saw that incidents of suspected abuse had been reported to the local authority and CQC.

A range of audits were carried out both by the manager and provider. We saw where issues had been identified; action plans with agreed timescales were in place to help drive improvements. However the provider audits could be improved in order to identify where further guidance or support was needed to enhance people’s care.

Overall we saw people received their medicines safely and were well organised. Risk assessments were in people’s care plans for areas such as moving and handling and pressure area care so staff were aware of how to support people to remain safe. We saw the service worked with visiting professionals and followed their advice.

We saw people’s care plans contained some person centred detail. Staff knew people very well and the manager and deputy were supporting the staff team to re-write all the care plans and ensure more relevant and current information was included. These were not all complete and daily notes were also being improved. Staff had not always been proactive in identifying where support or equipment would benefit people.

We made a recommendation for the provider to continue to improve the quality monitoring systems.

Servicing and checks of the building and equipment were undertaken to ensure people’s health and safety. There was a maintenance person employed by the service.

Recruitment and selection was robust and appropriate checks had been undertaken before staff began work. There was sufficient staff working at the service to meet people’s needs. They felt supported through supervision, training, staff meetings and their involvement in running the service. Staff told us they felt well supported by the manager.

There were positive interactions between people and staff. We saw staff treated people with dignity and respect. Observation of the staff showed they knew the people very well and could anticipate their needs. People and their relatives told us they were happy and felt very well cared for.

People had a choice of meals. We saw the mealtime experience was positive. People had their weight monitored to ensure they were receiving enough nutrition.

People’s hobbies and leisure interests were individually assessed. We saw there was a plentiful supply of activities.

People and relatives were regularly asked for their views. People and their relatives said they would talk to the manager or staff if they were unhappy or had any concerns. They told us they felt confident to do this.