CARE HOMES FOR OLDER PEOPLE
Connell Court 20 Weld Road Southport Merseyside PR8 2DL Lead Inspector
Daniel Hamilton Unannounced 24th August 2005 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 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. Connell Court 20050824 Connell Court X10015 UN Stage 4 S5346 V246216 F53.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Connell Court Address 20 Weld Road Southport Merseyside PR8 2DL 01704 560651 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Methodist Homes for the Aged Mrs Anne Glover Care Home 35 Category(ies) of OP - Old Age registration, with number of places Connell Court 20050824 Connell Court X10015 UN Stage 4 S5346 V246216 F53.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service users to include up to 35 Op. Date of last inspection 5th January 2005 Brief Description of the Service: Connell Court is owned by Methodist Homes, a national charity. The home is registered to provide personal care and support for up to 35 older people and is situated within walking distance of Birkdale village where public transport, shops, a post office, banks and other local amenities are available. The home is a 3 storey purpose built building which is fitted with a passenger lift giving access to all floors. All the rooms are for single occupancy and have en-suite facilities. Assisted bath and toilet facilities are available and a call bell system is fitted throughout. There is a lounge, dining room and tea bay areas, which together with the conservatory provide ample communal space for the residents to watch television, join in activities or meet with visitors. There is a large, well-kept garden and a car park area to the rear of the building Connell Court 20050824 Connell Court X10015 UN Stage 4 S5346 V246216 F53.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over 9 hours. It was an unannounced visit and conducted as part of the regulatory requirement for care homes to be inspected at least twice a year. There had been no cause for any visits to the home since the last routine inspection in January 2005. A partial tour of the premises took place and observations were made. A selection of care, staff and service records were also viewed. The manager and an assistant manager, 2 staff members, 3 relatives and 8 of the 35 residents were spoken to during the visit and their views obtained of the home. Leaflets were also left in the home to enable people to comment on the service provided. What the service does well:
All residents and relatives spoken with during the visit complimented home and the standard of care provided. Comments from two residents included: “The staff care for you and are very sensitive and patient” and; “The staff are very considerate and caring. The care provided is very individual.” A relative said; “The standard of care is very good. Residents are well looked after.” Staff spoken with demonstrated a good awareness of their role and responsibilities and showed a clear understanding of how to value residents living in a group care environment. Healthcare, medication and meals were well managed and visiting times were flexible. Residents were empowered to retain control of their own lives and routines. A resident said; “I have the liberty to do as I wish” and another reported; “I do what I want.” Although nine complaints had been recorded since the last inspection, residents spoken with were confident that any complaints would be listened to and acted upon. One resident stated; “I have never made a complaint but I am sure Ann [Manager] would listen to me. She is very good.” Sufficient staff were on duty to meet the needs of residents and safeguards were in place to protect the people living in the home from abuse. The home had a pleasant, friendly and relaxed atmosphere and the building was well maintained and clean and tidy. A resident said; “I think the home is excellent” and a relative reported; “The home is always clean and very hygienic.” Suitable arrangements were in place to promote and protect the Health and Safety of residents, staff and visitors.
Connell Court 20050824 Connell Court X10015 UN Stage 4 S5346 V246216 F53.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Connell Court 20050824 Connell Court X10015 UN Stage 4 S5346 V246216 F53.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Connell Court 20050824 Connell Court X10015 UN Stage 4 S5346 V246216 F53.doc Version 1.40 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 standard(s) 3 Some pre-admission assessments had not been completed in full and lacked key information. Unless a full assessment is completed, there is no assurance that care needs will be met. EVIDENCE: Three new residents had moved into the home since the last inspection. Four assessments were viewed during the visit, two were for new residents and two were for residents who had been living in the home for over a year. Files viewed contained a domiciliary assessment, which had been completed prior to each resident’s admission to the home. Two of the assessments had not been fully completed as pages were missing. This resulted in important information being omitted from the assessment process. The home’s assessment documentation was well constructed and enabled a comprehensive assessment of individual needs to be undertaken when completed in full. Information generated from the assessment process was used to develop a plan of care for each resident.
Connell Court 20050824 Connell Court X10015 UN Stage 4 S5346 V246216 F53.doc Version 1.40 Page 9 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 standard(s) 7, 8, 9 & 10 Care plans had been completed which detailed each resident’s needs and the support required to meet them. Residents had access to health care services according to individual need and medication practice safeguarded the welfare of residents. Care was provided in accordance with the needs and expectations of residents. EVIDENCE: Four files were viewed. Each file contained a resident care plan that included details of resident’s assessed needs and the action required by staff to ensure that the health, personal and social care needs of each resident were met. Progress was reviewed on a monthly basis and supporting documentation including; personal profiles, daily routines, past history, personal assessments and a range of person centred risk assessments were available on files subject to need. Residents confirmed they had access to health care professionals as required and a resident said: “If you need to see a doctor they will get one.” Medical records viewed showed that residents had access to; district nurses, opticians, general practitioners, dentists and chiropodists. Hospital visits were also recorded. Connell Court 20050824 Connell Court X10015 UN Stage 4 S5346 V246216 F53.doc Version 1.40 Page 10 A corporate medication policy was in place to provide guidance to staff on how to manage medication. The names of staff designated with responsibility to administer medication and their sample signatures were recorded and photographs of residents were also on file, to verify the identity of residents prior to administering medication. Medication profiles had been completed for each resident and risk assessments and disclaimers had been completed for residents who were self-administering medication. Medication checked was stored and recorded correctly. Staff spoken with demonstrated a good understanding of social care values and how to treat residents in accordance with their individual wishes and preferences. The aims and values of the service of the home were covered with all staff as part of their induction process and formed part of the home’s quality standards manual. Residents spoken with were satisfied with the service provided. The views of three residents included: “As a human being I am well respected and cared for”; “The staff care for you and are very sensitive and patient” and “The staff are very considerate and caring. The care provided is very individual”. Likewise, comments from two relatives included; “I am happy with the care provided and the staff are lovely” and; “The standard of care is very good. Residents are well looked after.” Connell Court 20050824 Connell Court X10015 UN Stage 4 S5346 V246216 F53.doc Version 1.40 Page 11 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 standard(s) 13, 14 & 15 Visiting times were flexible and residents could maintain contact with family and friends as they wished. Residents had control of their own lives and were encouraged to maintain their independence and chosen lifestyle. Meals were well managed and provided in comfort, to ensure residents received an appealing and nutritious diet. EVIDENCE: The home had a visiting policy with guidelines for visitors. Residents were observed to receive visitors during the inspection and three residents reported: “I can have visitors whenever I want”; “We can have visitors as we choose” and; “There are no set visiting times.” Relatives spoken with during the visit also confirmed that the home had a policy of open visiting. A relative said; “I can visit whenever my mum wants and I am made to feel welcome.” Another advised; “Visiting times are flexible.” Residents spoken with confirmed that they retained control of their own lives and influenced the routines of daily life within the home. Comments from three residents included: “I have the liberty to do as I wish”; “I do what I want” and “We are given the choice to decide what to do each day.” Residents were able to bring personal possessions into the home and rooms viewed were personalised with pictures, ornaments and other personal belongings. Connell Court 20050824 Connell Court X10015 UN Stage 4 S5346 V246216 F53.doc Version 1.40 Page 12 The home had a four-week rolling menu, which showed that residents received a wholesome, balanced diet. Two choices were available for the lunch and teatime meal and the content of the menu was discussed with residents during the monthly Residents’ Forum Meetings, to ensure residents were consulted about the choice of food. Meals were served in the home’s dining room, which was pleasantly furnished and spacious. China crockery was used and tables were furnished with tablecloths, napkins and condiments. Residents spoken with were satisfied with the standard and choice of food. Comments included: “The food provided is very good”; “They ask you want you want the day before meals are served. The food is very appetising” and; “The food is pretty good. There is a nice variety. I have no grumbles.” Connell Court 20050824 Connell Court X10015 UN Stage 4 S5346 V246216 F53.doc Version 1.40 Page 13 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 standard(s) 16 & 18 Complaints received by the home since the last inspection were handled objectively and residents were confident that their complaints would be acted upon. Safeguards were in place, to protect the people living in the home from abuse. EVIDENCE: The home had a corporate complaints procedure in place, a copy of which was displayed in the reception area and provided to each resident or their relative via the Service User Guide. Records showed that nine complaints / issues had been received by the home since the last inspection. All the complaints had been addressed promptly by the home and the action taken had been recorded. Residents spoken with had no complaints about the home and were confident that staff would deal with their concerns, should any issues arise. Comments included: “I have no complaints about the home. I am sure the staff would listen to me if I had any problems”; The care is excellent. I have no concerns or complaints” and; “I have never made a complaint but I am sure Ann would listen to me. She is very good.” The home had policies and procedures in place to protect residents from abuse. These included an Abuse of Vulnerable Adults policy, a copy of the local authority adult protection procedures for vulnerable adults and a Whistleblowing policy. Staff spoken with had a good understanding of the concept of abuse and their duty of care to report any suspicion or evidence of abuse. Records showed that the majority of staff had completed Elder Abuse Training.
Connell Court 20050824 Connell Court X10015 UN Stage 4 S5346 V246216 F53.doc Version 1.40 Page 14 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 standard(s) 19 & 26 The home was suitable for the needs of the residents and maintained to a good standard. Areas viewed were homely and clean and the comfort of residents was safeguarded. EVIDENCE: The home had a five-year maintenance plan to ensure the environment received ongoing maintenance, refurbishment and investment. An Assistant Manager and the home’s maintenance person completed health and safety checks every two months and a record of jobs requiring attention by the maintenance person was available. The maintenance person was responsible for general building and garden maintenance. All areas viewed during the visit were accessible and appeared to be free from hazards. Furthermore, the fabric and decoration was in good order and this provided residents with a pleasant, comfortable environment in which to live. Since the last inspection, two bedrooms had been redecorated and the carpets replaced, new garden chairs had been purchased and the flat roof at the rear of the building had been replaced. A relative reported; “I think the home is excellent” and a resident said; “you can’t get better than this home.”
Connell Court 20050824 Connell Court X10015 UN Stage 4 S5346 V246216 F53.doc Version 1.40 Page 15 The home employed three domestics and all areas viewed, including the laundry, were clean, hygienic and tidy. Infection control policies and procedures were in place to control the spread of infection and residents confirmed that the home was always clean. The views of two residents included: “The home couldn’t be better. It’s always spotless” and; “The cleaning staff are very good.” A relative reported; “The home is always clean and very hygienic.” Connell Court 20050824 Connell Court X10015 UN Stage 4 S5346 V246216 F53.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 & 30 Sufficient numbers and an appropriate skill mix of staff were deployed to meet the needs of residents. Recruitment issues identified at the last inspection had not been addressed and some recruitment practice did not fully safeguard the welfare of residents. Training records were not up-to-date and did not confirm that staff were trained in some safe practice areas. EVIDENCE: Direct observation and inspection of rotas confirmed that three care staff and a senior member of staff were on duty from 7.00 am to 10.00 pm, with three waking night staff on duty throughout the night. The home also employed an activities coordinator, 2 cooks, 3 kitchen assistants, 3 domestics, 2 laundry assistants and a maintenance man. Residents confirmed that there were sufficient staff on duty to meet their needs. Comments included; “The staff are all very nice and are always there to help you” and; “The staffing levels seem fine to me.” The home had a corporate recruitment procedure in place that was based on equal opportunities. The recruitment records for two members of staff who had commenced employment since the last inspection were viewed. One file contained only one written reference. Likewise, although there was written confirmation on file that Criminal Record Bureau (CRB) and Protection of Vulnerable Adult (POVA) checks had been completed, original copies of CRB Certificates were not available on files to view, despite a requirement at the last inspection. All other recruitment records required under the Care Home Regulations were in place.
Connell Court 20050824 Connell Court X10015 UN Stage 4 S5346 V246216 F53.doc Version 1.40 Page 17 Each member of staff had a record of induction and training completed. Training records viewed were not up-to-date and showed that some staff had not completed all safe practice training. The home had made excellent progress with (NVQ) National Vocational Qualifications and the majority of care staff had attained an NVQ in Care. Connell Court 20050824 Connell Court X10015 UN Stage 4 S5346 V246216 F53.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 & 38 Systems and procedures had been developed to protect the financial interests of residents who required support with personal allowances. Safeguards were in place to protect the health, safety and welfare of residents and staff. EVIDENCE: The home had a corporate procedure in place that covered residents’ money and valuables including the encashment of cheques. Residents looked after their financial affairs independently or with support from family members or solicitors. The manager did not act as an appointee for any of the residents however looked after some personal allowances. Records were maintained that detailed how the money was spent and balances were correct. Receipts were also retained by the home. Cheques cashed on behalf of residents were also recorded and residents signed to confirm receipt of their cash. The home had a comprehensive health and safety manual in place. Service equipment and public liability insurance certificates were available within the home. Health and Safety Audit checks were carried out at regular intervals to monitor environmental risks and hazards. General and fire risk assessments
Connell Court 20050824 Connell Court X10015 UN Stage 4 S5346 V246216 F53.doc Version 1.40 Page 19 had been completed and inspection of fire records confirmed that weekly fire alarm tests were undertaken. Staff received fire training at appropriate intervals. Connell Court 20050824 Connell Court X10015 UN Stage 4 S5346 V246216 F53.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x 3 x x 3 Connell Court 20050824 Connell Court X10015 UN Stage 4 S5346 V246216 F53.doc Version 1.40 Page 21 yes Are there any outstanding requirements from the last inspection? 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. 1. 2. Standard 3 29 Regulation 14 19 Requirement A full assessment of need must be completed for each resident, before moving into the home. Criminal Record Bureau Certificates must be retained securely at Connell Court and available at the next inspection for staff who have been recruited in the period between inspections. [Previous timescale of 5/3/2005 not met]. Staff must only be confirmed in post if two satisfactory written references have been received. All staff must have an up-to-date record of induction and all training completed. Safe practice training must be completed by all staff and refresher training must be completed periodically. Timescale for action 24/09/05 24/09/05 3. 4. 5. 29 30 30 19 19 18 24/09/05 24/10/05 24/11/05 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
20050824 Connell Court X10015 UN Stage 4 S5346 V246216 F53.doc Version 1.40 Page 22 Connell Court 1. Connell Court 20050824 Connell Court X10015 UN Stage 4 S5346 V246216 F53.doc Version 1.40 Page 23 Commission for Social Care Inspection Burlington House Crosby Road North Waterloo, Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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