Inspection on 12/12/05 for St Christopher`s House

This inspection was carried out on 12th December 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St Christopher`s House 21/06/07

St Christopher`s House 18/09/06

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Townley Road, 2-3

Chatsworth Care - Tudor Lodge

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

CARE HOME ADULTS 18-65 St Christopher`s House 6 Mays Lane Barnet Hertfordshire EN5 2EE Lead Inspector Daniel Lim Announced Inspection 12th December 2005 09:35 St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 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 House DS0000063893.V257723.R01.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 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. St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service St Christopher`s House Address 6 Mays Lane Barnet Hertfordshire EN5 2EE 020 8364 8085 020 8364 8085 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) Platinum Health Resources Ltd Mr Ephantus Maina Njogu Care Home 6 Category(ies) of Learning disability (0), Mental disorder, registration, with number excluding learning disability or dementia (0) of places St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection NA Brief Description of the Service: St Christopher’s House is a care home registered to provide care for a maximum of six adults who may have either a mental disorder or learning disabilities. The home was opened in June 2005. It is owned by Platinum Health Resources Limited, a private company based in London. This is the only home owned by the company. The aim of the home is to provide individualised care for all it’s service users by working in partnership with service users and other relevant agencies and to encourage service users to lead as independent a life as possible and attain their full potential. The home is an end of terrace two storey house with a loft conversion. There are a total of six single bedrooms, a large lounge on the ground floor and a smaller one on the first floor. On the ground floor there is one bedroom, a kitchen/diner, a lounge, a bathroom with a toilet, a small toilet and an office. The first floor has a bathroom and three bedrooms. The attic is converted into a further two bedrooms. There is a small parking area at the front of the house and a garden at the back. The home is set in a residential area and overlooks a primary school. It is within walking distance of Barnet General Hospital, local shops, restaurants, underground station and community facilities located along the High Street in High Barnet. St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on the 12 December 2005 and took six hours to complete. The inspector found that many of the National Minimum Standards assessed had been met and the overall quality of care provided was good. During this inspection, the inspector (Daniel Lim) and observer (Denise Rogers, senior administrative officer, CSCI) were assisted by the home manager (Mr Ephantus Njogu). The inspector was able to interview three residents independently of staff. They spoke highly of staff and indicated that they were satisfied with the quality of care provided. This was also confirmed in a completed questionnaire received from a resident. Three residents’ case records were examined in detail. The premises including bedrooms, communal areas and the gardens were inspected and the maintenance records were examined. Two staff on duty were interviewed on a range of topics associated with their work and a sample of staff records were examined. Minutes of staff meetings and residents’ meetings were also examined. What the service does well: What has improved since the last inspection? This was the first inspection of the home since it was registered. St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 Page 6 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 House DS0000063893.V257723.R01.S.doc Version 5.0 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 St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 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): 1, 2, 3, 4, 5 The manager and his staff had a good understanding of the needs of residents and arrangements were in place to ensure that their needs were met. Improvements are however, required in the statement of purpose and in contracts with residents. EVIDENCE: Three residents who were interviewed indicated that their care needs had been met at the home and they were happy with the care provided. Comments made included, “staff are respectful”, “nice staff ”, “satisfied with care”. A sample of three residents’ case records which were examined, contained plans of care and details of how residents needs had been met. The inspector observed that residents in the home were clean, appropriately dressed and appeared well cared for. The statement of purpose was not sufficiently comprehensive as it did not clearly specify the criteria for admission into the home (such as residents who have been stabilised and non admission of highly disturbed service users, those on certain restriction sections of the Mental Health Act and those with a history of abusing children. This is required to ensure that the admissions into the home are appropriate. (The criteria for admission into the home is partly St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 Page 9 determined by staff arrangements. Please also refer to the section on staffing). The contract with residents did not clearly specify the obligations of residents (such as co-operating with staff, complying with treatment, not taking illicit drugs etc). This is necessary to ensure that residents are fully informed. St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 Page 10 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, 7, 8, 9 Residents had been consulted and encouraged to remain as independent as possible. Improvements are however, needed in the care documentation of a resident. EVIDENCE: The three residents who were interviewed were able to confirm that staff listened to them and suggestions made by them had been acted upon. This included meals prepared and outings organised. The minutes of residents’ meetings were examined. These contained evidence that residents’ preferences had been responded to. The sample of three residents’ case records contained evidence that residents had been encouraged to be as independent as possible. Residents were able to confirm that they took part in some household chores such as assisting with cooking, washing and cleaning. The risk assessment of a resident who had misused alcohol and had exhibited paranoid behaviour (identified to the manager) was examined in detail. It was St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 Page 11 not sufficiently comprehensive as it did not contain strategies for minimising the identified risk mentioned. This is needed to ensure that staff are fully informed regarding potential risks and the care to be provided. St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 Page 12 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): 11, 12, 13, 14, 15, 16, 17 Residents had opportunity for personal development and the provision of meals was satisfactory. Improvements are however, needed to ensure that residents have access to a range of social and leisure activities. EVIDENCE: The daily life and routines of residents were flexible and residents could attend day centres and some had part time jobs within a sheltered environment. The inspector was informed by residents and staff that a Christmas party had been organised and on certain days, a take away meal was purchased for residents. Meetings had been organised and the minutes examined indicated that residents had been consulted regarding the management of the home. St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 Page 13 Resident interviewed indicated that they took part in planning the menu and they were satisfied with the meals served. The menus examined appeared varied and balanced. The kitchen was clean and a record of fridge and freezer temperatures had been kept. Residents interviewed stated that they could watch TV and listen to music. The home however, did not have an organised weekly programme of leisure and social activities. This is required to ensure that residents are provided with social and mental stimulation. This programme should be on display so that residents and staff are informed. St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 Page 14 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, 19, 20, 21 The personal and healthcare needs of residents had been met at the home. Further improvements are however, needed to ensure that staff are trained in the administration of medication and residents are assessed before they are allowed to self medicate. EVIDENCE: Feedback from residents interviewed, indicated that residents’ healthcare needs had been met. Comments made included, “we can see the doctor ” and “my medication has been given by staff”. The sample of three case records examined were up to date and plans of care had been reviewed. Records of medical and healthcare treatment were documented. Staff interviewed were knowledgeable regarding the care to be provided to residents. The temperature of the room where medication was stored had been recorded daily and was satisfactory. St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 Page 15 MAR charts had been signed appropriately to indicate that medication had been administered. Not all staff who administer medication had received the appropriate training. This is required and a certificate must be obtained to evidence this. A self administration assessment form had not been completed (and agreed with the doctor concerned) for a resident who administered his own medication. This is required to ensure that professionals concerned are satisfied with the arrangements. St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 Page 16 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, 23 Arrangements were in place to ensure that residents were listened to and protected from abuse and neglect. EVIDENCE: The complaints book was examined. No complaints were recorded. The manager explained that none had been received since the home opened. The five residents interviewed stated that they were well treated by staff and staff were respectful towards them. The home had an adult protection policy and procedure. The local authority guidelines were available in the home. The two staff interviewed were knowledgeable regarding the procedure to be followed when responding to allegations of abuse. St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 Page 17 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): 24. 25, 26, 27, 28, 29, 30 The home was well furnished and comfortable, therefore providing a pleasant environment to live in. A risk assessment regarding the use of the washing machine is however, required. EVIDENCE: All three residents interviewed stated that they were happy with the accommodation provided. The premises were inspected and found to be clean and well furnished. The hot water in the bathroom sink was tested and found to be within the required safe temperature range of no higher than 43 C. The home had the required safety certificates. These included safety inspection certificates for the gas and electrical installations. St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 Page 18 The washing machine was located in the kitchen. This was discussed with the manager and a requirement is made in this report for a risk assessment to be carried out and for instructions to be given to staff to minimise potential risks from cross infection. There was no lampshade for the ceiling lamp in the kitchen. A lampshade was purchased and fitted the same day. St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 Page 19 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, 32, 33, 34, 35, 36 Residents’ needs were on the whole, met by the skill mix of staff. However, some deficiencies were noted in the staffing arrangements. EVIDENCE: The manager and two staff on duty were interviewed and noted to be knowledgeable regarding their roles and the care to be provided to residents. The three residents who were interviewed indicated that they were well cared for and staff were pleasant and professional in their approach. The sample of three staff records examined contained the required documentation such as satisfactory CRB disclosures, references, evidence of identity and contracts. The training records examined, indicated that staff had been provided with some of the required essential training. This included training in health and safety, fire safety and food hygiene. Further training is required in first aid, adult protection, administration of medicines and the care of residents who have challenging behaviour. St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 Page 20 The staff rota was examined and staffing arrangements discussed with the manager. The rota indicated that there was always a minimum of two staff on duty during the day until 5 pm. The inspector further noted that after 5 pm there was only one staff on duty until the night shift. This was brought o the attention of the manager and a requirement is made for the home to have a minimum of two staff on duty at all times during the day and evening shifts. This is required for safety reasons and to ensure that the needs of residents are met. It was also noted that there were occasions when the manager had worked continuously over a seven day period. This was discussed with the manager and a requirement is made for this arrangement to be discontinued for health and safety reasons and to ensure the well being of the manager. St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 Page 21 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): Systems were in place to ensure the welfare of residents and staff. However, further improvements are required in the area of health and safety. EVIDENCE: The manager was noted to be knowledgeable and staff and residents interviewed expressed confidence in him. There was evidence that residents had been consulted regarding the management of the home and their preferences responded to. The home had the required health & safety policy and procedure. Weekly fire alarm checks, fire drills and fire training had been documented. Staff interviewed were aware of the procedure to follow in the event of a fire. St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 Page 22 Window restrictors had not been fitted to all windows. For safety and security reasons, these are required. St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 Page 23 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 3 3 2 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 2 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 2 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 2 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 2 3 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 St Christopher`s House Score 3 3 2 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 2 X DS0000063893.V257723.R01.S.doc Version 5.0 Page 24 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. Standard Regulation Requirement The registered person must update the statement of purpose (to include the criteria for admission). The registered person must update the statement of terms and conditions of tenancy/ contract to contain information on the obligations of the service user The registered person must ensure that comprehensive service users’ risk assessments together with strategies for minimising risks are identified and documented in service users’ case records. The registered person must ensure that residents are provided with a programme of weekly social activities appropriate for them. The registered person must ensure that a self administration assessment form is completed and signed (by the doctor concerned) for residents who administer their own medication. Timescale for action 13/02/06 1 YA1 4 2 YA5 5(1)(b,c) 13/02/06 3 YA9 13(4) 01/02/06 01/02/06 4 YA14 16(2)(m) 5 YA200 13(1)(2) 01/02/06 St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 Page 25 The registered person must ensure that staff receive training in the following areas. - administration of medication - first aid - adult protection - the care of residents who have challenging behaviour. Evidence that such training has been provided must be forwarded to the inspector. The registered person must arrange for a risk assessment to be carried out (and documented) regarding the locating of the washing machine in the kitchen. This risk assessment must include a strategy for minimising cross infection. The registered person must ensure that there is always a minimum of two care staff on duty at the home. The registered person must ensure that a risk assessment is carried out when only one staff is scheduled to work during the night shift. The registered person must ensure that care staff do not work continuously without a break (ie. They must not work a day shift followed by a night shift). The registered person must provide window restrictors for all rooms. 6 YA35YA20 18 (1) (c) (i) 13/03/06 7 YA30 13(4) 31/01/06 8 YA32 23(2)(j) 01/02/06 9 YA32 13(4) 23(2)(j) 01/02/06 10 YA32 13(4) 23(2)(j) 01/02/06 11. YA42 13(4)(c) 01/02/06 St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 Page 26 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 St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 St Christopher`s House DS0000063893.V257723.R01.S.doc Version 5.0 Page 28 - 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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