Inspection on 14/08/06 for Connolly House

This inspection was carried out on 14th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Connolly House 20/12/05

Connolly House 08/09/05

Connolly House 28/02/05

Connolly House 17/11/04

Similar services:

Eastwood

Farmborough Court

Falstone Court Nursing Home

Craghall Residential Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Connolly House Reynolds Avenue Whiteleas Estate South Shields Tyne and Wear NE34 8JP Lead Inspector Deborah Haugh Key Unannounced Inspection 14th August 2006 09:30 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 Connolly House DS0000037959.V294676.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. Connolly House DS0000037959.V294676.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Connolly House Address Reynolds Avenue Whiteleas Estate South Shields Tyne and Wear NE34 8JP 0191 5361527 0191 5361527 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) South Tyneside MBC Eileen Foster Care Home 36 Category(ies) of Dementia - over 65 years of age (36), Learning registration, with number disability (1) of places Connolly House DS0000037959.V294676.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service may from time to time admit persons between the ages of 60 and 65 years of age with Dementia. The LD service user category relates to a service user presently residing at Connolly House. Date of last inspection Brief Description of the Service: Connolly House is a purpose built home situated in the centre of a housing estate. It is close to all local amenities and forms part of the local community. Next-door is a Local Authority Day Centre where service users have the opportunity to meet people, maintain links with the local community and join in with a wide range of activities should they wish. The home, owned by South Tyneside Local Authority has undergone recent variation to service user categories. It provides 36 places for Dementia over 65 years of age. The home does not provide nursing care. The home is divided into 4 wings (living areas). Wing 1 offers permanent care to 6 older people and also includes 3 beds for short break services. Making a total of 9 beds. Wing 2 consists of 9 beds which provide permanent care to service users with a diagnosed dementia. Wings 3 & 4 offers permanent accommodation to 18 service users who have a dementia type illness. A central independent area of the home provides a day care service for a maximum of 12 persons over a 7day period and this is operated in partnership with the Alzheimers Society. All of the units are self-contained with lounges, small conservatories dining rooms, kitchenettes, bathrooms toilets and garden areas. There is a large reception area and separate smoking lounge with an activities area. Centrally are the kitchen and laundry facilities. The current fees charged per week are between £94.45 and £408.79. Connolly House DS0000037959.V294676.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The un-announced inspection took place on 14/08/06 from 9.30am until 5pm by Deborah Haugh, Inspector. There were 33 residents living at the home. The home’s Registered Manager Eileen Foster was on duty during the visit. The homes Residential Services Manager Dave Joplin was also present. Time was spent looking around the home to check the cleanliness, maintenance and decoration. Time was also spent observing the contact between the residents and staff. Visitors were seen to freely come and go. Residents completed five questionnaires. Relatives/visitors completed five questionnaires. Residents, visitors and staff were spoken with. Three Care Plans were examined. Arrangements for the administration and management of medication were checked. Health and safety arrangements were examined as well as the catering, recruitment, protection of vulnerable adults (POVA) residents finances, training and complaints. What the service does well: Some of the residents and relatives shared their views of the home and these included. - ‘I had no worries coming here. I go to bed and get up when I want. Lovely carers, I like the girls.’ - ‘ X went to great lengths to ensure we had all the information regarding Connolly House. They also took great care in assessing X to ensure they could meet her needs.’ - ‘The Christmas lunch and afternoon party with entertainment was lovely. The staff put in a great deal of work. Everyone enjoyed themselves.’ - ‘A lovely Christmas party all the family was made to feel most welcome.’ - ‘If something is not right you can always talk to members of staff and they deal with it straight away.’ - ‘Staff are very helpful and understanding to our needs.’ - ‘The staff are very friendly and always take time to chat and help you with any advice they can.’ - ‘Cannot speak highly enough of the home. The food is lovely and it is always spotless. If I could give 200 I would.’ Staff demonstrated their knowledge of the needs of the residents and a commitment to improving the service provided at Connolly House. Connolly House DS0000037959.V294676.R01.S.doc Version 5.2 Page 6 The catering arrangements are good and the cook ensures that residents are satisfied with the food provided. The atmosphere is homely in the four smaller living areas. There are plans to develop the sensory and tranquil garden areas. 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. Connolly House DS0000037959.V294676.R01.S.doc Version 5.2 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 Connolly House DS0000037959.V294676.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The home ensures that it can meet the needs of residents as their needs are assessed prior to admission. However accredited assessment tools are not used. EVIDENCE: Three records were examined and residents are only admitted following a care manager’s assessment and the home completes their own assessments. The home has developed their own admission tool, which looks at activities of daily living. However accredited tools are not used to assess people’s needs. (See NMS 7). Service users and relatives felt satisfied that their admission was thorough and that they were involved and consulted. Connolly House DS0000037959.V294676.R01.S.doc Version 5.2 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): 7-10 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Residents’ social and health care needs are regularly assessed, care planned and reviewed, ensuring that their care needs continue to be met. However accredited assessment tools are not used. Residents are protected by the home’s medication recording system but some areas must improve. There are practices to make sure resident privacy and dignity is maintained but one area must be addressed. EVIDENCE: The care plans have continued to develop and good progress has been made. Three care plans were examined. They were clear, evaluated and reviewed. The home does not use accredited assessment tools for identifying and meeting people’s needs. These assessment tools identify people who may be Connolly House DS0000037959.V294676.R01.S.doc Version 5.2 Page 10 at risk of pressure sores, nutritional risk, mental health and dependency levels. The inspector provided more information regarding the tools. Care plans identify resident’s preferences and residents and relatives said that staff know them well and their needs. An audit of the medication arrangements was completed in the presence of the deputy manager. The home has good support from the pharmacist and Primary Care Trust. Some areas must be addressed and these include - Obtaining a current copy of the British National Formula (BNF) - Handwritten entries to Medication Administration Records (MAR) must have 2 signatures. - Creams/ointments must be recorded on MAR and dated when opened. The home provides respite care for a number of people and it is strongly recommended that photographs for identifying residents when administering medication be placed on medication records. Residents are supported to administer their own medication if able and suitable secure storage is provided. Residents feel that they are treated with respect and their right to privacy is upheld. Residents spoke about their personal wishes and preferences, which are respected by staff and documented. Examples include locking their bedroom doors, not being checked by staff during the night unless requested, receiving private telephone calls and being addressed by their preferred name. The laundry arrangements ensure that people wear their own clothes but the arrangements to prevent people sharing hosiery items was not robust. The home should consider using delicate bags for hosiery. Connolly House DS0000037959.V294676.R01.S.doc Version 5.2 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): 12-15 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The residents are able to follow their own daily routines, which satisfy their social and religious needs, and there are opportunities to take part in social activities on a daily basis. Friendships and relationships with people outside the home are encouraged and this ensures that residents are able to maintain good contact with relatives and friends. Residents are able to take control over their own lives and where this is not possible risk assessments are in place. Residents enjoy a nutritious and wholesome diet. EVIDENCE: Individual care plans identify resident’s interests and how they wish to spend their time in the home. Residents are involved in choosing whether they want to take part in activities. A range of activities was on offer, which varied from dominoes, reminiscence, baking, listening to music and watching an old style film on television. Due to the level of dementia that residents experience not Connolly House DS0000037959.V294676.R01.S.doc Version 5.2 Page 12 everyone is able to make a choice so staff use information collected as part of the assessment process to determine what they would like to do. The Local Authority intends to provide an activities co-ordinator to their four residential care homes to provide activities and advice to staff starting in September 2006. There are no restrictions on visiting the home and throughout the inspection there was a steady stream of visitors to the home. All questionnaires indicated that visitors are made welcome and people can visit in private. A four week menu is provided to residents and there at least two choices at each meal. The manager and the cook have worked hard to produce a menu which people will enjoy but also demonstrates a nutritionally balanced diet. Snacks, supper and breakfast details are now included. The lunchtime meal was relaxed and conducive to people enjoying their food. Visitors are welcome to join residents for meals. Staff were helpful and supportive to people who needed help. Connolly House DS0000037959.V294676.R01.S.doc Version 5.2 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 & 18 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The home deals appropriately with complaints ensuring that they are taken seriously and service users listened to. There are procedures to protect residents from abuse. EVIDENCE: There have been no complaints since the last inspection in December 2005. Resident and relative questionnaires indicated that they knew who to speak to if they were unhappy. The policy and procedure for making a complaint is available in the entrance. The home has policies and procedures for the protection of vulnerable adults, prevention of abuse and whistle blowing (informing on bad practice). Staff were able to describe in practice the Whistle Blowing Policy. Staff are provided with relevant training. The home deals appropriately with allegations of abuse. Connolly House DS0000037959.V294676.R01.S.doc Version 5.2 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): 19,25 & 26 Quality in this outcome area is adequate. This judgment has been made from evidence gathered both during and before the visit to this service. The premises are suitable for the needs of residents but some areas require improvement. EVIDENCE: All communal lounges and dining rooms are clean and tidy and furnished to a good standard. Lighting which was also commented on in previous inspection reports has not been fully completed by the estates department. Though some improved lighting has been provided to the front of the home and also in the day centre. Specialist equipment is available for those resident’s who have been assessed as requiring it. The home has sought advice from the public health officer and has implemented a set of procedures to be used by staff as a way of controlling infection. However paper towels and liquid soap are not always available in WC’s and bathrooms. There were odours in the corridor and WCs. The home should consider double bagging continence pads to reduce odours Connolly House DS0000037959.V294676.R01.S.doc Version 5.2 Page 15 and also consider providing plastic coated pull cords to light switches in WC’s and bathrooms for ease of cleaning. The kitchen units in smaller living areas are damaged due to wear and tear. The Residential Services Manager said that there are plans to improve the kitchens. Bedrooms are spacious and homely. Permanent residents have decorated their rooms with keepsakes, photographs and artwork. People are able to bring their own possessions with them. The two enclosed gardens are being developed into tranquillity and sensory gardens. These will be peaceful and secure areas for residents and visitors once they are complete. Connolly House DS0000037959.V294676.R01.S.doc Version 5.2 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): 27-30 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. There are good staffing levels to meet the needs of the number of residents. The recruitment process is robust and protects residents. Staff are provided with a range of training relevant to their work with older people, including care qualifications but training records must be updated. EVIDENCE: At the time of the inspection there was 33 residents. There is suitable care staffing levels of 8 carers in the morning, 7 carers in the afternoons and evening and 3 carers at night. There is always at least one senior member of staff on duty through the waking day and a senior sleeps-in the building at night. Weekly catering, domestic and laundry staffing hours were satisfactory. Five weeks of staffing rotas were examined and satisfactory cover was provided. Connolly House DS0000037959.V294676.R01.S.doc Version 5.2 Page 17 No new staff have been appointed since the last inspection. Staff recruitment records were examined. Records for recruitement are satisfactory. Staff do not start work until Criminal Records Bureau (CRB) and Protection of Vulnerble Adults (POVA) checks are cleared. Two references are sought and provided. Details of all training courses and certificates were not up to date. Staff have received training in dementia, stoma care, values and attitudes, infection control, depression, moving and handling, nutrition and first aid. Staff will also have training in POVA and complaints. Care staff have either completed NVQ qualifications or are in the process of studying. The basic standard is for 50 of staff to have achieved NVQ Level 2 or above by 2005. The current level in the home is 85 , which is commendable. Connolly House DS0000037959.V294676.R01.S.doc Version 5.2 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): 31,33,35,36, 37 & 38 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The home has a very experienced Manager who provides clear leadership. Quality assurance systems are in place to ensure that residents receive the service they want. The home ensures that service users finances, which are looked after by them are protected. Staff are appropriately supervised which assists in promoting and safeguarding the best interests of the resident’s. Some records are not in place, which may affect service users. Routine servicing and maintenance checks are completed. Connolly House DS0000037959.V294676.R01.S.doc Version 5.2 Page 19 EVIDENCE: The Registered Manager is a very experienced qualified Registered Social Worker with a Masters Degree in Social Work and Social Welfare. She is a Practice Teacher for student social workers, an NVQ Assessor and has completed the Registered Manager’s Award. She also has over 16 years management experience. People spoke of their confidence in the manager and her team. Examination of the homes quality assurance file confirmed that systems are in place, which are aimed at continually improving the service. Lay visitors have been introduced by the authority and they carry out monitoring visits to the home and comment on the services being offered as part of an external quality control measure. The home is also monitored by the authority’s contracting department to ensure that standards are maintained. Resident’s personal finance records were examined. A record is maintained for each person’s transactions. Entries were suitably recorded with two signatures and numbered receipts. There was evidence of personal spending. Spot checks of balances and cash were found to be correct. Staff receive supervision with management to discuss their performance and training needs. Each staff member has a performance development plan. Records regarding staff training and employment details are incomplete and resident photographs must be placed on their records. Maintenance and service checks are in place. Fire safety records are mainatined. Records of accidents are maintained and the Manager carries out periodic accident analysis. Connolly House DS0000037959.V294676.R01.S.doc Version 5.2 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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 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 2 X X X X X 2 2 STAFFING Standard No Score 27 3 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 2 3 Connolly House DS0000037959.V294676.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? YES 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 OP7 OP8 OP3 Regulation 15 Requirement The registered person must ensure that accredited assessment tools support arrangements for identifying and meeting people’s needs. The registered person must ensure that the following medication areas are addressed; - Obtain current BNF - Handwritten entries to MAR must have 2 signatures. - Creams/ointments must be recorded on MAR and dated when opened. The registered person must ensure that - paper towels and liquid soap are always available in WCs and bathrooms. - odours in the home are managed. The upgrading of the lighting in communal areas must continue. (Outstanding since 08/09/05) The registered person must ensure that kitchen units in smaller living areas are DS0000037959.V294676.R01.S.doc Timescale for action 30/11/06 2. OP9 13(2) 14/08/06 3. OP26 16(2) 14/08/06 4. OP25 13 (4) C 31/12/06 5. OP19 23(2) 01/01/07 Connolly House Version 5.2 Page 22 6. OP37 OP30 17 schedule 2, 3 & 4 repaired/replaced The registered person must ensure that records for all persons employed include their start date, position, number of hours, and training. Provide a photograph for all service users. 30/09/06 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 OP9 OP26 OP10 Good Practice Recommendations Consider photographs for identifying residents when administering medication. Consider double bagging continence pads. Consider providing plastic coated pull cords to light switches in wc’s and bathrooms. Consider using delicate bags for hosiery. Connolly House DS0000037959.V294676.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT National Enquiry Line: 0845 015 0120 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 Connolly House DS0000037959.V294676.R01.S.doc Version 5.2 Page 24 - 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. 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