Inspection on 09/12/05 for St Christopher`s Home

This inspection was carried out on 9th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

St Christopher`s Home 15/09/09

St Christopher`s Home 21/06/07

St Christopher`s Home 19/06/06

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 The Old Rectory Abington Park Crescent Northampton Northants NN3 3AD Lead Inspector Mrs Sarah Smart Unannounced Inspection 9th December 2005 09.10 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.V270373.R02.S.doc Version 5.0 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.V270373.R02.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service St Christopher`s Home Address The Old Rectory Abington Park Crescent Northampton Northants NN3 3AD 01604 637125 01604 604114 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) St Peter & St Paul, Abington 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.V270373.R02.S.doc Version 5.0 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 15th June 2005 Brief Description of the Service: St Christophers 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 Christophers 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 Christophers is registered as a Church of England War Memorial home. St Christopher`s Home DS0000012922.V270373.R02.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was undertaken between the hours of 9.00am and 1pm. Preparation for the inspection included, review of the previous inspection report, requirements and recommendations, and took approximately 2 hours. The pre-inspection questionnaire had been completed and returned to the inspector prior to the inspection. Written feedback in the form of questionnaires was received from 30 service users, and 41 relatives. Some of the feedback received from relatives, included comments such as need more activities, a wonderful place, happy, sensitive carers, delighted with care and high standards. 40 of the relatives stated they were happy with the overall standards, and 39 feel welcomed into the home. 10 said they do not have knowledge of the complaints procedure. 90 of the service users stated that they liked living at the home, and over 95 said they are treated well. 19 of the service users said that the activities were suitable. The primary method of inspection used was ‘case tracking’. This involves selecting a number of service users and tracking their care and experiences through review of their records, discussion with them, the care staff and observation of care practices. The following areas were covered during the inspection: case tracking, medication, staff rota, tour of the premises, observation of the kitchen and food, service users finances, previous requirements made, and staff and service user interviews. Two service users were case tracked. Two staff members, plus the manager, were interviewed at length, and several others briefly, whilst five service users were spoken to in detail. What the service does well: Needs assessments were recorded to a high standard. The provision of activities appeared satisfactory, and service users gave positive feedback. Staff demonstrated an adequate knowledge of the Protection of Vulnerable Adults and complaints procedures. The home was clean and tidy, and service users rooms were personalised. There were no infection control issues noted. There was sufficient staff on duty at the time of the inspection. Service users and relatives generally gave positive feedback about the home. Service users finances were accurately recorded. St Christopher`s Home DS0000012922.V270373.R02.S.doc Version 5.0 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. St Christopher`s Home DS0000012922.V270373.R02.S.doc Version 5.0 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.V270373.R02.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Service users needs are adequately assessed, and recorded. EVIDENCE: Service users assessments were recorded to a high standard. The assessments were dated and signed by the author and reviewed. In one of the two case tracked, the service user had signed the assessment. These assessments were the subject of a previous requirement which has been met. St Christopher`s Home DS0000012922.V270373.R02.S.doc Version 5.0 Page 9 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 the following standard(s): 7,8,9 Service users health and personal care needs are not adequately assessed, recorded or managed. EVIDENCE: One of the two service users cases tracked did not have any care plans written. The seconds care plans did not contain specific instruction to staff as to their care needs. A requirement has been made in relation to this. In both instances the paperwork pertaining to healthcare assessments was in the service users file, however, they all remained blank. One of the service users in particular would be considered at some risk of developing pressure sores. This was the subject of a previous requirement which remains unmet. The manager stated that approximately 25 of such assessments had been carried out. The inspector requires that the assessments are prioritised, and completed at the earliest opportunity. Records in relation to personal hygiene were not completed fully, in that the records indicated that service users bed linen was only changed once per fortnight. The manager stated that this is not the case. A sample of medication was viewed. Storage and administration was generally satisfactory. The medication administration record sheets had a few gaps in St Christopher`s Home DS0000012922.V270373.R02.S.doc Version 5.0 Page 10 the records. Due to the number of gaps noted, a recommendation had been made in relation to this. One service user was noted to be self administering her medication. A staff member stated that the home are unsure exactly what medication she is taking, as it is not all recorded on the medication administration record sheets. Evidence also indicated that the service user is taking two medications which work against each other. The home must demonstrate how they intend to manage this. A risk assessment had been carried out in relation to the service users ability to self medicate, however this was not robust as it did not cover all aspects of safety. The medication storage room appeared to be hot. A thermometer was not available. The manager is required to measure this, and take necessary action. St Christopher`s Home DS0000012922.V270373.R02.S.doc Version 5.0 Page 11 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 the following standard(s): 12,15 Records of activities on offer are limited, although the provision was satisfactory. The food provided was acceptable. EVIDENCE: The home produce a magazine, which outlines the planned activities for the coming weeks. The manager stated that in addition to these activities various other impromptu sessions are held, such as film afternoons, carpet bowls etc. the inspector recommends that records are introduced to demonstrate all the activities offered to service users, which would include if an activity was offered that the service user declined. Service users spoken to seemed a little vague about the activities in the home, but stated that they do not get bored. On the evening of the inspection, a carol concert and party was planned. The home benefits from having a group called the “friends of St Christopher’s” which is a fundraising group who organise and host social events periodically. The kitchen was a well managed area, with all of the required records kept. Food was stored appropriately. In one fridge in the coffee lounge an out of date Easter egg was found. The manager should ensure that procedures are put in place to ensure that items are disposed of when out of date. St Christopher`s Home DS0000012922.V270373.R02.S.doc Version 5.0 Page 12 Feedback from service users in relation to food was generally positive, and they stated that they are offered a choice. St Christopher`s Home DS0000012922.V270373.R02.S.doc Version 5.0 Page 13 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 the following standard(s): 16 and 18 partially Staff knowledge of the procedures and policies was satisfactory. EVIDENCE: Staff were given a scenario of abuse, and correctly described the action to be taken. Staff were also asked what action they would take should they receive a complaint. Their response was appropriate. St Christopher`s Home DS0000012922.V270373.R02.S.doc Version 5.0 Page 14 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 the following standard(s): 19,20,21,22,23,24,25,26 The areas of the home accessible to the service users are maintained to a high standard. Some risk assessments are required to maintain safety. EVIDENCE: A sample tour of the premises was undertaken. The kitchen did not appear to offer a great deal of work space, and had an awkward layout. The kitchen would benefit from refurbishment or modernisation, and if possible, additional space or work areas which were laid out appropriately. (see standard 15) Several service users bedrooms were visited. These areas were all clean and tidy, and personalised by the individual occupying that room. Several radiators throughout the home did not have low surface temperature covers in place. As a minimum a risk assessment must be carried out. A fire door was wedged open at the time of the inspection. This was removed at the time by the manager. One service users bedroom had a frayed carpet across the entrance to her room. This posed a tripping hazard, and must be addressed as a matter of St Christopher`s Home DS0000012922.V270373.R02.S.doc Version 5.0 Page 15 urgency. The manager stated that in the interim protective tape would be applied. First floor windows were noted not to be restricted by the amount they open, posing a risk of falling to service users and visitors. As a minimum a risk assessment must be carried out in relation to this. One service users ensuite contained steradent on the window cill. A risk assessment was noted in this service users file in relation to this, however the risk assessment stated that it must be stored in a locked area. This should be addressed. A kitchenette in the building had a water heater which was accessible to service users. A risk assessment must be carried out in relation to this, to reduce the risk of scalds. There were no infection control issues noted during the inspection. Communal bathrooms were satisfactory. St Christopher`s Home DS0000012922.V270373.R02.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 The home is appropriately staffed. EVIDENCE: The staff rota demonstrated that the home is adequately staffed to meet the service users current needs. Service users spoken to stated that their call bells are answered timely. The staff rota did not include the manager or the deputy managers hours worked. These should be available, including if either of these staff cover care shifts. Staff spoken to gave positive feedback. At the time of the inspection staff were undergoing food hygiene training. St Christopher`s Home DS0000012922.V270373.R02.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35,38 The home is satisfactorily managed. EVIDENCE: A sample of service users monies held by the home were viewed. The money held was accurately recorded. The records indicated that only one signature is recorded when transactions occur, whether money is deposited or removed. The inspector recommends that in every instance two signatures are obtained. Such signatures may be two staff members, or a staff member and the service user or a relative. In some instances risk assessments are required to ensure that risks are identified and reduced appropriately. These have been addressed in previous standards. The previous recommendation in relation to the electrical room has been met. St Christopher`s Home DS0000012922.V270373.R02.S.doc Version 5.0 Page 18 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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 2 St Christopher`s Home DS0000012922.V270373.R02.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? yes 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 OP7 Regulation 15(1) Requirement Care plans must be written in relation to all service users needs, and contain specific instruction to staff. Assessments and appropriate intervention, must be recorded in residents plans of care, in relation to pressure care, catheter care, nutritional needs and falls prevention. This was a previous requirement with a timescale of 31.7.05, which remains unmet. This must be prioritised and addressed as a matter of urgency. Medication issues must be addressed: 1. The medication store room temperature must be monitored. 2. Robust self administration risk assessments must be recorded. 3. AN identified service users medication must be appropriately managed. A risk assessment must be carried out in relation to the lack of low surface temperature DS0000012922.V270373.R02.S.doc Timescale for action 15/01/06 2. OP8 13 (1) (b) 15/01/06 3 OP9 13 15/01/06 4 OP25 23(2) 30/01/06 St Christopher`s Home Version 5.0 Page 20 5 OP19 23 6 7 OP19 OP25 23 23 radiator covers. Identified action must be undertaken. A risk assessment must be undertaken in relation to the wide opening of the first floor windows. Identified action must be undertaken. The carpets must not pose a tripping hazard to service users. A risk assessment must be undertaken in relation to the accessible hot water heater. Identified action must be undertaken. 30/01/06 10/01/06 30/01/06 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 3 4 5 6 Refer to Standard OP9 OP15 OP15 OP25 OP27 OP35 Good Practice Recommendations Gaps should not occur in the recording of administered medication. Processes should be put in place to ensure that out of date food is not accessible to service users. Kitchen refurbishment should be considered in the maintenance plan for the forthcoming year. Sterident should be stored in line with the recorded risk assessment. All staff hours should be recorded on the duty rota, including the manager, deputy manager, and volunteers. Two signatures should be recorded when financial transactions are undertaken. St Christopher`s Home DS0000012922.V270373.R02.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Northamptonshire Area Office 1st 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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