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Reports


Inspection carried out on 14 January 2019

During an inspection to make sure that the improvements required had been made

About the service: Connaught Court provides residential and nursing care for up to 90 older people, including people who are living with dementia. 79 people were receiving a service at the time of this inspection.

People’s experience of using this service:

People received safe care and support because systems and processes in place ensured any risks were safely managed by staff, and their needs met with minimal restrictions in place.

Medicines were managed and administered safely. Records confirmed people had received their medicines as prescribed

People received care and support from staff who had been assessed as competent to carry out the roles, who were trained and supervised appropriately and who had been appropriately vetted prior to employment.

People were assured of a good service because the provider supported the registered manager to maintain, and where required, improve the service provided.

People, relatives and the staff team were given opportunities to provide feedback on the quality of the service. The provider used the feedback to help maintain and improve standards where this was required.

People received care and support that was individualised and reflective of any specific needs. The service was provided equally and without discrimination.

People and their relatives told us they were confident if they had any complaints the registered manager would address them appropriately.

Rating at last inspection: At the last inspection the service was rated requires improvement (report published May 2018).

Why we inspected: This inspection was a planned inspection based on previous rating

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme.

Inspection carried out on 25 May 2018

During an inspection to make sure that the improvements required had been made

We undertook an unannounced focused inspection of Connaught Court on 25 May 2018. The inspection was prompted by the death of a person who used the service who had left the service and had fallen.

We inspected the service against two of the five questions we ask about services: is the service safe and is the service well led? No risks, concerns or significant improvement were identified in the remaining Key Questions through our ongoing monitoring or during our inspection activity so we did not inspect them. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection.

Connaught Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Connaught Court accommodates up to 90 people across six separate units, each of which have separate adapted facilities. At the time of our inspection one of the units was closed for some renovation work. There were a total of 82 people living at the service. Two of the units specialised in providing care to people living with dementia.

The service had a registered manager. 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.

The CQC had been notified about two police incidents. These involved the police being contacted in respect of two people who had left the service unobserved on two separate occasions. Actions to reduce the risks related to these incidents had been taken immediately to ensure the risks were managed as effectively as possible.

One person whose behaviour posed a risk of harm to themselves and others did not have a risk assessment in respect of this. This was completed during our inspection. Two incidents of distress which could have caused harm to others had not been handed over to the senior staff team. This meant they were unable to take the action required to mitigate the risks to the person and others.

Overall risks to people living at the service were assessed and measures to reduce risks were put in place. We saw that risk assessments and mental capacity assessments in respect of people’s ability to independently access the community were being completed.

There were sufficient staff to meet people’s needs. In the main we saw a relaxed environment with people being supported by staff in an unrushed manner. However, prior to the lunch time meal call bells sounded repeatedly on the general residential unit. The registered manager agreed to review the deployment of staff before, during and after meal times.

Staff were safely recruited and a senior member of staff had recently been employed for two days per week as a ‘medicines champion.’

There were a range of systems in place at a management and provider level to assess and monitor the quality of service being provided to people living at Connaught Court.

People, relatives and the staff team were given opportunities to comment on the running of the service. They told us the management team were supportive.

Care records were electronic and they were stored securely. In the main CQC notifications were made appropriately by the management team. However, the CQC had not been notified about a specific incident. We asked for a retrospective notification once we had been alerted to the incident which was received. This is being looked at outside of the inspection process.

Inspection carried out on 28 March 2017

During a routine inspection

This inspection took place on 28 March 2017 and was unannounced. This is the first inspection since the home was registered under a different legal entity in March 2016.

The home is registered to provide residential and nursing care for up to 90 older people, including people who are living with dementia. On the day of the inspection there were 85 people living at the home, including two people who were receiving respite care. The home is situated on the outskirts of York. There are six units: Knavesmire, Fred Crossland House, Viking, Fairfax, Yorvik and Ebor. Viking is for people who require nursing care, and Fred Crossland House and Knavesmire are for people who are living with dementia. The other units are for people who require residential care.

Some parts of the premises were on one level and other areas had a lower ground floor and a first floor. The first floor was accessed by a passenger lift.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager who was registered with the Care Quality Commission (CQC). 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.

The areas of the home specifically designed for people living with dementia provided an exceptional environment that promoted meaningful occupation. This included tactile items, old fashioned furniture and rooms that looked like a living room in a person’s own home. This resulted in a calm atmosphere where people were able to live as they chose to live.

We saw that people's nutritional needs had been assessed and individual food and drink requirements were met. People told us that they were very happy with the food provided and we observed that there was ample choice. The dining room was presented in ‘hotel’ style and people had their own bottles of wine on the table if this was their wish. People socialised with other people and with staff. Staff support in the dementia areas of the home was unobtrusive. People were shown a variety of choices and alternatives were provided if people were not interested in the choices on offer. Staff ate with people in these areas of the home and this produced a calm family atmosphere where people were encouraged to eat and drink.

The home was following a recognised dementia model that incorporated good practice guidance. They were one of the few homes in the country to have achieved awards with the organisation that produced the model.

People were protected from the risk of harm or abuse because there were effective systems in place to manage any safeguarding concerns. Staff were trained in safeguarding adults from abuse and understood their responsibilities in respect of protecting people from the risk of harm.

There was evidence that the registered provider was working within the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

There were recruitment and selection policies in place and these had been followed to ensure that only people considered suitable to work with vulnerable people had been employed. On the day of the inspection we saw that there were sufficient numbers of staff employed to meet people's individual needs.

Training records showed that staff had completed the training they needed to carry out their roles effectively. Staff told us that they were well supported by the registered manager.

There were appropriate policies and procedures in place on the management of medicines, and senior staff had received appropriate training. We checked medication systems and saw that medicines were stored, recorded and administered safely.

People who lived at the home and relatives told us that staff were caring a