Care Home: Connell Court

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• Chirnside House
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What the care home does well Connell Court had continued to receive ongoing investment since the last visit and areas viewed were found to be warm, clean and homely. Health and Safety audits continued to be undertaken by the manager and senior staff to monitor the condition of the environment to ensure it was safe and appropriately maintained. Staff spoken with confirmed they had access to a range of training and development opportunities and demonstrated a good understanding of the needs of the people they cared for and how to provide person centred care. Throughout the inspection staff were observed to communicate and engage with residents in a respectful and caring manner and feedback from residents confirmed their support needs were fully met and that they felt valued. Comments received included: "The staff are kind, caring and very responsive"; "I have always been treated and cared for very well" and "In my opinion the standard of care is excellent. The manager and her staff genuinely care". Another resident stated; "I recommend it [Connell Court] to everyone - even the taxi drivers." Information had been produced in the form of a Statement of Purpose and Service User Guide to provide prospective residents and their representatives with key information on the service. Likewise, assessment and care planning systems had been developed to ensure the health, personal and social care needs of residents were identified, risk assessed and planned for. Daily life, social activities and meals continued to be well managed offering residents choice and control over their lives. The registered provider continued to employ staff to plan and coordinate a range of person-centred activities and feedback received from residents was good. Comments included:"There is a good variety of activities and entertainment. No-one gets bored here as there is plenty of stimulation"; "Happy atmosphere"; "Bebe [Activities coordinator] offers a good range of social activities" and "I am satisfied with all the care and entertainment provided." The service continued to provide a choice of nutritious and wholesome meals based upon a four-week rolling menu. Meals were served in the home`s dining room which was decorated, furnished and equipped to a high standard. Comments regarding the standard of meals remained good and were as follows: "The standard of catering is first class"; "We get a choice of meals and the menu is varied" and "The food provided is always nicely presented and very tasty." Systems had been established to ensure an appropriate response to complaints and to safeguard the welfare of the people using the service. Records confirmed that any concerns or complaints received had been acted upon and no issues of concern were noted during the visit. Feedback from residents included: "I have no complaints"; "I`m very satisfied and happy" and "A very good home. Well run. No problems". A programme of quality assurance, self review and consultation with residents remained in place as noted at the last visit and a range of policies and procedures had been developed to ensure best practice. What has improved since the last inspection? Since the last inspection arrangements had been made for the fire extinguishers to be visually inspected on a monthly basis. The home had continued to receive ongoing investment in order to improve the environment for residents. For example, the electrical wiring installation had undergone a full review and a new fire alarm and nurse call system had been installed. Furthermore, new lighting had been fitted in all corridors and hallways; the hallway had been redesigned; new carpet had been fitted in the lounge, dining room, hallways and several bedrooms; the chairs in the lounge had been replaced; the kitchen had been refurbished and the dining room and several communal and bedroom areas had been redecorated. Staff continued to have access to a range of training and development opportunities relevant to their role and good progress has been made in supporting the majority of the care staff to successfully complete a National Vocational Qualification in Care. What the care home could do better: The Statement of Purpose and Service User Guide should be updated and reference to the Commission for Social Care Inspection should be replaced with the Care Quality Commission. This will ensure that people have access to correct information on the regulator. Information on ethnicity and gender should be obtained (whenever possible) as part of the assessment process to ensure equality and diversity issues are identified and acted upon. Staff responsible for writing support plans should receive further guidance on the key information that should be included. This will help to ensure that plans describe in more detail the support required from staff and to clarify outcomes. The manager should complete a National Vocational Qualification in Care at level 4 to ensure she has the necessary qualifications for her role. Furthermore, the training matrix should be updated to include the full range of training completed by the manager and action should be taken to complete any outstanding mandatory training. Day staff should receive fire instruction training every six months and night staff every three months as recommended by the fire service to ensure an appropriate response in the event of the outbreak of a fire. Action should be taken to ensure the fire alarm system is always tested on a weekly basis to safeguard the health and safety of the people using the service. Key inspection report Care homes for older people Name: Address: Connell Court 20 Weld Road Southport Merseyside PR8 2DL     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Daniel Hamilton     Date: 0 8 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Connell Court 20 Weld Road Southport Merseyside PR8 2DL 01704560651 01704551983 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.mha.org.uk Methodist Homes for the Aged care home 37 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 37 Date of last inspection Brief description of the care home Connell Court is owned by Methodist Homes for the Aged, a national charity. The home is registered to provide personal care and support for up to 37 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 Care Homes for Older People Page 4 of 30 Over 65 37 0 Brief description of the care home visitors. There is a large, well-kept garden and a car park area to the rear of the building. Information on the service is available in the form of a Statement of Purpose and Service User Guide. Copies of the documents are available in the reception area of the home or can be obtained from the manager. The weekly care home fees range from £475.00 to £552.00 per week. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 star. This means the people who use the service experience excellent quality outcomes. This unannounced inspection took place over one day and lasted approximately 9 hours. Thirty-six residents were being accommodated at this time. A site visit took place as part of the unannounced inspection and a partial tour was conducted of the premises. A number of the homes care, staff and health and safety records were viewed. Discussion also took place with the registered manager, three assistant managers, three care staff and eight residents. During the inspection four residents were case tracked (their care files were examined and their views of the home obtained). This process was not carried out to the detriment of other residents who also took part in the inspection process. Care Homes for Older People Page 6 of 30 Reference was also made to an Annual Quality Assurance Assessment (AQAA) which was completed by the registered manager. This document enables a registered person to undertake a self-assessment on the service, prior to an inspection. Survey forms were also distributed to a number of residents and staff before the inspection. Comments included in the report are taken from the survey forms and through discussions with residents during the visit. All the key standards were inspected and action taken in response to recommendations made at the last inspection in March 2007 reviewed. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? Care Homes for Older People Page 8 of 30 Since the last inspection arrangements had been made for the fire extinguishers to be visually inspected on a monthly basis. The home had continued to receive ongoing investment in order to improve the environment for residents. For example, the electrical wiring installation had undergone a full review and a new fire alarm and nurse call system had been installed. Furthermore, new lighting had been fitted in all corridors and hallways; the hallway had been redesigned; new carpet had been fitted in the lounge, dining room, hallways and several bedrooms; the chairs in the lounge had been replaced; the kitchen had been refurbished and the dining room and several communal and bedroom areas had been redecorated. Staff continued to have access to a range of training and development opportunities relevant to their role and good progress has been made in supporting the majority of the care staff to successfully complete a National Vocational Qualification in Care. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given information and have their needs assessed before deciding whether to move into Connell Court. This enables the service to identify needs and to determine whether care needs can be met. Evidence: A Statement of Purpose and Service User Guide had been developed in a standard format to provide information on Connell Court for prospective and current residents and their representatives to view. At the time of the visit the document needed to be updated as some of the text referred to the name of the previous regulator (Commission for Social Care Inspection). The registered manager confirmed that the Service User Guide could be produced in alternative formats and languages subject to the individual needs of the people using the service. Feedback received from residents and their representatives via care home surveys and discussion confirmed people had generally received information on the Care Homes for Older People Page 11 of 30 Evidence: home and a contract, which outlined terms and conditions of residency. Information received from the registered manager via an Annual Quality Assurance Assessment confirmed policies and procedures were in place for referral and admission and the manager reported that herself and / or senior staff remained responsible for undertaking assessments to identify the needs of prospective residents. Residents spoken with also confirmed that they were encouraged to visit Connell Court and spend time in the home prior to deciding whether to move in. Four of the residents files were viewed during the visit. Two files were for residents who had moved into Connell Court in the last 12 months and two were for residents who had lived in the home for over three years. Each was found to contain a copy of a Domiciliary Pre-Admission Assessment and an Admission Assessment Summary. The assessments had been designed to enable staff to undertake a comprehensive assessment of the physical, health and social care needs of the people using the service. The manager was recommended to also gather information on the gender and ethnicity of prospective residents as this information had not been recorded. Previous inspections have confirmed that assessments completed by social and / or health workers are also obtained by the home when available. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care of the people who live at Connell Court is well managed. This ensures residents receive the care and support they need in the way they prefer. Evidence: The Annual Quality Assurance Assessment for Connell Court confirmed the Registered Provider had policies and procedures in place covering Individual Planning and Review and the Control, Storage, Disposal, Recording and Administration of Medication. The files of four residents were viewed during the visit. Two files were for residents who had moved into Connell Court in the last 12 months and two were for residents who had lived in the home for over three years. As noted at the last inspection, each file viewed was found to contain a Support Plan, which outlined the Identified Needs, Support Required and Support Outcomes for individual residents. Support plans viewed had been kept under monthly review and signed by residents and / or their representatives to confirm their agreement with the plan of care. As Care Homes for Older People Page 13 of 30 Evidence: noted at the last inspection some care plans viewed were in need of additional information to describe in detail the support required from staff and to clarify outcomes. Despite the need for some additional information, care staff spoken with demonstrated a good understanding of the needs of the people they cared for, how to provide person centred care and the value base of social care. Furthermore, feedback received from residents confirmed their support needs were fully met and that they felt valued and were treated with respect and dignity. Comments received included: The staff are kind, caring and very responsive; I have always been treated and cared for very well and In my opinion the standard of care is excellent. The manager and her staff genuinely care. Another resident strated; I recommend it [Connell Court] to everyone - even the taxi drivers. Supporting documentation including risk assessments, personal profiles, daily support plans, personal inventory information and consent forms were also available on residents files and information on equality and diversity issues such as religion, sexuality, cultural and dietary needs had been taken into consideration as part of the care planning process. Feedback received from residents and their representatives via Care Home Survey forms and through discussion confirmed the people living in the home received the medical support they required. Records viewed detailed that residents had received visits from a range of health care practitioners including: District Nurses, opticians, general practitioners, chiropodists, dentist etc subject to individual need. Connell Court had a copy of the registered providers corporate medication policy which acknowledged the right of residents to self-administer their medication. At the time of the visit four residents were self-administering medication and risk assessments, monitoring forms and disclaimers were in place as previously noted. Medication profiles had also been completed to provide information on each residents medication and patient information leaflets had been obtained to provide information and general guidance on prescribed medication. The registered manager confirmed that all staff responsible for the administration of medication had completed training and a record of staff responsible for administering medication, together with sample signatures was available for reference. Medication was checked with an assistant home manager who demonstrated a very thorough understanding of the procedures to follow in regard to the ordering, receipt, safe storage, administration and disposal of medication. The home continued to use a monitored dosage system and medication checked was correctly stored and separate Care Homes for Older People Page 14 of 30 Evidence: storage and recording systems were in place for controlled drugs and medication requiring cold storage. Medication Administration Records (MAR) were completed by staff to account for the administration of medication. All MAR viewed had been correctly completed and provided a good audit trail. Auditing systems were also in place to monitor standards and to safeguard the welfare of residents. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Daily life, social activities and meals are flexible and varied. This enables residents living in Connell Court to exercise choice and control over their lives. Evidence: Two part time Activities Coordinator were employed to organise a range of activities each week based upon the needs, expectations and preferences of residents. A weekly programme of activities was displayed on the notice boards throughout Connell Court, a copy of which was distributed to each resident on a weekly basis together with details of the main menu for the week. The activities coordinator was spoken with during the visit and provided an overview of the activities on offer. Records detailed that residents had participated in a wide variety of in-house and community based activities including: one to one time and seize the day projects; special events; bingo; music to movement; quizzes; coffee mornings; film shows; shop and paper rounds; board games; trips to a local high school, garden centres and for tea dances and visits from outside entertainers etc. Representatives from different religious denominations also visited residents in the home subject to their individual religious beliefs and a general service was coordinated each Sunday for residents to attend. Feedback received from residents on the Care Homes for Older People Page 16 of 30 Evidence: activities provided was positive and included; There is a good variety of activities and entertainment. No-one gets bored here as there is plenty of stimulation; Happy atmosphere; Bebe [Activities coordinator] offers a good range of social activities and I am satisfied with all the care and entertainment provided. One relative reported Provides a welcoming environment. Tries to provide stimulating activities. The dining room looks like a good hotel and the food is excellent. The management are always accessible and responsive. As noted at the previous inspection the activities coordinator demonstrated a very thorough knowledge and understanding of the social, spiritual and recreational needs of the people using the service. Information on each residents likes and dislikes had been recorded for reference and summary reports were completed following activities to record and monitor key information. The Annual Quality Assurance Assessment (AQAA) confirmed the service had a policy on contact with and visits by family and friends. Residents were observed to follow their preferred routines and receive visits from their family and friends throughout the day and residents spoken with reported that the environment remained relaxed and friendly. There were no set visiting times and residents were able to maintain contact with people of their own choice both inside and outside the home. The service continued to provide a choice of meals based upon a four-week rolling menu. A copy of the menu plan was displayed in a booklet in the reception area and a laminated copy of the daily menu was placed on each dining table for residents to view. Mealtimes at Connell Court remain a social occasion. Although meals are generally served in the dining room alternative arrangements can be made to accommodate individual needs upon request. The dining room was pleasantly furnished, spacious and had recently been redecorated and fitted with new carpet. As noted at the last inspection, china crockery was used and tables were furnished with tablecloths, napkins, condiments and flowers. Tea bay areas were also located on each floor to enable residents to prepare light refreshments as and when required. Staff were observed to be available to provide support to residents, subject to their individual needs. Comments on the standard of meals included; The standard of catering is first class; We get a choice of meals and the menu is varied and The food provided is always nicely presented and very tasty. Care Homes for Older People Page 17 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in Connell Court and their relatives understand how to complain and systems are in place to safeguard people from abuse. Evidence: The Annual Quality Assurance Assessment (AQAA) for Connell Court confirmed a corporate concerns and complaints policy was in place as noted at the last visit. A copy of the complaints procedure was displayed in the reception area and on noticeboards throughout Connell Court for people to reference. Likewise, information on how to complain was included in the service user guide and feedback received via care home surveys and discussion confirmed the people using the service and their representatives were aware of how to complain. No complaints or concerns were raised during the inspection process and feedback received from residents confirmed they were generally satisified. For example, comments included: I have no complaints; Im very satisfied and happy and A very good home. Well run. No problems. The AQAA for Connell Court detailed that four complaints had been received from the people using the service or their representatives in the last 12 months of which only one had been upheld. Examination of the complaints log for the service revealed six complaints had been received from residents or their relatives. The complaints concerned a range of issues including medication (1); personal care (2); a bathroom being out of order due to re-tiling (1); transportation to hospital (1) and temperature Care Homes for Older People Page 18 of 30 Evidence: in a bedroom (1). Records showed that four of the complaints had been upheld and that appropriate action had been taken by the manager in response to the complaints. No complaints, concerns or allegations have been received by the Care Quality Commission about Connell Court in the past 12 months. Examination of internal policies and procedures confirmed the service had developed an abuse of Vulnerable Adults and Whistle blowing policies. A copy of the local authoritys safeguarding adults procedure was also in place for staff to reference. The AQAA for Connell Court detailed that there had been no adult protection referrals or investigations in the last 12 months. The registered manager and staff spoken with demonstrated a sound understanding of the different types of abuse, alerting procedures and their their duty of care to protect vulnerable people. Training records viewed confirmed all the staff team had access to ongoing training in the protection of vulnerable adults from abuse. Care Homes for Older People Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Connell Court provides a homely, safe and comfortable environment for residents to live in and this contributes to a good quality of life for residents. Evidence: Two maintenance men were employed by the service on a full-time job share basis to monitor the condition of Connell Court and to undertake minor maintenance tasks. Contractors were also hired as and when necessary to attend to specialised maintenance work and the servicing of equipment. An annual repairs and renewals plan had been developed to ensure Connell Court received ongoing maintenance and refurbishment and health and safety audits were undertaken periodically by the manager and senior staff to monitor the condition of the environment. Weekly room checks were also completed by the domestic staff as part of their duties. Examination of the Annual Quality Assurance Assessment (AQAA) for the service and a partial tour of the premises with the registered manager confirmed the environment had continued to receive ongoing investment and maintenance since the last inspection. For example, the electrical wiring installation had undergone a full review and a new fire alarm and nurse call system had been installed. Furthermore, new lighting had been fitted in all corridors and hallways; the hallway had been Care Homes for Older People Page 20 of 30 Evidence: redesigned; new carpet had been fitted in the lounge, dining room, hallways and several bedrooms; the chairs in the lounge had been replaced; the kitchen had been refurbished and the dining room and several communal and bedroom areas had been redecorated. The service had extensive grounds to the front and rear of the home which were well tended and the location and layout of the home was suitable for its stated purpose (please refer to the Brief Description of the Service section for more information on the premises).Residents were observed to have access to personal mobility aids as required and a hearing loop system was fitted in the lounge. Bedrooms viewed had been personalised with pictures and other memorabilia. The AQAA for Connell Court confirmed that policies and procedures were in place for Communicable Diseases and Infection Control and the Control of Substances Hazardous to Health. The laundry was sited away from food preparation areas and was appropriately equipped. Two domestics and two laundry assistants were employed as previously noted and areas viewed were clean and hygienic. Training records showed that all staff had completed infection control training and areas viewed were clean, tidy and odour free. No issues of concern were received from residents via surveys or discussion about the standard of hygiene in the home. Care Homes for Older People Page 21 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are correctly recruited and have completed the necessary training to undertake their roles effectively. Evidence: 36 residents were living in Connell Court at the time of the visit. Examination of the staffing rota and discussion with the manager confirmed the staffing levels remained the same as per the last inspection. 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 and a sleep-in on duty throughout the night. A number of ancillary staff were also employed. This included two part-time activities coordinators, two cooks, two kitchen assistants and two job share maintenance staff. The registered manager confirmed that the dependency needs of the residents and staffing levels were kept under review. Feedback received from residents or their representatives via Care Home Survey forms and discussion confirmed people were generally satisfied regarding the standard of care provided. The Annual Quality Assurance Assessment (AQAA) for Connell Court confirmed a policy was in place for recruitment and employment as previously noted. Furthermore, the document confirmed that all the people who had worked in Connell Court in the past twelve months had completed satisfactory pre-employment checks. The Care Homes for Older People Page 22 of 30 Evidence: registered manager reported that 7 staff (a part-time cook, 5 care assistants and a domestic) had commenced employment in the last year. The registered manager remained responsible for all aspects of recruitment and selection and the registered providers head office in Derby was responsible for confirming that Protection of Vulnerable Adult (POVA) and Criminal Record Bureau (CRB) checks had been completed and the outcome. The recruitment records pertaining to three of the care staff were viewed. Each file contained the necessary records required under the Care Home Regulations 2001. For example, copies of application forms, medical questionnaires, two references, Protection of Vulnerable Adults and / or Criminal Record Bureau checks were on each file together with proof of identification and interview notes. At the time of the visit the service employed 28 care staff (including assistant home managers and the activities coordinator). The training matrix detailed that 26 (92.85 ) of the staff had completed a National Vocational Care at level 2 or above in care and that the two outstanding staff were working towards the award. Once completed 28 (100 ) of the care staff in the home will be qualified to NVQ level 2 or above in Care. Files viewed contained evidence of induction training that was compliant with the Skills for Care induction standards, supervision records and documentary evidence of training completed. Staff spoken with confirmed they had access to a range of training and development opportunities including: safe working practice; protection of vulnerable adults; dementia awareness; medication; Methodist Homes for the Aged values and care plans etc and this was verified by examining the training matrix. Care Homes for Older People Page 23 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management and administration systems are subject to ongoing development and review to ensure Connell Court is run in the best interest of the people using the service. Evidence: Connell Court continues to be managed by Mrs Anne Glover who is registered as the manager of the service with the Care Quality Commission. Previous inspection records detail that Mrs Glover has managed the home since June 2000 and confirm she has the necessary experience for her role. Training records viewed provided evidence that the Registered Manager had continued to undertake periodic training since the last inspection that was relevant to the care of older people. This included dementia, deprivation of liberty and fire training. Documentary evidence was also available to confirm the manager had competed a National Vocational Qualification (NVQ) Registered Managers Award at level 4. Care Homes for Older People Page 24 of 30 Evidence: At the time of the visit the training matrix highlighted that the manager had not completed some mandatory training subjects including: health and safety, food hygiene, Control of Substances Hazardous to Health (COSHH), Protection of Vulnerable Adults (POVA), Moving and handling or Medication training. The training records should be updated or training organised if necessary. Furthermore, the manager should work towards a NVQ level 4 in Care or Health and Social Care to ensure best practice. Feedback received from residents and staff confirmed the manager was helpful, open and transparent in her leadership. For example, one staff member reported; I find the home works well as a team. We all respect each other in each role that we play within the running of the home. The manager and assistant managers are always available to discuss any matters / issues that may arise and are very approachable. It is a very happy place to work and makes coming into work a pleasure. Systems had been established to monitor and obtain the views of key stakeholders and records of staff and resident forum meetings were in place. A suggestion box was also available in the reception area to enable residents and their representatives to share their views in confidence. Records viewed provided evidence that the Registered Provider (Methodist Homes for the Aged) continued to commission an external consultant to undertake a quality assurance audit each year. An internal quality assurance programme was also in operation by the Provider. This involved the undertaking of an annual Standards and Values self-assessment, a 6-monthly internal audit, the distribution of annual resident satisfaction surveys and internal management reviews. On the day of the visit it was not possible to review the most up-to-date action plan arising from the internal audit in July 2009 as the results of the last surveys had not been returned from head office in order for an action plan to be developed. The Annual Quality Assurance Assessment (AQAA) for the service detailed that policies and procedures on the Management of Services Users Money, Valuables and Financial Affairs had been developed together with a finance manual for staff to reference and to safeguard residents money and personal belongings. The manager reported that she did not act as an appointee for any of the residents. A volunteer continued to provide a weekly service to facilitate the cashing of personal cheques for residents via Methodist Homes for the Aged. At the time of the visit the management team and administrator looked after the personal spending money for fifteen residents. Records were maintained that detailed how the money was spent Care Homes for Older People Page 25 of 30 Evidence: and receipts were obtained to account for expenditure. Records and cash balances checked were correct and secure facilities were available for the safekeeping of money. Health and Safety policies and procedures were in place which were updated periodically by the organisations Health and Safety Adviser. Records of quarterly audits undertaken by the manager were also available for reference which confirmed safety and compliance checks were completed. The fire log and a selection of service records were checked during the visit. Records viewed confirmed the fire doors, fire extinguishers routes of escape and emergency lighting had been tested on weekly basis however some gaps in the weekly testing of the fire detection and alarm system were noted which were brought to the attention of the manager. This issue was also noted at the last inspection and action should be taken to ensure the system is always tested each week. Examination of the AQAA confirmed that test, maintenance and / or associated records were in place and up-to-date for all key areas. A selection of service certificates were viewed during the visit which confirmed the fire alarm system, extinguishers, gas appliances and electrical wiring were safe and appropriately maintained. A public liability insurance certificate was also displayed in the reception area of the home and the fire risk assessment had been kept under review. Discussion with staff and examination of training records confirmed staff had access to ongoing safe working practice training including fire safety training. It was noted that some night staff had not received fire instruction refresher training every three months as recommended by the fire officer. This should be addressed to ensure best practice. Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 1 The Statement of Purpose and Service User Guide should be updated and reference to the Commission for Social Care Inspection should be replaced with the Care Quality Commission. This will ensure that people have access to correct information on the regulator. Information on ethnicity and gender should be obtained (whenever possible) as part of the assessment process to ensure equality and diversity issues are identified and acted upon. Staff responsible for writing support plans should receive further guidance on the key information that should be included. This will help to ensure that plans describe in more detail the support required from staff and clarify outcomes. The training matix should be updated to include the full range of training completed by the manager and action should be taken to complete any outstanding mandatory training. The manager should complete a National Vocational Qualification in Care at level 4 to ensure she has the Page 28 of 30 2 3 3 7 4 31 5 31 Care Homes for Older People Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations necessary qualifications for her role. 6 38 Action should be taken to ensure the fire alarm system is always tested on a weekly basis to safeguard the health and safety of the people using the service. Day staff should receive fire instruction training every six months and night staff every three months as recommended by the fire service to ensure an appropriate response in the event of the outbreak of a fire. 7 38 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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