Inspection on 06/02/06 for Cristos

This inspection was carried out on 6th February 2006.

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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cristos 19/09/06

Cristos 18/05/05

Cristos 25/02/05

Cristos 21/09/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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 Linda Boereboom Announced Inspection 6th February 2006 10:00 Cristos DS0000014194.V282505.R01.S.doc Version 5.1 Page 1 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 Cristos DS0000014194.V282505.R01.S.doc Version 5.1 Page 2 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 Stationery 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 DS0000014194.V282505.R01.S.doc Version 5.1 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 Provider Web 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 L Skatulla Mrs Joy L Skatulla Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Cristos DS0000014194.V282505.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The number of service users to be accommodated is ten (10) Service users must be aged 45 years or over on admission Only service users with learning disabilities may be accommodated Date of last inspection 18th May 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 accommodation consisting of six single and two double rooms. Bedrooms are shared by prior arrangement. 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 C ommission for Social Care Inspection formally in the near future. Cristos DS0000014194.V282505.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place during the morning of 6 February, it was announced and took three and a half hours, during that time the Inspector was able to look at the home’s administration process, speak to residents and staff and tour the premises. The Registered Provider/Manager had already returned the pre-inspection questionnaire and six comment cards to the Inspector. Mrs Joy Skatulla the home’s Registered Provider/Manager facilitated the inspection. On the day of inspection eight residents were living in the home. The inspection was a very positive one and the Inspector would like to thank Mrs Skatulla and the staff for their hospitality and making the inspection enjoyable. What the service does well: The Registered Provider/Manager and staff are committed to providing a service that has a ‘home from home’ ethos. On the day of inspection residents were either out at their day centres or in the home taking part in their hobbies. There is no pressure on residents to attend a day centre or college activity and staff are always available to be in the home with those residents who wish to stay in all day. Staff are encouraged to be involved with residents beyond care planning creating a family feel to the environment. The Inspector noted that residents and staff communicated freely and in a friendly way. The home is very much ‘resident-led’ and residents are given choice and encouraged to be involved in all aspects of life in the home. The Registered Provider/Manager is experienced and approachable. This is reflected in the Deputy Manager and staff. During conversation with residents the inspector noted the following comments: ‘the staff are kind’, ‘I never call anyone at night but a very nice lady is always here’, ‘I have what I want to eat’, and ‘We like going out shopping together, we go on very nice trips out’. Staff duties are dovetailed to accommodate the social needs of the residents ensuring they take part in activities and attend the places of worship of their choice. During the inspection the Inspector found that all Criminal Records Bureau checks for staff are renewed three yearly as a matter of course. Cristos DS0000014194.V282505.R01.S.doc Version 5.1 Page 6 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cristos DS0000014194.V282505.R01.S.doc Version 5.1 Page 7 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 Outcomes Statutory Requirements Identified During the Inspection Cristos DS0000014194.V282505.R01.S.doc Version 5.1 Page 8 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 the following standard(s): 2 and 4. Prospective residents are assessed fully prior to being offered a place in the home and can make an informed choice themselves which includes the opportunity to visit the home before they make their decision. EVIDENCE: The Registered Provider/Manager told the Inspector that all residents undergo a pre-admission assessment prior to being offered a place in the home, this either involves them visiting the home or the assessment can take place in their place of residency. The pre-admission assessments cover both physical and mental health and capabilities, involvement in domestic tasks and social interests. The Registered Provider/Manager receives a referral from the funding authority, which goes towards the assessment. Residents are invited to visit the home at least three times before making the final decision to move in, this enables both the staff and prospective resident to ensure that there is suitability on both sides including that of the physical environment. Visits include one with the social worker or representative from the funding authority, one for an evening to share a meal and meet residents and staff, and one for an overnight stay. Cristos DS0000014194.V282505.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 6, 8 and 10. The home’s staff encourage residents to be actively involved in decision making and participate in all aspects of life in the home. Confidentiality is a priority and residents are protected by the homes policies and record keeping procedures. Care planning in the home is good. EVIDENCE: Care plans showed that initial information is transferred from the preadmission assessment to the current care plan. The Registered Provider/Manager told the Inspector that she does not assume that another agency’s care plan for a prospective resident is always fully comprehensive and does not base her decision to offer a place on an outside opinion. Care plans include personal and social history, tertiary care, risk assessments, behaviour, personal care and current social needs. Daily diaries are kept for all residents and a list of appointments kept with healthcare professionals. Care assessments are ongoing and reviewed regularly. Activities in the home and outside are posted on the notice board in the dining room a week in advance and through discussion residents are able to make choices about the events they attend. Residents meeting take place regularly and records are kept; the Inspector saw records of meetings. Senior staff hold the meetings during the weekends and then liaison takes place with the Cristos DS0000014194.V282505.R01.S.doc Version 5.1 Page 10 Registered Provider/Manager who responds to any queries that may have been raised. The last meeting took place on 29/01/06. All residents have a copy of the statement of purpose and service user guide. The home has a confidentiality policy in place, which is available to all. Residents are encouraged from the onset to request to see the Registered Provider/Manager privately; she said they now ask personally to see her in her office. Confidentiality and its importance is a subject brought up at the residents meetings and the Inspector noted that this had been recorded. All residents personal files are locked away when not in use and are kept separately from care plans. Staff are trained in confidentiality as part of their induction programme. Cristos DS0000014194.V282505.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 12,13,15 and 16. Residents in the home are able and encouraged to take part in appropriate activities to suit them both within the home and externally. The home is based in central Hove and residents use local shops and facilities where their neighbours know and recognise them. All residents in the home are encouraged to take responsibility and have the respect of the staff. EVIDENCE: Residents in the home are encouraged to take responsibility and enjoy activities both inside and out of the home. One resident has an employment support worker who oversees her placement in a local supermarket canteen. Residents have the choice of staying at home or going to local centres and those who decide to stay in the home during the day undertake their own activities and hobbies assisted by staff. Others prefer to go to local colleges and take part in courses e.g. yoga, well women and art. On the day of inspection one resident had attended a course that morning and was keen to tell the Inspector about it. Course choices are made by each individual resident and arranged with him or her by the Deputy Manager. An elderly resident has been given a place at a local day centre for the elderly close by. Cristos DS0000014194.V282505.R01.S.doc Version 5.1 Page 12 Staff also spend time with residents going through various scenarios to help them with money handling skills. Seven residents are able to go out alone and are known locally in Hove. Staff organise their bus passes. The home has connections with two organisations SPIRAL and MENCAP who organise holidays and social events i.e. dances and BBQues. A member of staff by takes one resident with a physical disability out each weekend to look at the shops and have coffee. The Registered Provider/Manager told the Inspector that staff shifts are dovetailed to accommodate the social needs of residents and those who wish to go to a place of worship are either accompanied or provided with assistance to attend. The Inspector and Registered Provider/Manager spoke of the home’s role in maintaining family links for residents and the Registered Provider/Manager told the Inspector that as the residents are largely elderly very few have immediate family. Families who keep in touch are invited to visit the home as they wish and efforts are made at Christmas time to include them in social gatherings. Residents are able to choose whom they see and staff are taught during induction that residents must always be given the choice of whether they want to speak to a caller on the telephone or see a visitor at the door. The home has a sexuality policy in place and is sensitive to the needs of residents who wish to have a special relationship. The Inspector observed that residents’ privacy is respected and they are treated with respect. Staff are requested they always knock on residents doors before entering and all residents have their own front door and individual room keys. All residents open their own mail, are referred to by their preferred name and given the choice of whether or not they want the night staff to look in on them during the night. Freedom of movement within the home is encouraged. Cristos DS0000014194.V282505.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 18 and 21 Residents receive personal support from staff in a way that they prefer and is suitable to their individual needs. Staff are trained in their approach to assisting residents and ensuring they have choices in the way the care is provided. Residents are able to stay in the home for life as long as all their needs can be thoroughly met. EVIDENCE: All staff receive relevant training to assist them in providing appropriate and safe care for residents. One resident has a physical mobility difficulty and staff are aware of her specific requirements. One resident at the time of inspection required full personal support and the remaining residents required prompts and/or supervision with personal needs. All residents choose their own clothes and are encouraged to shop either with staff or each other. There are two male and six female staff who provide care to the four male and four female residents. Although the home has a death and dying policy in place the Registered Provider/Manager reported that all deaths have been age related and taken place either in hospital or in nursing homes. The home will only keep residents if they are fully able to meet their needs and liaise with relevant healthcare agencies to achieve this. Cristos DS0000014194.V282505.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 22 and 23 The home encourages residents to speak to staff about their views and any concerns they may have. The home’s training programme and policies and procedures protect them from abuse however the recording of complaints requires addressing. EVIDENCE: Since the last inspection in May 2005 the home had not received any complaints however through discussion it was agreed that concerns raised by residents were not being recorded and the Registered Provider/Manager and Inspector agreed that all future concerns/complaints would be recorded with the action taken and outcome, no matter how minor they appeared to be. The home ensures that staff receive appropriate training with Brighton and hove council for the protection of vulnerable adults and both the Registered Provider/Manager and the Deputy Manager were booked for a refresher course on 9/2/06. The Registered Provider/Manager ensures that residents are protected financially and although she acts as appointee for seven residents she has specific accounts in place to manage their direct payments that is separate from the everyday banking account used by the home. The Inspector saw duplicate accounts kept in the home. Cristos DS0000014194.V282505.R01.S.doc Version 5.1 Page 15 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 the following standard(s): 25,27 and 29 Residents each have rooms that are individual to them and meet their needs and lifestyles. Although there are not any ensuite rooms the home has sufficient bathroom facilities for the number of residents. Specialist equipment is obtained from local healthcare services as and when it is required. EVIDENCE: Resident’s rooms reflect their own ideas and personalities. The Inspector was able to look at all the rooms and found them to be very comfortable and suitably furnished with matching and colourful bed-linen. The Registered Provider/Manager told the Inspector that residents are encouraged to bring their own possessions to the home and pets are individually assessed. At the time of the inspection no resident had their own pet but all enjoyed visits from the Registered Provider/Manager’s dog. Residents told the Inspector that in addition to watching television in the main sitting room, they could if they wished watch their own televisions in their individual rooms. Throughout the home there are four bathrooms and five toilets. All have overriding lock devices in case of an emergency. A new bathroom on the lower ground floor is currently being completed. Cristos DS0000014194.V282505.R01.S.doc Version 5.1 Page 16 At the time of inspection only one resident required the aid of additional grab rails. There is the provision of a swivel seat in one bath and booster seats in the others. No other equipment is required for the current residents. Cristos DS0000014194.V282505.R01.S.doc Version 5.1 Page 17 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 and 34 Residents are protected by the home’s recruitment process and the clarity of staff roles and responsibilities that are reflected in their job descriptions. EVIDENCE: During the inspection the Inspector spoke at length with the Registered Provider/Manager about the recruitment process, administration, and the roles of the staff members. Looking at staff recruitment files it was apparent that all staff had job descriptions including the Registered Provider/Manager. Discussion evolved about the role of the Senior Carer/Supervisor who also acts as the Deputy Manager in the absence of the Registered Provider/Manager. It was agreed that the new job description for the Deputy Manager would reflect the Registered Provider/Manager’s own job description. On application each prospective staff member is asked to provide two written references, one from their last employment. The Registered Provider/Manager said she sometimes backs the references with a telephone call. Each staff member has a job description and code of conduct. All were seen to have terms and conditions relating to their employment and all had been Criminal Records Bureau checked and Pova First checked if appropriate. The Registered Provider/Manager is to be congratulated on her commitment to ensuring staff are re-checked every three years. Other information in staff records included an up to date photograph, absence record, training information and certificates Cristos DS0000014194.V282505.R01.S.doc Version 5.1 Page 18 and a completed induction workbook with additional information on policies and procedures used in the home. Cristos DS0000014194.V282505.R01.S.doc Version 5.1 Page 19 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 The home is well run and the outcome for residents is good. The health and safety of residents is protected by the home’s policies and procedures and attention to risk assessment and fire safety in the home. EVIDENCE: The Registered Provider/Manager has been in post for fifteen years but has worked in the home for twenty-five years. She has completed half the Registered Manager’s Award modules and attends training for her work that is relevant. The Registered Provider/Manager is committed to good communication and working relationships between herself and the staff, promoting the ethos that the resident’s must always feel that the home is theirs and their choices and rights are protected. There is a quality control system in place and a questionnaire goes out to residents twice a year. Feedback is available for visitors and was seen by the Inspector. Questionnaires include all aspects of life in the home and asks for views on meals, personal care delivery, daily living arrangements, the Cristos DS0000014194.V282505.R01.S.doc Version 5.1 Page 20 premises and management. In 2005 the questionnaires were sent out in April and October; those returned were all very positive. Residents are encouraged to take their questionnaires to their day centres for help with completion to make the process fair. The home has adequate safety signage throughout and has a policy that residents remain where they are in the event of a fire until they are collected by staff. This follows advice sought by the Registered Provider/Manager. All doors with automatic closures are checked regularly. The home has fire doors throughout and no doors apart from those with automatic closing devices are wedged open. The fire brigade inspected the home in January 2006 and did not make any requirements. The Registered Provider/Manager undertakes regular environmental and fire risk assessments (last undertaken 10/01/05), this includes all doors, alarms, emergency lighting, fire extinguishers, exits, smoking notices, staff roles, staff training and COSHH. All staff have moving and handling training. Checks to water temperatures are undertaken on a rotation system. The home has relevant policies and procedures in place and an up to date accident-recording book. Cristos DS0000014194.V282505.R01.S.doc Version 5.1 Page 21 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. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (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 Standard No Score 1 X 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 X 25 3 26 X 27 3 28 X 29 3 30 X STAFFING Standard No Score 31 3 32 X 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X 3 X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X X 3 X Cristos DS0000014194.V282505.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? NO 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 2 Standard YA22 YA24 Regulation 22 23(2)b Timescale for action The Registered Provider/Manager 12/02/06 to ensure that all complaints are recorded no matter how minor. The laundry room ceiling and 01/04/06 walls to be repaired and painted. Requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cristos DS0000014194.V282505.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection East Sussex Area Office 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 DS0000014194.V282505.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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