- Care home
Connect House
Report from 16 February 2024 assessment
Contents
On this page
- Overview
- Learning culture
- Safe systems, pathways and transitions
- Safeguarding
- Involving people to manage risks
- Safe environments
- Safe and effective staffing
- Infection prevention and control
- Medicines optimisation
Safe
People told us they felt safe. Staff understood their duty to protect people from abuse and knew how and when to report any concerns they had to managers. When concerns had been raised, managers reported these promptly to the relevant agencies and worked proactively with them, to make sure timely action was taken to safeguard people from further risk. However, people had not always been protected from harm. The technology system in place to alert staff for help when someone had a fall did not always work. The management team had put measures in place when this was identified. The staff team assessed and reviewed safety risks to people and made sure people were supported to stay safe. We received mixed feedback from people regarding staffing levels. While some people felt there were enough staff, some people stated care was task based to suit staff rather than focusing on people's individual needs. Managers reviewed staffing levels regularly to make sure there were always enough suitably skilled and experienced staff on duty. Staff received relevant training to meet the range of people’s needs at the service. Staff received support through supervision and appraisal to support their continuous learning and improve their working practice. Managers made sure recruitment checks were undertaken on all staff to ensure only those individuals that were deemed suitable and fit, would be employed to support people at the service.
This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.
Learning culture
We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.
Safe systems, pathways and transitions
We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.
Safeguarding
People told us they felt safe. One person told us, “I’m well looked after so feel in safe hands."
Staff understood how to protect people from abuse and were able to explain how to respond to allegations of abuse. Staff told us, they had no concerns. Staff were confident if they raised concerns management would take action. One staff member told us, “Safeguarding is protecting people from abuse of harm. If I see any of the type of safeguarding, I would listen to the person if it was them telling me. I would raise it with the senior staff member and ensure action is taken. If no action is taken, I would go higher and if they do not take any action, I would report it to the regulator CQC.”
The provider had a clear policy in place for management and staff team to enable staff and leaders to safeguard people from harm and abuse. Safeguarding incidents had been referred to the local safeguarding team. The staff team had completed safeguarding training. We reviewed records and the deputy manager had taken appropriate action when safeguarding incidents were raised and appropriate professionals were notified such as the local authority, police and CQC.
Involving people to manage risks
People told us staff understood their needs well and offered support to keep them safe. One person said, “I have to have a lot of help and getting me into my wheelchair and they are very gentle as I’m a bit frail.”
Staff were able to explain how people risks were managed. Staff told us people had key assessments completed where risks were present. The deputy manager told us people were involved at the initial admission process and when their care plans and risk assessments were reviewed.
We observed staff supporting people in a safe way. People who required equipment such as hoists to assist them to transfer, were assisted safely. We observed that when people were showing signs of distress, staff managed this in a positive way that protected people’s rights and dignity.
The provider had clear processes and systems in place to assess risks to people. People’s care plans included risk management plans. However, records did not demonstrate that people were involved in managing risks through care planning.
Safe environments
We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.
Safe and effective staffing
We received mixed feedback from people regarding staffing levels. While some people felt there were enough staff, some people stated their care was delivered inline with what was suitable for staff rather than people's needs. Comments from people were, “They could do with a few more as it can be a long wait to get to the loo if I’m bursting.” “I notice it’s a bit quieter for staff at weekends.” “Some staff are quite good; some are awful as you either don’t get what you asked for or get nothing at all.”
The management team described how agency reliance would be reduced which meant people received care from a stable and consistent team of staff. The management team understood the importance of succession planning and was actively upskilling and supporting staff to enable internal promotion safely. The deputy manager told us there was an active recruitment ongoing for activities coordinators to support people to have more meaningful activities. Staff told us that staffing levels had improved and training was consistently delivered. Staff also said they felt supported by the management and felt were offered opportunities to give feedback through regular team meetings and one to one supervision.
We observed staff responding to call bells in a timely manner. When people pressed their call bell staff were co-ordinated and effective in responding and assisting people. Each area of the home was overseen by a care co-ordinator. We observed them actively delegating staff safely were needed in line with people’s immediate needs and supporting people appropriately at busy times such as meal service and medicine rounds. This meant that people receive their care timely and safely.
There were robust and safe recruitment practices to make sure that all staff, including agency staff were suitably experienced, competent, and able to carry out their role. Staff received a comprehensive induction which included shadowing and mentoring from senior colleagues prior to working independently. Staff had completed a range of training modules to ensure they had the knowledge and skills to do their role safely. The management team had a dependency tool which reflected people’s needs and supported them in planning staff requirements accurately and safely. We reviewed rotas which showed staffing levels consistently met the requirements identified.
Infection prevention and control
People told us that the home was consistently kept to a clean standard, and that staff would always support them using suitable personal protective equipment. This kept them safe from the spread of infection. One person said, “it’s a lovely clean place and my bed is always fresh.”
The staff team were knowledgeable about infection prevention and control. Staff confirmed they had received training to ensure people were protected from the risk and spread of infection. The deputy manager told us they worked with the local infection, prevention and control team and ensured they followed their guidance to ensure they are working within best practice guidance.
The home was clean and hygienic. We saw that staff had access to personal protective equipment throughout the home. This allowed them to support people in a hygienic way. We saw any dirt or spillages in the home were quickly resolved.
There were robust processes to ensure there was infection prevention control measures in place. The staff team had completed infection prevention and control training. There was a cleaning schedule in place to guide staff on the frequency of when tasks needed to be completed. The management team had oversight to ensure the cleaning tasks were completed.
Medicines optimisation
People told us they received their medicines from staff safely and in line with their wishes. People told us staff were responsive if they requested pain relief. One person said, “I have a headache today and staff looked after me, they got me tablets straight away to help.”
The management team described actions and processes they had put in place to reduce medicine errors. A care coordinator told us, “Our deputy and myself, are able to step up and administer medicines if needed. So, if our nurse is busy dealing with an emergency, people will always receive their medicines as needed.” The care coordinator described a 12-point check which had been implemented to support staff to identify errors early which helped to keep people safe and was completed daily. The staff member said, “This check helps staff to review each other actions and spot errors immediately and allows me to identify if anyone needs additional support or training.”
Medicines were managed safely. Staff kept clear records of when they had given prescribed medicines. Paperwork we reviewed, medication administration records (MARs) showed medicines were given as prescribed. Staff did regular checks of the amount of medicine in stock. Staff did regular checks of the amount of medicine in stock. This ensured that suitable stock levels were always in place, and more medicine could be ordered from the pharmacist as needed. Some people required ‘as needed’ medicine and staff had clear written guidance on how this should be administered. Although senior staff were responsible for administration of this medicine, guidance was clearly written in care plans, which meant staff knew how and when to support people safely. We observed staff administering and supporting people with their medicines appropriately. We saw staff explaining medicines to people obtaining their consent prior to administering medicines. At times people’s dignity and privacy were not always upheld due to medicines being administered in communal areas especially at mealtimes. However, staff took steps to mitigate these risks were possible. For example, we observed a staff member asking someone if they wished to wait until after their meal to receive their medicines.