CARE HOMES FOR OLDER PEOPLE
Connolly House Reynolds Avenue Whiteleas Estate South Shields, Tyne and Wear NE34 8JP Lead Inspector
Clifford Renwick Unannounced 8 September 2005 10:00 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. Connolly House B52-B02 S37959 Connolly House V219587 080905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Connolly House Address Renolds Avenue Whiteleas Estate South Shields Tyne and Wear NE33 8JP 0191 5361527 0191 5361527 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) South Tyneside MBC Eileen Foster Care Home 36 Category(ies) of OP Old Age (36) registration, with number DE(E) Dementia over 65 (18) of places PD Physical Disability (1) Connolly House B52-B02 S37959 Connolly House V219587 080905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1 The service may from time-to-time admit persons between the ages of 60 and 65 years of age Date of last inspection 28 February 2005 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 18 places for Dementia over 65 years of age and 18 places for Older Persons. 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 and is currently unoccupied and it is the intention of the authority to use this wing to 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 7- day period and this is operated in partnership with the Alzheimer’s 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. Connolly House B52-B02 S37959 Connolly House V219587 080905 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 6 hours and was carried out as part of the statutory twice-yearly inspection process. All communal areas of the premises were viewed and care records were examined as well as records that related to health and safety and new staff employed in the home. Discussion took place with the staff on duty and also with 6 residents and families who were visiting the home at the time of the inspection. Time was spent observing staff practices. The judgements made are based on the evidence available on the day of the inspection. What the service does well: What has improved since the last inspection?
The Statement of Purpose and Homes brochure has been completed and this contains photographs and a range of information about the services provided in the home. A condensed version of this is available as a service users guide and is available to those persons expressing an interest into moving into the home. The individual contracts/terms and conditions of residence for residents have been improved and a copy has been issued to each resident. The homes assessment process, which is used to determine whether someone can be admitted to the home, is much improved and more thorough and this ensures that only residents whose needs can be met are admitted to the home. Care plans which set out in written form how individual care will be provided to residents are improving and being developed by the staff team. Work has been carried out to make the complaints process more clear and a copy is on display in the entrance lobby which informs everyone of the
Connolly House B52-B02 S37959 Connolly House V219587 080905 Stage 4.doc Version 1.40 Page 6 complaints procedure. Quality assurance systems are in place and which also incorporate external \monitoring processes to ensure that the services offered are continually improved. The acting manager has recently completed the registered managers award. 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 B52-B02 S37959 Connolly House V219587 080905 Stage 4.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 Connolly House B52-B02 S37959 Connolly House V219587 080905 Stage 4.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) 1, 2, 3, 4 A range of information is available which enables residents to make a fully informed choice about where they would like to live. Each resident is issued with a contract of their terms and conditions of residency and this confirms the type of service they will receive in the home. Positive practices are in place which ensure that no one moves into the home until an assessment of needs has taken place and the home confirms in writing that peoples needs can be met in the home. EVIDENCE: The Statement of Purpose and Service User Guide, which were available for examination includes a range of information about the services, provided in the home and a copy is given to prospective residents and their families prior to admission. These documents also include a range of colour photographs of different rooms in the home in order to provide information of what facilities are available in the home. Each resident is issued with a copy of his or her individual terms and conditions of residence at the point of admission into the home. Families/ representatives
Connolly House B52-B02 S37959 Connolly House V219587 080905 Stage 4.doc Version 1.40 Page 9 as well as the individual resident are encouraged to sign this document confirming that they are satisfied with the terms and conditions of residence. Discussion with staff and examination of case files confirmed that no one is admitted to the home without an updated assessment being completed and accompanied by a care plan when referrals are made by the social worker. The homes staff also carries out their own assessment and this takes place during a visit to the prospective resident in their own home or wherever they are residing at the time. Connolly House B52-B02 S37959 Connolly House V219587 080905 Stage 4.doc Version 1.40 Page 10 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 Residents care plans are in place and are being developed to reflect their individual assessed needs. Service users’ health care needs have mostly been identified, areas such as pressure care and falls prevention have been addressed and these are being addressed in the care plans. EVIDENCE: Discussion took place with management staff during the visit and case files for 3 residents were examined. The care plan format and assessment documentation which is in use is new and being developed by staff in order to demonstrate how individual residents assessed needs are being met by staff in the home. This new format was discussed and it was clear that staff saw these as a positive development with the service and as such was keen to put them in place for every resident in the home. An assessment document, which had been completed for a prospective admission, was viewed and this was satisfactory and comprehensive and included a good range of information to assist staff with meeting individual needs. It was agreed that these would be focused upon in the next inspection.
Connolly House B52-B02 S37959 Connolly House V219587 080905 Stage 4.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) 15 The meals provided offer a good balanced diet which contributes to the promotion of healthy eating and service users are involved menu planning. EVIDENCE: Lunch was taken with the residents in one of the small dining rooms and this was a pleasurable experience. Menus were on display on the table to inform residents of the meals available and two choices were evident for both the main course and the dessert. The meal was piping hot, well presented, sufficient in quantity and very tasty. Discussions with the residents confirmed that they enjoyed the meals in the home and that there was always sufficient to eat. Discussion also took place with the cook during the meal who confirmed that she is in the process of changing menus to include a greater range of foods that can be eaten buffet style (finger foods) as well as reviewing the amount of dishes which contain pastry in order to assist residents with a healthy eating lifestyle. It was positive to see individual teapots on each table as well as condiments and table cloth’s, which contributed to the enjoyment of the meal. Connolly House B52-B02 S37959 Connolly House V219587 080905 Stage 4.doc Version 1.40 Page 12 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 in the home are handled objectively and openly with the manager and staff encouraging residents, their friends and families to offer comment on the services that are offered. Residents are confident that any complaints made would be acted upon. Robust procedures are also in place, which ensure that residents are protected from abuse. EVIDENCE: The complaints procedure is on display in the entrance lobby to the home as well as being included in the service user guide. Discussions with residents confirmed that they had no complaints. Policies and procedures are in place, which deals with the protection of vulnerable adults, and an incident was dealt with as a result of a complaint earlier in the year using these procedures. The investigation findings were that most areas of the complaint were unfounded but two aspects of the complaint confirmed that there had been some shortfalls in the admission process and the assessment obtained prior to the admission. As a result immediate changes were made by staff in the home in relation to the admission process and also the assessment document in use. These changes have ensured that residents continue to be protected. Connolly House B52-B02 S37959 Connolly House V219587 080905 Stage 4.doc Version 1.40 Page 13 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, 21, 22, 25 The home is clean, warm and well maintained offering residents a homely and safe environment in which to live. Resident’s bedrooms, communal areas and bathing/WC facilities are accessible to meet resident’s mobility needs. Specialist equipment is available to maximise resident’s independence. The lighting in some communal areas is poor and consequently could have an impact on those service users who have a visual impairment. EVIDENCE: One bathroom has had an assisted bathing facility removed and is to be fitted with a newer unit in order to ensure that assisted bathing facilities are available to all residents. Orders have been placed for hearing loop systems for all lounges used by the residents and this will assist those residents who have a hearing impairment. A number of bedrooms have been decorated and plans are in place for the lounge on “Wing” two to be decorated. All communal areas of the home were viewed and these were fitted with a good range of comfortable furniture. As identified at the previous inspection lighting in the communal areas was going to be improved with work due to commence in
Connolly House B52-B02 S37959 Connolly House V219587 080905 Stage 4.doc Version 1.40 Page 14 April 2005. Work has not yet commenced on improving the lighting. In addition to this work is still required in the bathrooms with regards to the exposed pipe work. Connolly House B52-B02 S37959 Connolly House V219587 080905 Stage 4.doc Version 1.40 Page 15 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 The deployment and number of staff on all shifts is appropriate to ensure that at all times service users are supported by an experienced group of staff. The staff recruitment procedures protect the residents. A well-trained staff team meets the resident’s needs. EVIDENCE: A number of staff has commenced work in the home having been redeployed from another of the authorities homes, which has closed. This has resulted in an increase in staffing numbers. In addition to this three new staff have been employed to carry out personal care. Staffing files are being compiled to ensure that all information as required by regulation is held in the home as opposed to being held by the authorities personnel department. Examination of some staffing files confirmed that not all documentation was in place but requests had been made to obtain this from the personnel department. Induction training has been completed for all new staff including the staff that has transferred from other homes. There is a positive commitment towards staff training and a training file was available which confirms forthcoming training courses for staff. The manager has also identified future training needs for staff that have recently commenced work in the home. Connolly House B52-B02 S37959 Connolly House V219587 080905 Stage 4.doc Version 1.40 Page 16 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) 31, 33, 38 Staff are appropriately supervised which assists in promoting and safeguarding the best interests of the resident’s. The resident’s health and safety is promoted by a well managed home. However, there are some areas of potential risk to resident’s safety, which need to be addressed. EVIDENCE: The manager has recently returned from long-term sick leave and is working three days per week as part of a phased introduction to work. An acting manager is also in post and who has responsibility for the day-to-day management of the service and who is supported by a senior team of staff. Examination of the homes quality assurance file confirmed that systems are in place, which is aimed at continually improving the service. Lay visitors have been introduced by the authority and these carry out monitoring visits to the
Connolly House B52-B02 S37959 Connolly House V219587 080905 Stage 4.doc Version 1.40 Page 17 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. There were no identifiable hazards in the home other than the pipe work in bathrooms, which requires boxing off in order to prevent the risk of burns to residents. The manager is aware of this and is taking steps through the authority’s internal reporting procedures to have this matter rectified. Connolly House B52-B02 S37959 Connolly House V219587 080905 Stage 4.doc Version 1.40 Page 18 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 3 3 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3
COMPLAINTS AND PROTECTION 2 x 3 2 x x 3 x STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x x x x 3 Connolly House B52-B02 S37959 Connolly House V219587 080905 Stage 4.doc Version 1.40 Page 19 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 7 21 Regulation 15 23 Requirement Care plans must continue to be developed as advised during the inspection. An assisted bath must be installed to replace the condemned bath which was removed Communication aids such as a hearing loop must be provided to assist those residents with a hearing impairment. Exposed pipe work must be boxed in order to prevent the risk of scalding. Timescale for action 31.03.06 30.10.05 3. 22 22 4. 25 23 5. 6. 25 29 13 (4) C 7, 9, 19 & Schedule 2 The upgrading of the lighting in communal areas must continue. Individual staff files must contain 30.11.05 all information as required by regulation. 31.12.05 (Outstandi ng since 28.02.05) Immediate (Outstandi ng since 28.02.050 Ongoing 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.
Connolly House B52-B02 S37959 Connolly House V219587 080905 Stage 4.doc Version 1.40 Page 20 Refer to Standard Good Practice Recommendations Connolly House B52-B02 S37959 Connolly House V219587 080905 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Baltic House Port of Tyne South Shields Tyne and Wear NE34 9PT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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