CARE HOMES FOR OLDER PEOPLE
St Christophers Home The Old Rectory Abington Park Crescent Northampton Northants NN3 3AD Lead Inspector
Stephanie Vaughan Unannounced 15 June 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 Older People. 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. St Christophers Home DC51 C08 S12922 St Christophers V232343 150605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service St Christophers Home Address The Old Rectory Abington Park Crescent Northampton Northants NN3 3AD 01604 637125 01604 604114 manager@stchristopherscofehome.co.uk St Peter & St Paul Abington (Reverend Stephen Adams) 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) Christine Anne Church Care Home 54 Category(ies) of PD(E) Physical dis - over 65 registration, with number OP Old age of places St Christophers Home DC51 C08 S12922 St Christophers V232343 150605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: No person falling within the category Older Persons (OP) can be admitted where there are already 54 persons of category OP already in the Home. No person falling within the category PD (E) can be admitted where there are 54 persons in the category PD (E) already in the Home. The total number of service users in the Home must not exceed 54. Date of last inspection 25.1.05 Brief Description of the Service: St Christopher’s is a large Home close to Abington Park in Northampton. The Home was originally an old vicarage, which has been extensively extended on the ground floor level and refurbished throughout. The Home now provides care and personal support for up to 54 older people with needs arising out of old age and physical disability. St Christopher’s is set in two acres of landscaped grounds, which are well maintained, and are accessible to the service users. All service users are accommodated in single rooms with ensuite facilities There are 9 bedrooms upstairs, which are accessed, by a stair lift or a passenger lift. The remaining bedrooms and a choice of communal rooms are on the ground floor. Other facilities offered within the Home include a hairdressing room; a small shop; a computer suite and two Chapels.St Christopher’s is registered as a Church of England War Memorial home, and the trustees are the incumbents of the Parishes within the Deaneries. The Lord Bishop of Peterborough holds the office of President of St Christopher’s. St Christophers Home DC51 C08 S12922 St Christophers V232343 150605 stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over a period of five and a half hours following a period of one hours preparation, which included a review of previous inspection reports, service history, correspondence and other documentation. The methodology for the inspection covered a limited tour of the building, the inspection of records, discussion with the Registered Provider, Residents, and Staff. Prior to the inspection taking place a pre-inspection questionnaire was sent to the provider from The Commission for Social Care Inspection, together with residents and relatives comment cards. The pre-inspection questionnaire has not yet been returned to The Commission for Social Care Inspection, also no residents or visitors comment cards have been received and will be used to inform the next inspection planning process. What the service does well:
Residents’ plans of care are generally good, there is evidence that residents’ views are sought in agreeing what personal information they wish to be available within their plans of care. The internal and external environment and the facilities within the home is of a high standard. There is a small shop, hairdressing salon, 2 chapels and a computer suite available within the home, and therapeutic equipment such as a spa bath. There are quiet sitting areas available for residents to meet with visitors and pursue their interests. A named member of staff (a key worker) is available for each resident, ensuring that person centred care is practiced, and residents individual needs are accommodated. Residents are consulted through the use of a Residents meetings and Newsletter supplying details of forthcoming events. St Christophers Home DC51 C08 S12922 St Christophers V232343 150605 stage 4.doc Version 1.30 Page 6 Privacy and dignity is managed well, all residents rooms have privacy locks and the doors have brass fittings associated with a personal front door, including a door number, brass letter box and door knocker. What has improved since the last inspection? What they could do better:
Prior to moving into the home all prosective residents must have a full assessment of needs undertaken, to ensure the home can meet their needs and expectations. The residents plans of care must be improved to include greater detail in how the home can meet the health needs of residents with particular attention to catheter care, assessments for nutrition, the risk of pressure and falls. Staff files must evidence that two written references have been obtained prior to staff commencing employment at the home. The manager has addressed most of the requirements from the last Fire Inspection Report, however the requirement to fit flame retardant boarding remains outstanding.
St Christophers Home DC51 C08 S12922 St Christophers V232343 150605 stage 4.doc Version 1.30 Page 7 All combustible materials have been removed from the room housing the homes electrical supply, due to the removal of the hazard within the immediate environment the registered manager should to consult with the Fire Officer as to whether this is still a requirement. 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. St Christophers Home DC51 C08 S12922 St Christophers V232343 150605 stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection St Christophers Home DC51 C08 S12922 St Christophers V232343 150605 stage 4.doc Version 1.30 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3 & 4 Prospective residents and their representatives have access to information prior to moving into the home. However all new residents must have a full pre admission assessment to ensure that the home can meet their needs and expectations. EVIDENCE: The home has a statement of purpose, which is available to prospective residents in addition the home also supplies a brochure providing additional information to include photographs of the homes interior and grounds. A copy of the most recent inspection report from The Commission for Social Care Inspection is available, within each lounge on the residents/visitors notice boards. In general residents have a comprehensive pre admission assessment, however one recent admission had not received a pre admission assessment to establish whether the home was able to meet the residents individual needs and expectations. St Christophers Home DC51 C08 S12922 St Christophers V232343 150605 stage 4.doc Version 1.30 Page 10 Residents spoken to confirmed access to written material such as the service users guide and that they had opportunities to visit the home prior to admission. St Christophers Home DC51 C08 S12922 St Christophers V232343 150605 stage 4.doc Version 1.30 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 & 8,10 & 11 Personal and social care needs are set out in the residents’ plans of care, however some of the health information supplied within the plans of care required updating, to fully reflect the current situation of residents needs and dependency levels. EVIDENCE: Care plans provide sufficient information on the social and emotional needs of residents. However as residents become more dependent care plans should include greater detail regarding their needs and specific instruction to staff about how their needs are to be met. For example, the individual plans of care must include the management of catheter care, assessments for nutrition, the risk of pressure and falls. Residents are consulted and their views sought on personal information provided in their individual plans of care, including the wishes in the event of death, demonstrating residents’ rights to privacy, dignity and respect. St Christophers Home DC51 C08 S12922 St Christophers V232343 150605 stage 4.doc Version 1.30 Page 12 Residents spoken to confirmed satisfaction with the care provided in the home and that their wishes were respected. Privacy and dignity is managed well within the home and residents have their own letterbox, door knocker and name plate on their doors to their individual accommodation Residents confirmed that they were able to receive their chosen visitors in privacy should they wish to do so and the home provides ample quiet areas. St Christophers Home DC51 C08 S12922 St Christophers V232343 150605 stage 4.doc Version 1.30 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 & 14 Residents are supported in following their individual lifestyle preferences. EVIDENCE: There are facilities within the home including a shop, hairdressing salon, two chapels and a computer suite; there are separate lounges and seating areas where residents can meet with visitors. Residents confirmed that routines within the home are flexible and varied with regular opportunity to participate in social activity. During the inspection residents gathered in the main sitting room for a visiting musical performance and tea time refreshments. Other activities are ongoing within the home, examples of which are computer training, gardening club and tomato growing competitions. Residents confirmed satisfaction with the food provided and opportunities to contribute to the menu planning. Meals are generally served within the congenial setting of the dining room. However residents confirmed that they were also able to take their meals in the privacy of their private accommodation should they so wish. St Christophers Home DC51 C08 S12922 St Christophers V232343 150605 stage 4.doc Version 1.30 Page 14 Residents Association meetings take place biannually and a newsletter circulated to all residents. St Christophers Home DC51 C08 S12922 St Christophers V232343 150605 stage 4.doc Version 1.30 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 The home has a satisfactory complaints system and staff have a knowledge and understanding of Adult Protection issues, which ensures the Protection Of Vulnerable Adults. EVIDENCE: There is a complaints policy available and a copy of the complaints procedure was on display in the entrance to the building. Staff have received training on abuse awareness and ongoing training is included in the homes training plan. Residents Association meetings take place biannually, which provides the forum for residents to raise their individual and joint concerns and a newsletter circulated to all residents. Residents spoken to confirmed that they felt safe living at St Christopher’s and that the staff were very nice. In addition they were able to confirm access to the complaints policy and felt confident that any concerns that they may have would be appropriately addressed. St Christophers Home DC51 C08 S12922 St Christophers V232343 150605 stage 4.doc Version 1.30 Page 16 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,22,23,24,25 & 26 The home is spacious and furnished to a high standard, with all areas fully accessible and provides a choice of facilities for residents to access. The extensive garden is maintained to a high standard with pleasant paved patio areas and outdoor seating. EVIDENCE: The décor and furnishings are maintained to a high standard, there are quiet rooms available for residents to meet with visitors away from their individual bedrooms. There is a computer suite available within the home to enable residents to access the Internet, and a small shop for residents to purchase toiletries etc. There are good bathing facilities, to include a spa bath. The home has two chapels enabling residents to worship in keeping with their faith, religious services are held regularly throughout the week.
St Christophers Home DC51 C08 S12922 St Christophers V232343 150605 stage 4.doc Version 1.30 Page 17 The home is clean and free from any offensive odours. Residents spoken to confirmed satisfaction with the facilities provided by the home and the comfort of their private accommodation. Rooms evidenced a high level of personalisation. St Christophers Home DC51 C08 S12922 St Christophers V232343 150605 stage 4.doc Version 1.30 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 & 30 Staff moral is good resulting in an enthusiastic workforce that works positively with residents to improve their whole quality of life. Records of staff interviews and the recruitment process are generally good. EVIDENCE: Staff spoken to confirmed that there is good support from management and training opportunities are available. Training is being undertaken in NVQ (National Vocational Qualifications) level 2 & 3 in Care. Staff records contained evidence of a rigorous interview and vetting procedure in place, however there was evidence that a recently appointed staff member has one reference outstanding, all other vetting checks have taken place and are satisfactory. St Christophers Home DC51 C08 S12922 St Christophers V232343 150605 stage 4.doc Version 1.30 Page 19 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,36,37 & 38 The leadership in the home is good, there is an established staff team, and low staff turnover, which ensures consistency in the quality of care, provided for residents. EVIDENCE: The manager demonstrated a good understanding of the areas in which the home is able to improve. Plans are in hand to review and update policies and procedures, to ensure the information in residents care plans includes specific detail in meeting health care needs and risk assessments. Systems have been introduced to ensure that appropriate kitchen records are now maintained i.e. the recording of cleaning schedules, daily fridge and freezer temperatures. St Christophers Home DC51 C08 S12922 St Christophers V232343 150605 stage 4.doc Version 1.30 Page 20 The manager has addressed the requirements from the last Fire Inspection Report and the statutory fire signage is in place, however the requirement to fit flame retardant boarding remains outstanding. All combustible materials have been removed from the room housing the homes electrical supply, due to the removal of the hazard within the immediate environment the registered manager should to consult with the Fire Officer as to whether this is still a requirement. St Christophers Home DC51 C08 S12922 St Christophers V232343 150605 stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 2 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x
COMPLAINTS AND PROTECTION 3 3 x 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 x x 3 3 3 St Christophers Home DC51 C08 S12922 St Christophers V232343 150605 stage 4.doc Version 1.30 Page 22 No 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 3 Regulation 14 (1) (a) Requirement Prior to moving into the home all prosective residents must have a full assessment of needs undertaken, to ensure the home can meet their needs and expectations. Assessments and appropriate intervention, must be recorded in residents plans of care, in relation to pressure care, catheter care, nutritional needs and falls prevention. Two written references must be obtained for all staff employed at the home. Timescale for action 30th JUly 2005 2. 8 13 (1) (b) 30th July 2005 3. 29 19 (1) (i) 30th July 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 38 Good Practice Recommendations The Registered Manager should consult with the Fire Officer as to the measures put in place to reduce the fire risk within the homes electrical supply room, to ensure that this action is suitable to the level of risk. St Christophers Home DC51 C08 S12922 St Christophers V232343 150605 stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Fist Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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