Archived: St Christopher's Care Home

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.

We found that the staff were not trained effectively to ensure the people had optimum health, choice and independence. Care plans were written in a manner that assisted staff to deliver health care in a task orientated manner, social care was not promoted. We found that staff did not refer to the care plans and were unaware of relevant information contained in them that would have assisted staff care for the person.

The people we spoke with and those who were able to express their views were positive about living at St Christopher's Nursing Home. We noted that staff spent most time with people who were able to respond to them.

Generally people told us that they were not involved in the planning of their own care and where appropriate their relative's care.

We saw senior staff enter people's rooms without knocking or greeting the person. We saw poor care delivered and we had to intervene to stop what we considered to be dangerous practice.

People told us that temporary staff were not as good as the permanent staff and did not always know what they were doing.

Among the comments told to us by the people living there and their relatives were:

'I feel safe here [at the home], I like the staff, they look after me'. Another person said that 'The staff are amazing, we thought we would never find a place that my parent would like. They love it here and we are in all the time so we know what's going on'. 'The staff are very good, but they are pushed all the time'. 'I feel that they do not have time to spend with me'. 'My only complaint is that sometimes the home has been very short staffed'. 'one or two people call out all the time, staff come stay a short time but as soon as they go they call out again'.

All the people we spoke with told us that call bells were responded to in a timely manner though sometimes they have to wait too long.

Following our inspection we met with senior managers from BUPA who submitted an action plan to address the issues raised during our inspection.

We did however observe some incidents of concern on 'Johnson' unit, which we have raised with the senior management of the home.

We found that the provider was now meeting the standards we had reviewed during our follow-up inspection.