We carried out a review of the data available to us about Connaught Court on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Connaught Court, you can give feedback on this service.
Connaught Court is a residential care home providing regulated activities and nursing care to up to 94 people across six separate units. At the time of our inspection there were 89 people living at the service.
People’s experience of using this service and what we found
This was a targeted inspection which looked at systems in place to monitor accidents, incidents and safeguarding concerns, and managing risks to people's safety from other people, pressure care and the use of bed rails.
Based on our inspection of these areas, we found processes were in place to manage the risks associated with the use of bedrails. However, they had not always been followed on one unit, the registered manager acted quickly to resolve these shortfalls.
Accidents and incidents had been recorded with details of actions taken to mitigate associated risks.
People we spoke with were all positive about their experiences of the service. People told us they had reliable support that promoted their health, safety and wellbeing.
The provider ensured health and social care professionals were engaged with the safeguarding of people from abuse. Concerns had been reported and safeguarding risks including those of a sexual nature had been appropriately managed.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was outstanding (31 December 2019).
Why we inspected
We undertook this targeted inspection following a review of information we had received about the service which identified potential concerns about pressure care, the use of bedrails and the management of incidents of a sexual nature. The overall rating for the service has not changed following this targeted inspection and remains outstanding.
We use targeted inspections to follow up on Warning Notices or to check concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe sections of this full report.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
We found the following examples of good practice.
Effective systems were in place to ensure staff and visitors to the service followed government guidelines for wearing Personal Protective Equipment (PPE). Facilities were available for visitors to wash their hands and put on PPE. Screening questions and a temperature check were standard requirements for all visitors.
Several areas within the home had been adapted to accommodate visitors, in line with current guidance.
Infection prevention and control (IPC) procedures were clear and followed by staff. All staff were trained in safe IPC practices. The provider had funded additional staff hours to provide enhanced cleaning in the home.
A regular programme of testing for COVID-19 was in place for staff and people who lived in the service. There had been a good uptake of residents receiving the COVID-19 vaccine.
Connaught Court is a care home providing personal care and nursing for up to 94 older people. At the time of our inspection 85 people resided at the service.
People’s experience of using this service
The environment at Connaught Court was exceptional. Further improvements had been made to enhance the facilities for people to meet their care needs. Recent adaptations meant the service would be able to meet peoples changing needs as their dementia advances. Best practice in relation to the environment for people with dementia was followed and embedded within the service. This created a calm and homely environment for people to receive care.
All feedback received about the support provided to people was extremely positive. People who lived at the service received high-quality, personalised support from regular and committed staff. Recruitment checks were in place to ensure staff were suitable to work at the service. Staff had received training and support to enable them to carry out their role. Healthcare professionals felt staff were excellently trained in their role.
People’s health was well managed. Excellent relationships with healthcare professionals had been developed to ensure enhanced partnership working and holistic support for people.
People were fully integrated into the local community. They had access to a variety of activities which enhanced their wellbeing and friendships. Complaints procedures were in place and followed. People’s wishes at the end of life were explored.
The staff and management team were skilled in effective communication to ensure people felt supported and relaxed.
Risks were managed. Accidents and incidents were monitored, reviewed and analysed. Lessons learnt was embedded in the culture of the service and were improvements had been identified, actions were taken to address this.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. People received their medicines safely and on time.
There was excellent team work within the service, including the management and provider. Continuous improvement was a clear focus. Passionate and forward-thinking managers led the service and provided an inclusive service that engaged proactively with people, their relatives and the staff team.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Connaught Court on our website at www.cqc.org.uk.
Rating at last inspection
The last rating for this service was good (published 23 May 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
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.
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.
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 and that they respected people's privacy and dignity. We saw that there were positive relationships between people who lived at the home and staff, and that staff had a good understanding of people's individual care and support needs.
Care plans included information to guide staff on how to meet people’s assessed care and support needs and to understand their individual preferences and personalities, although some information required updating to ensure they included the very latest information.
A wide variety of activities were provided and people were encouraged to take part. This included activities specifically for people who were living with dementia. People told us their family and friends were made welcome at the home.
There were systems in place to seek feedback from people who lived at the home, relatives and staff and there was evidence that people’s comments were listened to and acted on.
People told us they were confident their complaints and concerns would be listened to. Complaints received by the registered provider had been investigated and appropriate action taken to make any required improvements.
Quality audits undertaken by the registered manager and others were designed to identify that systems at the home were being followed to ensure people were safe and well cared for.