Background to this inspection
Updated
23 September 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 24 August 2016 and was unannounced. The inspection team was formed of three inspectors, a Specialist Nursing Advisor and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of service.
Before our inspection we reviewed information we held about the service including statutory notifications that had been submitted. Statutory notifications include information about important events which the provider is required to send us. We also reviewed the provider information return (PIR) submitted to us in September 2015. This is information that the provider is required to send to us, which gives us some key information about the service and tells us what the service does well and any improvements they plan to make.
During the inspection we observed staff support people who used the service, we spoke with 14 people who used the service, 23 staff members, representatives of the senior management team and the registered manager. We spoke with relatives of seven people who used the service to obtain their feedback on how people were supported to live their lives.
We received feedback from representatives of the local authority health and community services and two visiting health professionals. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us due to their complex needs.
We reviewed care records relating to eight people who used the service and other documents central to people’s health and well-being. These included staff training records, medication records and quality audits.
Updated
23 September 2016
The inspection took place on 24 August 2016 and was unannounced.
St Christopher's Nursing Home is registered to provide accommodation for up to 163 older people who require nursing care and may also have a physical disability or are living with dementia. The accommodation is arranged over five separate houses each with its own management structure. There were 154 people accommodated at the home at the time of this inspection.
The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
When we last inspected the service on 27 October 2015 we found breaches of regulations 14 and 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the provider had failed to ensure that risks to people in relation to malnutrition and dehydration were managed appropriately and did not work in accordance with the Mental Capacity Act 2005.
Following the comprehensive inspection, the provider wrote to us to tell us how they would make the required improvements to meet the legal requirements. At this inspection we found that the provider had made the necessary improvements to help ensure that people’s nutritional and hydration needs were met. Some improvements had been made to support the staff team to work in accordance with the Mental Capacity Act, the registered manager reported that it was an ongoing process to provide staff with the skills and knowledge in this area.
At this inspection we found that people’s medicines were not always managed safely.
People felt safe living at St Christopher’s Nursing Home. Staff understood how to keep people safe and risks to people’s safety and well-being were identified and managed. The home was calm and people’s needs were met in a timely manner by sufficient numbers of skilled and experienced staff. The provider operated robust recruitment processes which helped to ensure that staff employed to provide care and support for people were fit to do so.
Staff received regular one to one supervision from a member of the management team which made them feel supported and valued. People received support they needed to eat and drink sufficient quantities and their health needs were well catered for with appropriate referrals made to external health professionals when needed.
People and their relatives complimented the staff team for being kind and caring. Staff were knowledgeable about individuals’ care and support needs and preferences and people had been involved in the planning of their care where they were able. Visitors to the home were encouraged at any time of the day.
The provider had arrangements to receive feedback from people who used the service, their relatives, external stakeholders and staff members about the services provided. People were confident to raise anything that concerned them with staff or management and were satisfied that they would be listened to.
There was an open and respectful culture in the home and relatives and staff were comfortable to speak with the registered manager if they had a concern. The provider had arrangements to regularly monitor health and safety and the quality of the care and support provided for people who used the service.