CARE HOMES FOR OLDER PEOPLE
Connell Court 20 Weld Road Southport Merseyside PR8 2DL Lead Inspector
Daniel Hamilton Unannounced Inspection 30th January 2006 09:10 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 Connell Court DS0000005346.V280333.R01.S.doc Version 5.1 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. Connell Court DS0000005346.V280333.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Connell Court Address 20 Weld Road Southport Merseyside PR8 2DL 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) 01704 560651 home.fxg@mha.org.uk Methodist Homes for the Aged Mrs Anne Glover Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Connell Court DS0000005346.V280333.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service users to include up to 35 OP Date of last inspection 24th August 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 that 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 to the rear of the building. Connell Court DS0000005346.V280333.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced 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 August 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, 2 staff members and 8 of the 34 residents were spoken with during the visit and their views obtained of the home. Comment cards were also left in the home to enable residents and others to comment on the service provided. What the service does well: What has improved since the last inspection?
‘Domiciliary Assessments’ had been completed in full to ensure the needs of residents were identified, before moving into the home.
Connell Court DS0000005346.V280333.R01.S.doc Version 5.1 Page 6 Suitable arrangements had been made for the Registered Provider’s Head Office to manage the administration of Criminal Record Bureau (CRB) certificates for inspection purposes and two references had been obtained for all new staff. Training records had been updated to provide accurate information on the training needs of staff and progress had been made with safe practice training. 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 DS0000005346.V280333.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Connell Court DS0000005346.V280333.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 An assessment system had been established, to enable the home to identify the care needs of residents, prior to admission. EVIDENCE: Four files were viewed during the visit. Three files were for new residents who had moved into the home since the last visit and one file was for a resident who had been living in the home for nearly eight months. Each file contained a domiciliary assessment, which had been completed prior to each resident’s admission to the home. The home utilised corporate assessment documentation that was well constructed and enabled a through assessment of individual needs. Since the last inspection, action had been taken to ensure that a full assessment of needs was undertaken for all residents. Personal assessment information had also been obtained for each resident and a copy of a social work assessment / care plan was in place, for one of the new residents. Connell Court DS0000005346.V280333.R01.S.doc Version 5.1 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 the following standard(s): 7 and 9 A care plan system had been established to provide staff with the information they required to meet the needs of residents. Medication was well managed and arrangements were in place, to safeguard the welfare of residents. EVIDENCE: Four files were viewed. Three files were for new residents who had moved into the home since the last visit and one file was for a resident who had been living in the home for nearly eight months. Each file contained a resident care plan that had been generated from an assessment of needs. Care plans identified the needs of residents and the support required from staff. Overall, care plans had been reviewed on a monthly basis, however four sections of one care plan had not been reviewed for over two months. Additionally, personal profiles had been completed which provided: general information; a personal description; information on past life; details of family and friends and key information on the physical, personal hygiene and communication needs of each resident. Connell Court DS0000005346.V280333.R01.S.doc Version 5.1 Page 10 Supporting documentation including: individual, Waterlow and moving and handling risk assessments; information on daily routines; records of health care visits and daily report sheets were also on file. Staff spoken to during the visit demonstrated a good awareness of the home’s care plan system and the needs of the people living in the home. Residents interviewed were satisfied that the care staff understood their needs. For example, one resident said: “The staff are aware of my care needs and do their best to help me maintain my independence.” Likewise, another resident said; “The care staff do a fantastic job. They are very helpful.” A corporate medication policy had been developed and a record of staff responsible for administering medication, together with sample signatures was in place. Staff responsible for handling medication had completed appropriate training and a system had been established to verify the identity of residents prior to administering medication. Medication profiles had been completed for each resident and risk assessments and disclaimers were available for residents who were self-administering medication. The home utilised a monitored dosage system. Medication checked during the visit was appropriately stored and accounted for via medication administration records. Systems were also in place to store and record controlled drugs correctly. Connell Court DS0000005346.V280333.R01.S.doc Version 5.1 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 the following standard(s): 12 Daily life and activities within the home were flexible and varied to meet the expectations, preferred routines and needs of residents. EVIDENCE: The home employed an ‘Activities Coordinator’ who was responsible for planning and facilitating a range of activities for the people living in the home. A weekly programme of activities was produced, a copy of which was given to each resident and also displayed on the notice board in the dining room. The manager reported that the preferences and recreational interests of residents were identified via assessments, reviews, suggestion boxes and resident forums. Monthly reports were completed to review each resident’s progress / interest in activities. The weekly activity records showed that a range of activities were provided for residents which included: Coffee and Biscuit mornings and Afternoon Tea; Movement to Music; Morning Services; Songs of Praise; Clothes Sales; Bingo sessions; Shop in the lounge; Various Art and Crafts; Hand Massage and Manicure; Games; Trips Out and Resident Forum meetings. Additional activities were also arranged. For example, a trip had been booked for some residents to visit the pantomime during February, to see ‘Babes in the Wood.’ Suitable arrangements were in place to enable residents to receive visitors / representatives from churches in the community and for residents to visit local churches, subject to their individual religious beliefs / preferences.
Connell Court DS0000005346.V280333.R01.S.doc Version 5.1 Page 12 Residents interviewed during the visit were satisfied with the range of activities provided and complimented how well they were organised. Comments from two residents included; “We have an activities coordinator called Barbara and she arranges a programme of activities each week that is sufficient for me” and; “If you want to participate in activities, they are there for you. Bebe [Activities Coordinator] is a breath of fresh air and is a great motivator. They have in-house and community based activities.” Some residents reported they preferred not to participate in the home’s organised activities and confirmed that their wishes were respected. For example one resident said; “There are plenty of activities but I prefer to read and look after my washing.” Likewise, another resident said; “I participate in music and movement. Otherwise, I prefer to listen to my music.” Connell Court DS0000005346.V280333.R01.S.doc Version 5.1 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 the following standard(s): 16 Complaints received by the home since the last had been appropriately managed and residents were confident that their complaints would be acted upon. EVIDENCE: The home had a corporate complaints procedure in place, a copy of which was displayed in the reception area and provided to residents or their relatives via the Service User Guide. Records showed that one complaint had been received by the home since the last visit. The issue had been addressed promptly by the manager, to ensure the matter was resolved to the satisfaction of the complainant. The Commission for Social Care Inspection had received no complaints about the home in the last six months. Residents interviewed during the visit had no complaints about the service provided and were confident that if they had any concerns they would be appropriately dealt with. Comments from four residents included: “There is not a thing you could complain about. The standard of care is amazing and all the staff are superb”; “I could not criticise the manager or staff. They work hard to provide a decent service”; “I’ve no doubt about it. Mrs Glover [Manager] is very attentive and if I had to complain she would sort it for me” and “I would speak to Anne [Manager] if I had a problem or complaint. Anne is reliable and would get to the bottom of an issue.” Connell Court DS0000005346.V280333.R01.S.doc Version 5.1 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 the following standard(s): 19 The standard of the environment within this home is good, providing residents with an attractive and homely place to live. EVIDENCE: A five-year maintenance plan had been developed, to ensure the home received ongoing maintenance, refurbishment and investment as required. Since the last visit, two rooms had received new carpets and two had been fitted with new curtains. Furthermore, one room had been fitted with new furniture. Health and Safety checks continued to be completed by an Assistant Manager and the home’s maintenance person every two months. A record of jobs requiring attention by the maintenance person was in place. At the time of the visit, some flags were in need of attention in the garden area, as they were uneven and presented a potential trip hazard. The maintenance person was responsible for general and garden maintenance. Contractors were used for major work as and when required. Connell Court DS0000005346.V280333.R01.S.doc Version 5.1 Page 15 Overall, areas viewed during the visit were accessible and maintained to a good standard. One resident said; “I think they look after the home very well.” Likewise, another resident stated; “The home is lovely. We’ve had a new fire place fitted.” Connell Court DS0000005346.V280333.R01.S.doc Version 5.1 Page 16 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28, 29 and 30 The welfare of residents was protected via the home’s recruitment procedures and practice. Some staff had not received all the necessary training, to ensure competency in their role. EVIDENCE: Following the last inspection, the manager had made arrangements to obtain a second reference for a member of staff - as there was only one reference on file for the employee at the last inspection. Furthermore, arrangements had been made for the Registered Provider’s head office to manage the administration of Protection of Vulnerable Adults (POVA) and Criminal Record Bureau (CRB) checks for staff. The home had a corporate recruitment procedure in place. Four members of staff had commenced employment at the home since the last visit. Preemployment checks had been completed for each member of staff and all records required under the Care Home Regulations were in place. Discussion with staff and examination of records confirmed that staff completed in-house induction training and had access to a range of training during their employment. The manager reported that the home employed 28 care staff. This figure consisted of: three assistant managers; 1 senior care assistant; 14 day care assistants and 10 night care assistants. Connell Court DS0000005346.V280333.R01.S.doc Version 5.1 Page 17 Records showed that thirteen staff had completed a National Vocational Qualification (NVQ) at level 2 or above (46.42 ). An additional three members of staff were studying the award. The manager had established a new training file which included: a training matrix for day and night staff; a record of training completed by staff and copies of certificates obtained. Records showed that the majority of safe working practice training was up-to-date, however a number of staff required infection control and first aid training. Connell Court DS0000005346.V280333.R01.S.doc Version 5.1 Page 18 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 and 33 The home operated an ongoing programme of self-review and consultations, which includes seeking the views of the people living in the home. EVIDENCE: The manager (Mrs Anne Glover) was registered with the Commission for Social care Inspection and had managed Connell Court since approximately June 2000. Mrs Glover had attained the National Vocational Qualification (NVQ) in Management at level 4 and had registered to undertake an additional 4 units, to gain the Registered Managers Award. Records showed that the manager had completed a range of training that was relevant to the care of older people. There were clear lines of accountability both within the home and to senior management. Staff and residents interviewed during the visit complimented the manager and the lifestyle experienced in the home. For example, a staff member said;
Connell Court DS0000005346.V280333.R01.S.doc Version 5.1 Page 19 “Anne is really nice and caring. You can talk to her.” Likewise, comments from two residents included: “Anne is a very efficient, approachable and reliable manager” and “There is a good atmosphere in the home and I appreciate the spiritual side of the care provided.” Minutes were available for ‘Resident Forum Meetings’, which were organised every three to four months. Residents spoken with confirmed that the meetings were informative and useful. For example, a resident said; “We have a residents forum meeting during which the residents are encouraged to speak and express their views”. Similarly, another resident said; “They have a residents meeting every few weeks and you are kept up-to-date and consulted on issues.” The home commissioned an external organisation to undertake a quality audit each year and had developed an internal quality assurance system and quality standards manual. The internal quality assurance system involved distributing questionnaires to residents on an annual basis, the results of which were collated and published by head office for people to view. An action plan had been developed by the manager to address any issues of concern. A suggestion box had also been placed in the reception area, to enable residents to share their views in confidence. Connell Court DS0000005346.V280333.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X X X STAFFING Standard No Score 27 X 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X X Connell Court DS0000005346.V280333.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP30 Regulation 18 Requirement Infection Control and First Aid training must be completed by all staff. Timescale for action 30/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP7 OP19 OP28 Good Practice Recommendations All sections of the care plan should be kept under monthly review. The uneven flags in the garden should be made level. 50 of the care staff should have a National Vocational Qualification (NVQ) in Care at level 2 or equivalent. Connell Court DS0000005346.V280333.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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