Archived: Connect House

Updated 8 August 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.

We inspected the service on 22 and 23 June 2017. The inspection was unannounced. The inspection team consisted of two inspectors, a member of the CQC medicines team and two experts by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Prior to our inspection we reviewed information we held about the service. This included information received from local health and social care organisations and statutory notifications. A notification is information about important events which the provider is required to send us by law such as such as allegations of abuse and serious injuries. We also contacted commissioners of the service and asked them for their views. We used this information to help us to plan the inspection.

During our inspection visit we spoke with 17 people who used the service and nine relatives. We spoke with eight members of care staff, a nurse, the team leader, and a member of the catering team. We also spoke with the activity coordinator, the unit lead for Heritage Suite, the deputy lead nurse for Garden Suite and the registered manager and nominated individual. The nominated individual is a person who is nominated by the provider to represent the organisation.

To help us assess how people's care needs were being met we reviewed nine people's care records and other information, for example their risk assessments. We also looked at the medicines records of 19 people, three staff recruitment files, training records and a range of records relating to the running of the service for example audits and complaints.

We carried out general observations of care and support also looked at the interactions between staff and people. In addition to this we used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 8 August 2017

We inspected Connect House on 22 and 23 June 2017. The inspection was unannounced. The service is a situated in Basford, Nottingham and is operated by CityCare Connect Limited. The service is registered to provide accommodation for a maximum of 56 people. Connect House is a fast paced service with one or two admissions and discharges a day. People tend to stay at the service of a period of around 6 weeks, although some people stay longer dependent upon their need for treatment and rehabilitation.

Connect House work closely with staff employed in CityCare partnership to provide a unique and innovative service where people are enabled to access expert support from a range of specialist health professionals. The service is split into two distinct units, Heritage Suite and Garden Suite.

Heritage Suite has been open since 2014 and provides a reablement service to people who have recently been discharged from hospital to help them regain their independence. Heritage Suite is supported by a range of health professionals including physiotherapists, occupational therapists and nurses. There are also five stroke beds in Heritage Suite dedicated to the care and rehabilitation of people who have experienced a stroke. During our inspection there were 27 people staying in Heritage Suite.

Garden Suite has been open since January 2016 and provides nursing care. Together with the hospitals they are piloting a healthcare of older people project aimed at facilitating discharge of people with complex health needs from hospital. Garden Suite is staffed by nurses who are on rotation from CityCare Partnership and health care assistants and is supported a range of visiting clinicians including GP's, consultants and specialist nurse practitioners. There are three beds on Garden Suite which are dedicated for the care of people who are coming towards the end of their lives. During our inspection there were 22 people staying in Garden Suite.

At the last inspection in September 2016 we found five breaches of the legal requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, these breaches were in relation to safe care and treatment, safeguarding service users from abuse and improper treatment meeting nutritional and hydration needs, consent and governance. We asked the provider to take action to make improvements to the quality and safety of the service and we received an action plan on 5 December 2016 which stated that all actions would be complete by 31 March 2017. During this inspection we found that improvements had been made but some improvements were still required, this resulted in us finding one ongoing breach of the Health and Social Care Act 2008 Regulations (2014). You can see what action we told the provider to take at the back of the full version of the report.

The service had a registered manager in place at the time of our 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.

The principles and application of the Mental Capacity Act were not always followed where people lacked capacity to make decisions for themselves. People were supported by staff who had not always received adequate training. Although staff felt supported they were not always provided with regular supervision. There were plans in place to make improvements in this area.

People’s medicines were not always stored or managed in a safe way. Improvements had been made to ensure that risks to people’s health and safety were managed appropriately and safely and further improvements were planned. There were enough staff to provide care and support to people when they needed it, however staff were not always deployed effectively to ensure the delivery of safe care and support.

The provider had made progress in developing systems and processes to monitor the quality and consistency of the service. However these were still not always effective at identifying the required improvements. There were processes in place to enable people and their relatives to provide feedback on the service. Staff felt supported in their roles and were confident to raise concerns or make suggestions about how to improve the service. The management team were responsive to feedback and swift action was taken to address some areas of concern raised during this inspection.

People told us they felt safe and they were supported by staff who knew how to recognise and report concerns about their safety. Safe recruitment practices were followed.

Improvements had been made to ensure people’s nutritional and hydration needs were met. People were offered a choice of freshly prepared, food and drink and were provided with assistance when required. People’s day to day health care needs were met and people had access to expert health professionals. This had a positive impact on people who used this service who were supported to be in the best possible health.

Where people had capacity they were encouraged to make decisions about their care and support, staff understood how people communicated and they were supported to maintain their independence. Staff understood the importance of treating people with kindness, dignity and respect and we observed this in practice. Staff also respected people’s right to privacy.

People told us they received the support they required and although care plans did not always contain adequate detail of the support people required there were other systems in place to ensure staff had access to this information. People had the opportunity to get involved in social activities and most people told us that they had enough to do with their time. Complaints were documented, investigated and action was taken to address concerns raised.