Inspection on 18/05/05 for Cristos

This inspection was carried out on 18th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Cristos 19/09/06

Cristos 06/02/06

Cristos 25/02/05

Cristos 21/09/04

Similar services:

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Insight - Eastchurch

Southfields

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Cristos 27 Medina Villas Hove East Sussex BN3 2RN Lead Inspector James Houston Announced 18 May 2005 10:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cristos H59-H10 S14194 Cristos V216934 180505 Stage4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Cristos Address 27 Medina Villas Hove East Sussex BN3 2RN 01273 773717 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Joy Skatulla Mrs Joy Skatulla Care Home 10 Category(ies) of Learning Disability (LD), 10 registration, with number of places Cristos H59-H10 S14194 Cristos V216934 180505 Stage4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of service users to be accommodated is ten (10). 2. Service users must be aged forty-five (45) years or over on admission. 3. Only service users with learning disabilities may be accommodated. Date of last inspection 25 February 2005 Brief Description of the Service: Cristos is a private family owned residential home registered for ten adults with learning disabilities who are over forty five years on admission.The home is a substantial detached Edwardian house in a residential road, close to the main shopping area of Hove and the seafront. It is arranged on four floors with service users accomodation consisting of six single and two double rooms. Bedrooms are shared by prior arragement. There is a passenger lift serving floors above ground floor level. Communal space consists of a sitting/dining room and small foyer that also serves as a smoking area. Access to both the front and rear of the home is via steps and the layout of the homes interior makes it unsuitable for service users who have restricted mobility.The immediate area provides banks and building societies, a post office, many restaurants, a local library and museum, and bus services to all parts of the city. Hove mainline station is within walking distance near to the Sussex County Cricket Ground. Mrs Skatulla is the registered Provider/Manager and leases the building. She is reorganising the lower ground floor of the premises, and will approach the commission for Social Care Inspection formally in the near future. Cristos H59-H10 S14194 Cristos V216934 180505 Stage4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place during the morning and early afternoon of the eighteenth of May 2005. Before the inspection the inspector read records held on the home by the Commission for Social Care Inspection and prepared to inspect those sections of the standards to be covered at that visit. The returned pre-inspection questionnaire completed by the home and comment cards completed by visiting professionals to the home, residents and their relatives were studied and the responses noted. The actual inspection of the home took five and a half hours. The inspector made a tour of the entire premises, and read a variety of policies, procedures and records. The manager, three staff and seven residents were spoken with. Eight residents were living in the home on the day of the inspection. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cristos H59-H10 S14194 Cristos V216934 180505 Stage4.doc Version 1.20 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Cristos H59-H10 S14194 Cristos V216934 180505 Stage4.doc Version 1.20 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,and 5. The home provides full information to prospective residents and their representatives to inform their decision about coming to live in the home. The home meets the needs of those living there. The home has a suitable contract with each resident. EVIDENCE: The home has a statement of purpose and service users’ guide which give full information. From discussion with staff and residents and examination of records it is clear that staff individually and collectively have the skills and experience to meet the needs of residents. Observation confirmed that staff are able to communicate with residents. The manager said that the home would not admit any resident whose needs they could not meet. The home draws up terms and conditions of residence with its residents. A record inspected showed a copy signed by a resident, and a copy is retained by the home and by the resident. The home has a contract with the responsible placing authority for each resident. Cristos H59-H10 S14194 Cristos V216934 180505 Stage4.doc Version 1.20 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9. Comprehensive care plans and risk assessments are kept and regularly reviewed. One record of monies held for a resident should have the current balance calculated. EVIDENCE: Good care plans are drawn up. Staff said that they read them and are familiar with them. Residents can access their plans and staff discuss their plans with them. Staff said that they are given guidance on how to write in the daily record books. These were found to be up to date and well kept. Plans and risk assessments inspected were found to be reviewed regularly. Staff provide residents with the information, assistance and support they need to make decisions about their own lives. Staff assist with shopping where asked but the manager said they respect residents’ decisions about what to buy. Residents manage their own finances as far as possible. Records were inspected of monies handled on behalf of residents. One balance had not been calculated for several months and it is recommended that the earlier practice of regular balancing resume. Cristos H59-H10 S14194 Cristos V216934 180505 Stage4.doc Version 1.20 Page 9 Staff confirmed that they use the risk assessments to assist residents lead lives which as are as full as possible, and that they give training and guidance to residents. A policy on the action to take if a resident goes missing is available to staff. Cristos H59-H10 S14194 Cristos V216934 180505 Stage4.doc Version 1.20 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,14,and17. Residents are enabled to maintain and develop social, communication and independent living skills. Residents have access to and choose from a range of leisure activities. Meals and mealtimes promote the health and well being of residents. EVIDENCE: Residents said that they are able to go out, some on their own. Those who wish to attend local churches. Residents each have a weekly schedule of planned activity. Most go to day centres where there are there are a range of activities and life skills programmes. A resident returned during the inspection from a local group for elderly people, which she said she likes attending. Staff and residents said that a range of activities in the home is enjoyed such as bingo, sewing, TV and jigsaws. Residents said that they are able to choose what entertainment they bring in to the home eg CDs videos etc. Several residents go to voluntary clubs, and holidays away from the home are arranged through these clubs. The manager said that staffing at the weekends is arranged so that there is a staffing overlap so that staff can take residents out. The home has its own people carrier to facilitate trips out. Cristos H59-H10 S14194 Cristos V216934 180505 Stage4.doc Version 1.20 Page 11 Meals and mealtimes are an important part of the home, and residents said that they are offered a choice of meals. Records inspected confirmed this. Residents said that they liked the meals served. They were said to be lovely. Staff said that they know residents’ likes and dislikes. The kitchen is well equipped. Cristos H59-H10 S14194 Cristos V216934 180505 Stage4.doc Version 1.20 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 20. The home makes effective arrangements to meet the healthcare needs of residents. The systems to manage medication for residents are thorough. EVIDENCE: Record inspected showed that arrangements to meet the healthcare needs of residents are thorough. Residents said that they are usually taken to see health professionals and staff will go in with the resident if the resident wishes for this. Some go on their own for dental check ups. The daily record books contain a separate reference system for health appointments and records sampled showed that full details are kept. At present no residents self administer their drugs, or have controlled drugs. The medicine administration record was inspected and was fully recorded. The manager said that a local pharmacist visits regularly and gives advice on the medication system. Staff said that they had had training on medication and records inspected confirmed this. The home has suitable policies and a requirement made at the last inspection to include in the medicine administration policy the need to keep drugs for seven days after the death of a resident had been met. An amendment was made during the inspection. Cristos H59-H10 S14194 Cristos V216934 180505 Stage4.doc Version 1.20 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23. The home has a clear complaints procedure of which residents are aware. The home has a suitable adult protection and whistle-blowing policy. The manager and deputy manager need to attend an updating course on the protection of vulnerable adults, and some staff need to attend training on restraint and aggression towards staff. EVIDENCE: The home now has a suitable complaints policy available to residents. A necessary modification to it was made during the inspection. Residents said that they are aware of their right to raise issues with the provider/manager. No complaints have been received by the home in the last year, and the Commission for Social Care Inspection has received none. The home has a system to deal with any complaints received. Staff said that they have received training in adult protection and records inspected confirmed this. The manager said that she and her deputy have applied to Brighton and Hove Council for dates to attend a course. Not all staff have attended training on restraint and aggression towards staff. Cristos H59-H10 S14194 Cristos V216934 180505 Stage4.doc Version 1.20 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,26, 28 and 30. The home has had extensive works done recently. The conservatory, a bedroom, bathroom, toilet, and laundry still require attention. The bedrooms and communal areas are spacious and well furnished. EVIDENCE: The home has been gradually upgraded internally and externally to a good standard over the past two years. Since the last inspection the rear windows and fire escape have been made good and repainted. Two further bedrooms have recently been redecorated. Some internal redecoration remains to be done. The provider/manager is in negotiation with the freeholder about the renovation or removal of the rear conservatory. The laundry has been upgraded but walls and ceiling remain in need of attention. The provider /manager is considering the use of the basement floor and may seek to re-site the laundry as part of these changes. She will make a formal written approach to The Commission for Social Care Inspection when ready to do so. Cristos H59-H10 S14194 Cristos V216934 180505 Stage4.doc Version 1.20 Page 15 Residents said that they like their rooms and have been able to bring their own things into them. They said that they have a key to their rooms and to the front door if they wish. The lounge/dining room is pleasantly furnished, and there is an additional foyer area by the front door that also serves as a smoking area. The home has a large office. This may be re-sited as part of wider changes. The home was found to be clean and tidy throughout at the inspection. The manager said that the home is spring-cleaned by a commercial company every month or six weeks. There is written guidance on infection control and staff said that they are aware of this. Suitable laundry equipment has been installed. Cristos H59-H10 S14194 Cristos V216934 180505 Stage4.doc Version 1.20 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33, and 36 Staff are competent. The recommended level of qualification of 50 of staff having NVQ level 2 by 2005 has not been met. The home has an effective staff team that operates in the best interests of residents. Staff are regularly supervised to assist them to continue to meet the needs of residents, but not to the recommended frequency of at least six times per year. EVIDENCE: Residents said that they find staff friendly and helpful. Staff were observed to accessible to residents. Staff said that they find the home to be a good place to work. Comment cards from visiting professionals and relatives said that they were satisfied with the overall care. Records inspected showed that staff have had training on the specific conditions of residents. One staff member holds NVQ level 2, and 3 are doing it. The manager is seeking to attain the recommended level of 50 of staff holding these qualifications but this level has not as yet been met. The home has a current staff rota. This shows that two staff are on duty during the working day, with one waking staff member on duty at night. Visiting professionals and relatives said in comment cards received that enough staff are on duty in the home. The manager and deputy manager live very close to the home and offer on-call support to staff. A new staff call system has recently been installed. The current staff team is stable with no new staff having been appointed since June 2004. Cristos H59-H10 S14194 Cristos V216934 180505 Stage4.doc Version 1.20 Page 17 The manager confirmed that no one left in charge of the home is aged under 21. Regular staff meetings are held, and the minutes of these were made available to the inspector. Staff confirmed that they receive regular supervision, but records inspected showed that this is not at the recommended frequency of at least six times per year. Cristos H59-H10 S14194 Cristos V216934 180505 Stage4.doc Version 1.20 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38,40,41, 42 and 43. The management approach of the home creates an open, positive and inclusive atmosphere. Records are generally well kept. Procedures are thorough and comprehensive. The health and safety of residents is promoted. Fuller records of fire training for staff must be kept. Management systems are good. EVIDENCE: Residents said that they like the manager and feel able to approach her. Comment cards received from visiting professionals and relatives of residents said that they are made welcome in the home. Regular residents’ meetings are held and the minutes of these were made available to the inspector. The manager said that there are discussion meetings which residents chair. Staff said that the manager is very open to new ideas and they feel free to put forward their views. Cristos H59-H10 S14194 Cristos V216934 180505 Stage4.doc Version 1.20 Page 19 Those procedures read were well written, and they are regularly reviewed. Staff confirmed that procedures are available to them, and that they are familiar with them. Those records inspected were well kept. Records are securely stored. Residents said that they are aware that they can see their records if they so wish. The manager said that to date none has asked to do so. There are extensive policies and procedures relating to health and safety in the home. Staff confirmed that they have had training in First Aid and food hygiene and moving and handling. Systems to support fire safety are in place. Fire alarms and emergency lighting checks are recorded, and service contracts for fire detection and fire fighting equipment are in place. An outside trainer provided fire training in April 2004, and there have been three fire drills since then. However only numbers not names of staff are recorded, so it is not possible to establish when individual staff have had fire training. Fuller records should be kept. Window restrictors in top floor bedrooms, which were found at the last inspection to have been removed, were replaced immediately after the last inspection. The home has a current certificate of insurance. The manager has an accountant and a bookkeeper to assist her with the finances of the home. Staff said that they are clear about who is responsible for what within the home. SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded Cristos (Commendable) 3 Standard Met (No Shortfalls) Version 1.20 Page 20 H59-H10 S14194 Cristos V216934 180505 Stage4.doc 2 Standard Almost Met (Minor Shortfalls) 1 Standard Not Met (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 3 x 3 x 2 Standard No 11 12 13 14 15 16 17 3 x x 4 x x 4 Standard No 31 32 33 34 35 36 Score x 3 3 x x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 4 x 3 3 3 3 Cristos H59-H10 S14194 Cristos V216934 180505 Stage4.doc Version 1.20 Page 21 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 23 Regulation 13(6) Requirement That the manager and deputy undergo updated adult protection training.(Previous tmescale of 1/6/05will not not met) All remaining staff to be trained in restaint and aggression(Previous timescale of 30/4/05 not met) That a bedroom, bathroom and a WC are redecorated and the conservatory repaired/repainted.(Previous timescale of 1/06/05 will not be met) The repair and repainting of the laundry to be addressed(Previous timescale of 1/6/05 will not be met) That a full record of fire training given is kept Timescale for action 30 September 2005 30 September 2005 30 September 2005 2. 24 13(4)bc 13(6)(7) (8) 23(2)(d) 3. 30 4. 30 23(2)(b) 30 September 2005 30 June 2005 5. 42 17(2) and Sch 14 94) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Cristos Refer to Good Practice Recommendations H59-H10 S14194 Cristos V216934 180505 Stage4.doc Version 1.20 Page 22 1. 2. 3. Standard 7 32 36 Calculate/audit monies held on behalf of a service user. 50 of staff to have NVQ level2 by 2005. Supervise staff a minimum of six times a year. Cristos H59-H10 S14194 Cristos V216934 180505 Stage4.doc Version 1.20 Page 23 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Cristos H59-H10 S14194 Cristos V216934 180505 Stage4.doc Version 1.20 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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