Background to this inspection
Updated
24 February 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection site visit was carried out by one inspector. Another inspector supported the inspection off site and an assistant inspector conducted telephone calls to staff and relatives remotely.
Service and service type
St Christopher’s Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
The inspection was announced at short notice to assess COVID-19 risk.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection-
We were unable to speak to people who used the service due to COVID-19 risk. We spoke to six relatives about their experience of the care provided. We spoke with 11 members of staff including care staff, housekeeping staff, the deputy manager and the registered manager.
We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
24 February 2021
About the service
St Christopher’s Home is a residential care home providing personal care to 40 people aged 65 and over at the time of the inspection. The service can support up to 54 people.
People’s experience of using this service and what we found
Systems and process in place to review and monitor the quality, effectiveness of the service required improvement.
Risks to people had not consistently been mitigated. Staff had not always followed the strategies in place and we found gaps in records for pressure care and food and fluids.
Records of injuries to people had not always been appropriately recorded.
Not everyone we spoke to felt there was enough staff on duty and staff did not always respond to people in a timely manner. Call bells were found to be unanswered for periods of time over 10 minutes on three separate occasions.
Medicine administration required improvements. We found gaps in the recording and best practice was not consistently followed.
Infection control measures were in place, however we found gaps in the cleaning records. The home appeared clean
People were supported by staff who had been recruited safely and who knew them well.
People were supported to stay in contact with their family during the pandemic via phone calls, video chats and outdoor visiting.
The registered manager and staff were open and transparent throughout the inspection and put actions into place after feedback.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 26 April 2018).
Why we inspected
We received concerns in relation to staffing levels and pressure sores. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St Christopher’s Home on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.
We have identified breaches in relation to risk management, medicine management and oversight at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.