18 and 21 May 2015
During a routine inspection
This inspection took place on the 18 May 2015 and was unannounced. This meant the provider did not know we would be visiting. A second day of inspection took place on 21 May 2015 and was announced. We last inspected the service on 28 January 2014 and found the provider was meeting all legal requirements we inspected against.
Connolly House is a care home run by South Tyneside MBC. It is set in a mainly residential area. It has good access both into and outside of the property with a secure courtyard available for people to use. It is registered to provide accommodation for people and their nursing needs are met by the local community nursing services.
At the time of the inspection there were nine people living at Connolly House, some of whom were living with dementia.
There was an established registered manager in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People told us they felt safe living at Connolly House. Staff were knowledgeable about safeguarding people and knew what to do if they felt someone was being harmed or at risk in any way.
Relevant risk assessments were in place which detailed the precautions and control measures that were in place to minimise any risks that may be present for people. This included the assessment and management of any health and safety risks which may be present in the environment.
Fire evacuation procedures were in place and the building plan highlighted where firefighting equipment was available as well as showing the vacant rooms in the building. Each vacant space had been risk assessed for security and maintenance issues dealt with on an ongoing basis.
Each person had a personal emergency evacuation plan and staff were able to describe in detail how they would evacuate people dependent upon their location and the location of any suspected fire.
A range of health and safety checks were completed to assess the safety and suitability of the premises and robust contingency plans were in place should there be emergencies in relation to utilities, staffing levels or the use of the building.
We were told that there were sufficient staff to meet the needs of the people living at Connolly House and we observed that all staff, including the ancillary staff and registered manager were able to spend quality time with people talking with them and engaging in activities. Staff were proactive in engaging with everyone in the room.
There had not been any recent recruitment but effective procedures were in place and existing staff had their disclosure and barring checks updated every three years.
Medicines were administered safely and effectively. Staff knew how people preferred to take their medicines and were robust in their checking of medicine against MAR charts before they administered any medicines. Procedures were in place for ‘as and when required’ medicines and staff were proactive in informing doctors if people weren’t using this medicine as intended.
Staff were trained in medicine administration and competency checks were completed by the registered manager and the dispensing pharmacist.
Staff told us they were supported by the registered manager and senior staff and that all worked well together as a team. Regular supervisions were held with staff and all staff had received an annual appraisal. Training was discussed at every supervision and staff had attended courses in compassionate care, oral hygiene and supervision training as well as mandatory training in moving and handling, safeguarding, and dementia. All the senior care staff acted as nutrition champions and ensured people received healthy, well balanced, enjoyable meals was high on everyone’s agenda.
Relevant DoLS authorisations were in place and the staff team understood what this meant in relation to the care people received. The team had received positive feedback from a best interest assessor who had spent time at the service assessing someone recently.
We were told that no one presented with behaviour that challenged the service. Care plans were in place for people who may show distressed or agitated behaviour and staff were aware of the triggers for this behaviour and managed it well which meant people were reassured and remained calm.
Specialist advice had been sought where needed in relation to people’s dietary needs but also in relation to their mobility needs and general health and welfare. The staff told us that there were positive relationships with people’s doctors and district nurses.
We spent time observing the care that was offered to people. We found staff to be very respectful and sensitive to people’s needs. Staff knew people well and used this knowledge effectively to engage people in conversation and activities and to reminisce with people. People were able to tell us about family members using photographs as prompts to recall precious moments and memories.
There was information available on advocacy services but staff explained that these weren’t being used at the moment as people had active and supportive family contact.
People’s care records were personalised to their specific needs and preferences and were regularly reviewed and updated. The registered manager said, “Sometimes we update them on a daily basis as people’s needs can change that often.”
There were a range of activities on offer including pet therapy, external entertainers, and trips out, arts and crafts, singing and reminiscence as well as gentle exercise. People who had an interest in gardening were encouraged to grow plants and tomatoes. The service also had its own cinema room and sensory room.
There were opportunities for people, their family members and staff to provide feedback. This was done by way of thank you cards and a comments book for family members as well as a satisfaction survey. Staff said they did not need to complete a survey as they felt able to share any comments openly with the managers and senior staff.
There had been no formal complaints made since the last inspection but there was a log in place and the registered manager was able to describe the process they would follow if they did receive a complaint. Several thank you cards and compliments had been received.
The culture was described as being, “caring and learning.” The atmosphere was relaxed, friendly and homely. Staff cared for people in a very professional, respectful yet friendly way.
Regular staff meetings were held with discussions about people being given priority alongside dignity and respect, compassion in care, dementia, health and safety and safeguarding.
A range of audits and quality assurance systems were in place to ensure the care provided and the systems used to record care practices were continuously improving and that a high quality of service was provided for all people living at Connolly House.