Our report following a visit to Rydon in Taunton. Wards one and two each have 15 beds, providing assessment and treatment primarily for adults of working age experiencing an acute mental health problem. This visit forms part of a wider project running from November 2015 to July 2016. Our Enter and View Representatives visited each of the nine wards in Somerset that provide treatment for people with acute mental health issues. Recommendations Healthwatch Somerset leaflets are displayed both in reception and also on the patient engagement noticeboard. Consider changing the lighting in the ‘female only’ corridor to make it less ‘gloomy’. Considered putting a smoking shelter in the garden for the first floor patients to contain smoke and litter for the benefit of other patients. Consult and involve patients in planning and maintaining the garden area. Information about making a complaint, raising a concern, advocacy support and Healthwatch Somerset should be provided to each patient in a patient information pack. Create a volunteering recruitment plan to encourage the recruitment of volunteers onto the ward. Consult a nutrition specialist for advice on improving food. Consider the good practice examples gathered by the Healthwatch Somerset enter and view team around activities and involvement. Please see appendices 2, 3 and 4. Consult with staff to identify and promote ways to complete paperwork with maximum efficiency to enable ward staff to spend more informal, interactive time with patients. Negotiate and clarify working relationships and processes with Taunton Association for the Homeless to improve discharge times. This report was produced by the previous Healthwatch Somerset service provider, The Care Forum. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286. Enter and View report: Rydon Ward, Taunton Service provider response

Our report following a visit to Winsor in Minehead, which is a period building providing nursing care for up to 40 residents. The home was notified about the Enter & View visit three weeks prior to the visit. There were 38 residents living there on the day of our visit. Recommendations The manager look into the “Get Connected” grant that exists to help those in social care access the Internet. Their website contains details about how this may also help those with dementia. The home consult with Action on Hearing Loss and take advice on the installation of hearing loop systems. The home to look at our publication ‘Environment – Residential and Nursing Home Good Practice Examples’ and discuss with staff and at resident and family meetings. The home produce memory boxes to house keepsake items and other reminders of their earlier life which can often stimulate their memory and become a talking point. The home looks into 'Rem Pods' and the benefits they could offer to residents. The home look at our publication ‘Staffing – Residential and Nursing Home Good Practice examples’. The home and the dementia support group find out about ‘Reminiscence Learning’ and the service they can offer homes such as 'Activity Angels' and 'Fitness Fairies'. The home consider our publication ‘Involving the local community – Residential and Nursing Home Good Practice Examples’ and share with staff resident and families at meetings. The staff look at our publication 'Good Practice Examples in Residential Care – Involving the Local Community'. The Activities Co-ordinator share our publication 'Activities in Residential and Nursing Homes' with residents and families both at meetings and individually to help inspire and further expand activities offered. The staff speak to the Musgrove Park Hospital Patient Engagement Manager and request that their concerns about information being lost or missing is passed on to the Director of Nursing. The Manager write to Podiatry Services and enquire about podiatry inconsistencies and why all diabetic residents cannot be seen at the same time. This report was produced by the previous Healthwatch Somerset service provider, The Care Forum. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286. Enter and View report: Winsor House, Minehead Service provider response

Our report following a visit to Carrington House, a purpose built residential home for up to 44 residents in Wincanton. The home was notified about the Enter & View visit two weeks prior to the visit. There were 31 residents living in Carrington House at the time of the visit. Many of the residents were on a respite stay and the manager informed us that respite care or temporary care. Recommendations That residents are consulted about the decoration of corridors and individualisation to bedroom doors and that existing plans to do this are implemented. That the home consult with ‘Action on Hearing Loss’ and take advice on the installation of hearing loop systems. That the home consider further ways of involving the local community, e.g. visits from scouts, hosting local clubs. that the home looks into the ‘Get Connected’ grant which exists to help those in social care access the Internet. That The ‘Activities List’ (Appendix 1) is shared at resident and family meetings and with activities staff. a) The home ensures ward staff & the director of nursing at YDH are made aware of the home’s need to assess all patients prior to discharge and that discharges will not be accepted after a certain time in the evening; b) The home inform us of any future difficulties relating to discharge from hospital; c) Somerset Care write to the board of directors and the CEO of Yeovil District Hospital outlining difficulties related to admissions and discharge; d) The home look at the Healthwatch document ‘Hospital Admissions & Discharges – Good practice Examples (Appendix 3). The home contacts ‘You can do’ and Aster Living who are often able to take residents out or transport them to Active Living Groups. This report was produced by the previous Healthwatch Somerset service provider, The Care Forum. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286. Enter and View report: Carrington House, Wincanton Service provider response

In this Annual Report we share our key challenges and successes, as we continued to engage with the public to understand people’s experiences of health and social care to make a difference. This report was produced by the previous Healthwatch Somerset service provider, The Care Forum. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286.

Our report following a visit to Frome Care Village. Up to 60 residents can be accommodated in the facility which is split over two buildings. Parsonage is a period building which is designated for dementia care and Woodlands is a modern building which provides nursing care. The home was notified about the Enter & View visit two weeks prior to the visit. When we visited the care village was at two-thirds occupancy. Recommendations That the home looks into ‘Rem Pods’ and the benefits they could offer to residents. That the home look into the ‘Get Connected’ grant which exists to help those in social care access the Internet. That the home look at our publication ‘ Residential; Care ‘Environment – Good practice examples’ (Appendix 1) with staff and at resident and family meetings to see if it generates further ideas for the enhancement and improvement to the environment. That the home consult with ‘Action on Hearing Loss’ and take advice on the installation of hearing loop systems. Management look at Appendix 2 ‘Staffing Good practice Examples’ and note any examples the home wish to try and adopt on the recommendations return sheet. That the home look at Appendix 3 of our publication ‘Resident and Family Meetings – Good Practice Examples’ and discuss this with staff and at resident and family meetings to aid further improvements in this area. Appendix 4 (Activities - Good practice Examples) be shared with activities and care staff and be discussed at ‘Resident and Family Meetings’ as well as on a one to one basis with residents. That the home look at our publication ‘Improving Hospital Admissions and Discharges – Good Practice Examples’, (Appendix 5 and implement the suggested actions to help improve future liaison between the hospital and the home). That the home researches other organisations such as Rethink, local schools or the Scouts with regard to minibus hire. The home could also consider giving support to smaller groups of residents to organise a taxi share into town if they wish and therefore reduce the cost. That the home invite us to make a further visit in a few months time, so that we can provide residents, staff and visitors with an independent body to discuss what difference the implemented changes have made and give further opportunity for the sharing of good practice during this improvement period. This report was produced by the previous Healthwatch Somerset service provider, The Care Forum. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286. Enter and View report: Frome Care Village Service provider response

Our report following a visit to Wyndham House in Minehead, which is a period property with modern extensions. It has 50 bedrooms and is registered to provide residential care. The home was notified about the Enter & View visit two weeks prior to the visit. On the day of our visit the manager informed us that they were 82% full. Recommendations The Enter & View team recommend that the home consult with Action on Hearing Loss and take advice on the installation of hearing loop systems. Good practice suggestions for resident and family meetings: Make meetings part of a larger event such as cheese and wine evening; Ensure that residents have the opportunity to add to the agenda and that they received the agenda well in advance; Invite guest speakers to talk about a topic of interest such as care home fees, hobbies, crafts, reminiscence or perhaps even a comedian; Involve domestic, kitchen and activities staff. Share ‘Consolidated Activities and good practice examples’ with activities staff and at resident & family meetings. This report was produced by the previous Healthwatch Somerset service provider, The Care Forum. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286. Enter and View report: Wyndham House, Minehead Service provider response

Our report following a visit to Grovelands, a large modern purpose built building with 61 single rooms in Yeovil. The home was notified about the Enter & View visit three weeks prior to the visit. The home is split into two sections, the main residential unit and a specialist dementia care unit called ‘Petals’. Recommendations Some of the signs could be larger for example the sign to the lift. Consider ways of involving the local community, e.g. visits by scouts, hosting local clubs. Share the Activities list (Appendix A) with activities staff and residents to further broaden the activities provided. Talk to other organisations about the sharing of minibuses - such as Rethink, local schools and scout groups. Speak to the Patient Engagement Manager at YDH and request that the concerns regarding information sharing are passed to the Director of Nursing. Social Service Reviews – some residents have been waiting 3 years for an annual review. To find out if this is a concern for other homes. This report was produced by the previous Healthwatch Somerset service provider, The Care Forum. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286.

Our report following a visit to The Firs Nursing Home, situated on the outskirts of Taunton. It can accommodate up to 40 residents and there were 38 residents living here at the time of visit. The home was notified about the Enter & View visit two weeks prior to the visit. Recommendations That the home consult with ‘Action on Hearing Loss’ and take advice on the installation of hearing loop systems. In the interests of sharing good practice examples from other homes we would invite the home to consider other opportunities for involving the local community. We invite the home to consider other good practices related to resident and family meetings. We have included a list of activities and good practice shared by other homes which we recommend The Firs share with their activities staff and perhaps at resident and family meetings to inspire ideas. In the interests of providing joined up medical care for the residents, it is essential that this information be shared. It is recommended that the home speaks to the Patient Engagement Manager and request that the concern is passed to the Director of Nursing. Medication destroyed when residents go into hospital by hospital staff according to procedures there. Consequently these then need to be re-ordered which causes problems as records show that a double order has been requested by the home or pharmacy. It is recommended this issue be raised with the Patient Engagement Manager. The home looks into talking to other organisations about the sharing of minibuses such as rethink, local schools and scout groups. This report was produced by the previous Healthwatch Somerset service provider, The Care Forum. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286. Enter and View report: The Firs Nursing Home, Taunton Service provider response

Our report following a visit to Rossetti House, a 70 bed care home in a purpose built building which opened in 2013. The home was notified about the Enter & View visit two weeks prior to the visit. Recommendations Residents could be offered a choice in the size of portions for meals to incorporate varying levels of appetite. Opportunities for contributing to good practice sharing should be taken up where possible to enable other providers to learn from Rossetti’s standards of excellence. This report was produced by the previous Healthwatch Somerset service provider, The Care Forum. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286.

Our report following a visit to Fletcher house, a large modern 60 bed residential home in Wells. The home was notified about the Enter & View visit two weeks prior to the visit. Recommendations That the home consult with ‘Action on Hearing Loss’ and take advice on the installation of hearing loop systems. That the home consider adopting the following examples: Inviting a speaker such as a nutritionist to speak on healthy eating, or a speaker about care fees for example; Ask residents for ideas about speakers; Ensuring residents are asked individually if there is anything they would like raised at the meeting; Including Kitchen and domestic staff in the meetings; Ensuring all residents have a copy of minutes from meetings. Suggestion boxes are placed around the home for those who prefer to comment anonymously. Ensuring fruit is also available in communal areas if this is not already done. Contact ‘You can do’ and Aster Living who are often able to take residents out or transport them to Active Living Groups. There are fewer activities for men and would recommend the Activities staff talk to male residents about this. This report was produced by the previous Healthwatch Somerset service provider, The Care Forum. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286. Enter and View report: Fletcher House, Wells Service provider response

Our report following a visit to Sydenham House is a modern 51 bed residential home in Bridgwater. The home was notified about the Enter & View visit two weeks prior to the visit. Recommendations Seek staff and residents views and input into future redecoration. Decoration and furnishings could also be added to the agenda for residents meetings. Priority is given to fixing the other downstairs toilet. Staff induction processes are reviewed to help ensure information such as the lost property box is communicated to all staff. Ensure that residents and staff of individual homes are consulted about decisions such as menus and activities. Attendance at resident/visitor meetings: Holding regular meetings at least quarterly if not more frequently; Making the meeting part of a larger events such as a cheese and wine evening; Inviting guest speakers to talk about a topic of interest such as finance/care home fees, hobbies and crafts, reminiscence or perhaps even a comedian; Ensuring that residents are able to feed into the agenda in advance and received minutes of meetings, noting in particularly ‘You said we did’ type comments; Giving residents who do not wish to attend the opportunity to contribute to the meeting in other ways, e.g. via a key worker or suggestion box. That the notice board be updated regularly. Open discussions with the Somerset Partnership about end of life care. Research other organisations such as Rethink or the Scouts with regard to minibus hire. The home could also consider giving support to smaller groups to organise a taxi share into town if they wish and therefore reduce the cost. Liaise with the male residents to find out if there are activities that they would enjoy. This report was produced by the previous Healthwatch Somerset service provider, The Care Forum. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286. Enter and View report: Sydenham House, Bridgwater Service provider response

Our report following a visit to West Abbey Care Home, Yeovil, which is a large modern home accommodating 90 residents. It provides both residential and nursing care. The home was notified about the Enter & View visit two weeks prior to the visit. Recommendations That the home give some thought to providing a selection of toys or small play area for visiting children. That the home look into the ‘Get Connected’ grant which exists to help those in social care access the Internet. Staff recruitment and retention of staff is reviewed and given top priority by the management and Barchester Healthcare. With regard to Improving the attendance of residents/visitors meeting, that the home consider some of the following ideas: Making the meeting part of a larger events such as a cheese and wine evening; Ensuring that residents have the opportunity to add to the agenda and receive the agenda well in advance; Inviting guest speakers to talk about a topic of interest such as finance/care home fees, hobbies and crafts, reminiscence or perhaps even a comedian. This would help to ensure that residents who may not otherwise attend might be motivated to give their input for different reasons; Ensuring that residents are able to feed into the agenda in advance. That the manager liaises with residents about noise levels at night and that policies and procedures are reviewed to ensure that residents are accommodated within the different areas of the home appropriately according to their needs. Where appropriate the home should consider additional soundproofing is needed. That the home consult with ‘Action on Hearing Loss’ and take advice on the installation of hearing loop systems. This report was produced by the previous Healthwatch Somerset service provider, The Care Forum. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286. Enter and View report: West Abbey Care Home, Yeovil Service provider response