Inspection on 21/06/07 for St Christopher`s Home

This inspection was carried out on 21st June 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

St Christopher`s Home 15/09/09

St Christopher`s Home 19/06/06

St Christopher`s Home 09/12/05

St Christopher`s Home 15/06/05

St Christopher`s Home 25/01/05

St Christopher`s Home 12/08/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE St Christopher`s Home Abington Park Crescent Northampton Northants NN3 3AD Lead Inspector Keith Williamson Unannounced Inspection 21st June 2007 09:30 X10015.doc Version 1.40 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 St Christopher`s Home DS0000012922.V340002.R01.S.doc Version 5.2 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 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 Christopher`s Home DS0000012922.V340002.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Christopher`s Home Address Abington Park Crescent Northampton Northants NN3 3AD 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) 01604 637125 01604 604114 manager@stchristopherscofehome.co.uk Mr Stephen Billings Mrs Christine Anne Church Care Home 54 Category(ies) of Old age, not falling within any other category registration, with number (54), Physical disability over 65 years of age of places (54) St Christopher`s Home DS0000012922.V340002.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 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 19th June 2006 Brief Description of the Service: St Christophers is a large Home close to Abington Park in Northampton. The Home is a converted 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 Christophers is set in two acres of landscaped grounds, which are well maintained, and are accessible to the residents. All residents are accommodated in single rooms with en-suite 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 newly formed library and two Chapels. St Christophers is registered as a Church of England War Memorial home. A copy of the last inspection report is kept in the home, and is made available to prospective residents. Currently the fees are between £288 and £450 per week with additional charges for hairdressing, toiletries, newspapers, private chiropody and outings. St Christopher`s Home DS0000012922.V340002.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspections is on outcomes for residents and their views of the service provided. The primary method of Inspection used was ‘case tracking’ which involves selecting a sample number of clients and tracking the care they received through looking at their records, talking with them where possible, and looking at their accommodation, in this case four residents were chosen. This site visit took place over one day, commencing at 9.30am and took eight hours to complete. One inspector conducted the inspection (or site visit). An opportunity was taken to look around the home, view records, policies and care plans and to talk to residents and staff. Information was gathered prior to the site visit from the pre inspection questionnaire from the acting manager. Information was recorded on an inspection record, and feedback was given to the manager at the end of the inspection. Twelve of the residents were seen and spoken with during the site visit. Observations made throughout the visit confirmed that residents were relaxed with their surroundings, the staff group and inspector. What the service does well: What has improved since the last inspection? St Christopher`s Home DS0000012922.V340002.R01.S.doc Version 5.2 Page 6 Assessment paperwork has been reviewed and updated and eight-week care reviews are now in place; minutes of these reviews are stored in resident files. The acting manager has begun process of creating a care management paperwork system. Staff now provide more activities, working closely with the Friends of St Christophers providing in house activities and outings. An activity file has been commenced to record any activities offered. A kitchen management system has been introduced. A post has been created for a senior housekeeper. Physical improvements to the building include radiators covers, ground floor window restrictors and a complete kitchen refurbishment. The numbers of staff trained to National Vocational Qualification level two in care have exceeded the minimum 50 . External agencies such as District Nurses, and the Dietician have been sourced for training provision. District Nurse services have been responsive and provided training. 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. The summary of this inspection report can be made available in other formats on request. St Christopher`s Home DS0000012922.V340002.R01.S.doc Version 5.2 Page 7 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 Outcomes Statutory Requirements Identified During the Inspection St Christopher`s Home DS0000012922.V340002.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessment process for residents is detailed and effective; resulting in detailed information for staff to ensure care needs shall be met. EVIDENCE: The Statement of Purpose, which sets out the latest aims, objectives and philosophy of the home, about its services, facilities, and current staffing, was available for inspection on this occasion. This document has not been updated to include the current Registered Person and acting manager details. The Service User Guide has also yet to be updated. All four residents had contracts in place; all were signed by the resident or their representative. St Christopher`s Home DS0000012922.V340002.R01.S.doc Version 5.2 Page 9 The Inspector viewed the assessment information for the residents. The information was comprehensive in providing the amount of detail from which a plan of care could be derived. Standard 6, the home does not provide services for residents with Intermediate Care needs. St Christopher`s Home DS0000012922.V340002.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are looked after well in respect of their health, medication and personal care needs, areas of risk are assessed appropriately, resulting in residents being safe in the home. EVIDENCE: Care plans are written in such a way that all the residents’ needs are taken into consideration. Personal healthcare needs including specialist health, nursing and dietary requirements are clearly recorded in each resident’s plan. The delivery of personal care is individual and is flexible, consistent and reliable. Care plans are regularly reviewed and reviews include the resident or a representative. Daily records are filled in regularly, and adds to the high level of care provided. Health care is well detailed with regular monitoring of residents health being evidenced by the Inspector. Nutritional assessments are in place, and St Christopher`s Home DS0000012922.V340002.R01.S.doc Version 5.2 Page 11 residents have regular visits from the General Practitioner who does a regular “surgery” in the home. Medication is well ordered and managed. The admission or assessment information contained details about the residents’ medication at that time. Records were well managed with no omissions in the medication administration records (mar charts). The home has an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. Regular management checks have yet to be put in place to fully monitor compliance. Issues around privacy and dignity were adequately dealt with in the plans of care, and staff witnessed knocking and waiting for an answer prior to entering residents’ bedrooms. Most bedroom doors have brass knockers, some residents have bedroom door keys, and one indicted “I never lock my door unless I am going to my sons for a few days” St Christopher`s Home DS0000012922.V340002.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy, experience and participate in activities and interests, and are supported to maintain their preferred individual daily routines and choice of lifestyle with the support of the staff. EVIDENCE: Residents’ social activities have been enhanced with the commencement of an activities organiser. This person works with the group of volunteers the “Friends of St.Christophers”, enhancing the activities and outings programme to include staff assistance for less able residents. The activities person has also commenced an activities file giving detailed social care information in addition to the main care plan. There continue to be regular residents and relatives meeting held at the home, these are minuted and available for viewing. A notice board in the dining room has details of forthcoming events and planned trips. One resident stated “I haven’t time to be bored”. St Christopher`s Home DS0000012922.V340002.R01.S.doc Version 5.2 Page 13 Residents’ religious preferences are well dealt with, with two chapels being used by the majority of residents in the home. Though the Church of England owns the home, residents of other denominations reside there, and are enabled to follow their own religious beliefs at a nearby church. Residents confirmed visiting is open and times are varied. Menus were viewed and demonstrated that meals provided are nutritionally balanced and appealing. The cook produces a variety of diets and has been active in enquiring from the residents their current taste and choices, this has positively effected the meal choice in the home. The menu offers a choice of two main meals at lunch though is currently not displayed in the home. A number of residents were observed discreetly being assisted with their meals. The interaction between the residents and staff was very positive. St Christopher`s Home DS0000012922.V340002.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ are protected by appropriate complaints and adult protection policies. EVIDENCE: Residents who were spoken with stated that they feel very comfortable discussing any concerns with the home’s manager or staff. The complaints procedures are available for residents and visitors, and are included in the Statement of Purpose and Service User Guide. Residents spoken with felt they were safe and protected. The Adult Protection procedure has been introduced and staff spoken with confirmed their recent training and were aware of their duties to alert a senior member of staff of any concerns. St Christopher`s Home DS0000012922.V340002.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A comfortable and safe standard of accommodation is provided for the residents. EVIDENCE: The home provides a relaxed and spacious environment that is appropriate to the specific needs of the people who live there. The building and grounds are well maintained, and specialist aids and equipment are provided to meet the needs of the people who use the service. Staff when spoken with have a good knowledge of cross contamination and cross infection issues. A range of protective clothing is available to ensure residents safety in the home. St Christopher`s Home DS0000012922.V340002.R01.S.doc Version 5.2 Page 16 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good staffing levels and a sound recruitment practices ensures residents and staff are safe within the home. EVIDENCE: Staff rotas viewed on the day, showed significant numbers of care staff are employed, and are backed up by cleaning, catering and other ancillary staff. Staff training has accomplished more than the minimum of care staff undertaking the National Vocational Qualification level two in care. The recruitment process is well managed and secure, with evidence of completed application forms, references, proofs of identification and the appropriate Criminal Records Bureaux checks seen on staff files. Staff training has improved with a number of statutory training courses taking place since the inspector last visited. The Acting Manager has identified a number of other training initiatives to assist the staff group, using external training sources such as District Nurses and dietician to broaden staff knowledge. St Christopher`s Home DS0000012922.V340002.R01.S.doc Version 5.2 Page 17 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 345, 36, 37 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management approach promotes effective care practice in the home for residents’ care and protection. The lack of frequency of emergency lighting tests makes the safety process less safe. EVIDENCE: The current acting manager is qualified having gained the Registered Managers award. Quality assurance questionnaires have been distributed to residents and their relatives, though not since the last visit to the home. Regular visits from the St Christopher`s Home DS0000012922.V340002.R01.S.doc Version 5.2 Page 18 board of trustees, and the reports produced following these visits are also a part of the quality assurance of the home. Resident finances are kept by individual residents; no monies are handled by staff. Staff supervision is periodically undertaken in the home. Staff spoken with confirmed sessions takes place regularly and include care practice and key working issues. A sample of accident reports were completed appropriately, and there is accuracy between these and the residents’ individual daily records. Fire records were viewed and the weekly fire alarm tests and periodic fire drills were found to be up to date, the tests for the emergency lighting were not, and more frequent testing be commenced. A number of policies and procedures were viewed in the home, these need to be reviewed and updated. St Christopher`s Home DS0000012922.V340002.R01.S.doc Version 5.2 Page 19 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 3 X 2 St Christopher`s Home DS0000012922.V340002.R01.S.doc Version 5.2 Page 20 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 Standard OP1 Regulation 4&6 Requirement The Statement of Purpose, which sets out the latest aims, objectives and philosophy of the home, must be brought up to date and distributed to prospective residents in the home. This is to ensure all residents have appropriate information prior to entering the home. The execution and recording of the emergency light tests must be done in line with nationally produced guidelines. This to ensure emergency lights are in good working order if an emergency occurs. Timescale for action 30/07/07 2 OP38 23 (4) 16/07/07 St Christopher`s Home DS0000012922.V340002.R01.S.doc Version 5.2 Page 21 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 2 Refer to Standard OP15 OP38 Good Practice Recommendations The menu should be displayed prominently in the home, in advance of meals being served. Policies and procedures in the home should be up reviewed and updated information substituted. St Christopher`s Home DS0000012922.V340002.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. 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