DHC - Connaught House

Updated 9 August 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

This service provides care and support to people living in their own apartments in an extra care setting, so that they can live as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care schemes; this inspection looked at people's personal care and support.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the CQC to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection, there was no registered manager in post.

Notice of inspection

This inspection was announced. We gave the service short notice of the inspection. This was because it is a small service and we needed to be sure that the provider or provider's representative would be in the office to support the inspection.

What we did before the inspection

We reviewed all information we had received about the service and spoke with local authority commissioners, responsible for funding some of the care provided at the service. The provider had not been sent a provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We gave the provider's representatives opportunity to share this information during the inspection visit.

During the inspection

We met with five people in the communal lounge and observed interactions between people and staff in communal areas and during an activity. We spoke with eight staff including two managers who were representing the provider during the inspection visit. We also spoke with a relative by telephone. We reviewed a range of records including care plans and records for five people, two staff recruitment files, training information and key policies, and other documentation relating to the management of the service.

Updated 9 August 2022

Help At Home (Connaught House) is an extra care scheme providing personal care for people living in their own apartments within one adapted building. At the time of our inspection, 27 people were receiving the regulated activity of personal care. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People's experience of this service and what we found

The provider did not have established, robust processes in place to ensure people received their medicines safely and as prescribed.

Systems to monitor the running of the service were not always effective in ensuring improvements were embedded into staff working practices and sustained. The service had experienced a significant turnover in staff and management and remained without a registered manager.

People were supported by enough staff to meet their needs. Staff were safely recruited and inducted into the service. Staff were aware of the risks people faced and the actions they needed to take to keep people safe. People were protected from the risk of infections.

Staff undertook training to meet the diverse needs of people living at the service. People were supported to maintain their health and well-being. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. We have made a recommendation to ensure the provider follows best practice in undertaking mental capacity assessments.

The provider was in the process of reviewing and developing care plans. People were supported to socialise, interact and maintain links with family and friends, where they wished to, to reduce the risk of social isolation.

People were happy living at Connaught House and enjoyed the support and interactions with staff and each other as part of a community. Staff spoke of increased morale and felt positive about the future development of the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating and update

The last rating for this service was requires improvement (published 7 October 2021).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to the safe management and administration of people's medicines and leadership and governance of the service at this inspection. You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.