About the service:

St Christopher’s Residential Home is a residential care home that provides personal care and support for up to 19 older people who had a range of needs. This included some people with mobility needs and some people who were living with dementia. At the time of this inspection there were 14 people living at the home.

People’s experience of using this service:

People continued to receive a good service. Improvements in quality assurance systems seen at the last inspection in July 2016 had been sustained and embedded within practice. This meant that the rating for the well-led domain had improved to Good.

• People, their relatives and staff said that the home was well-led.

• There were a range of audits in place which were used to improve the quality of the service.

• People were supported to be engaged in the running of the home and told us their feedback was listened to. Staff worked with other organisations to meet people’s needs.

• Risks to people were assessed and managed. Staff understood their responsibilities for safeguarding people. The home was clean and staff had a good understanding of infection prevention and control. People were supported to receive their medicines safely.

• Staffing levels met people's needs and staff were suitable to work with people. People received effective care from skilled and knowledgeable staff. Staff received training to support people's specific needs.

• People had enough to eat and drink and spoke highly of the food provided. Staff were proactive in supporting people to access the health care services that they needed. Staff understood their responsibilities to gain consent from people before providing care and support.

• People spoke highly of the care they received and described staff as kind and respectful. People were supported to express their views and to have control over their lives as much as possible. Staff maintained people’s privacy and treated them with dignity.

• Staff knew people well and care was provided in a person-centred way. People were supported to maintain contact with people who were important to them. Staff were responsive to people’s needs and supported people to have enough to do. People were confident that any complaints would be addressed. Staff supported people to plan for end of life care.

Rating at last inspection: Good, the last report was published on 29 July 2016.

Why we inspected: This was a scheduled inspection based on the previous rating.

Follow up: ongoing monitoring. We will continue to monitor the intelligence we receive about this home and plan to inspect in line with our re-inspection schedule for those services rated Good

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

St Christopher's Residential Home has 18 bedrooms and is registered to accommodate a maximum of 19 people. It specialises in providing support to older people who require minimal assistance with their personal care. The service does not have a hoist and therefore only provides accommodation to people who can transfer, for example from bed to a chair either independently or with minimal support from staff. Bedrooms are located over four floors which are accessible via stairs or a stair lift. There is level access to a patio at the rear of the property where there are raised flower beds. At the time of our inspection 14 people were living at the service, two of whom had agreed to share a room.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission 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 and associated Regulations about how the service is run.

At the last inspection we identified a breach of Regulation 10 of the Health and Social Care Act (HSCA) 2008 which is equivalent to Regulation 17 of the HSCA regulations 2014. At that time the provider had no quality assurance systems governing infection control, records or care plans to enable them to identify shortfalls in service provision. At this inspection we found this breach had been met, however systems had not yet been fully embedded, and was therefore an area of practice that needs improvement to ensure that risk was managed and improvements sustained.

Since the last inspection the provider had made improvements in relation to the storage of medicines and the recording of the quantity of medicines received from the pharmacy. They had also ensured that the risks associated with people who went out independently, and actions staff should take to reduce these risks, had been documented.

People’s independence was promoted; they were supported to remain mobile and encouraged to go for daily walks.

People had access to activities and opportunities for social engagement and stimulation. Exercise and arts and crafts sessions were held on a regular basis, activities such as quizzes were arranged in the afternoons and singers or musicians visited once a month to provide entertainment. People were supported to maintain relationships with people that mattered to them. Relatives were made to feel welcome.

Everyone told us they were happy with the care they were receiving and one person told us, “I get what I need, it’s really good here.” Another person commented “The girls are marvellous, very pleasant. You only have to ask and it’s done.” Relatives were kept informed of their loved one’s wellbeing and any changes in their needs.

One person told us “The staff are lovely, we are looked after very well.” Another commented “I feel very happy here. It’s a very homely place.” A relative told us “I think the staff are good in their attitude to residents.” A visitor told us “The staff are lovely. The care here seems very good; I’d recommend it”

People’s privacy and dignity was respected and upheld. One person told us “They are good when dealing with me privately.” Another person commented “They are respectful, they knock when coming in.”

Meal times were relaxed and sociable. People spoke highly of the quality of the food on offer which was homemade from fresh ingredients.

Feedback was regularly sought from people, relatives and staff. ‘Residents’ meetings were held on a regular basis which provided a forum for people to raise concerns and discuss ideas.

People’s needs had been assessed and planned for. Plans took into account people’s preferences, likes and dislikes and were reviewed on a regular basis. Staff worked in accordance with the Mental Capacity Act (MCA) and associated legislation ensuring consent to care and treatment was obtained. People were supported to make

We inspected St Christopher's Residential Home on the 13 January 2015. St Christopher's Residential Home is a small residential home in a quiet area of Hove. The home can provide care and support for up to 16 older people. On the day of the inspection 15 people were living at the home. The age range of people living at the home varied from 60 – 101 years old. The provider provided care and support to people living with diabetes, Parkinson’s, epilepsy, risk of falls and long term healthcare needs.

The home is centrally located in Hove with good public transport links to the city centre, which enabled people to go out and about independently. Bars and local shops were nearby and the seafront was a short walk away. Many people living at the home have lived there for many years. The provider also has good retention of staff with some staff members having worked at the home for over 16 years. Throughout the inspection, people, relatives and staff spoke highly of the registered manager and provider.

A registered manager was in post who was also a co-owner of the home. A registered manager is a person who has registered with the Care Quality Commission 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 and associated Regulations about how the service is run.

People received medicines on time and staff had received medicine administration training. However, medicines were not always stored in line with best practice guidelines and the recording of medicines into the home was not always clear. We have asked the provider to make improvements in this area.

Systems were not in place to analyse, monitor or review the quality of the service provided. The provider was not completing formal audits and there were no mechanisms to assess the standards of care. We have asked the provider to make improvements in this area.

Feedback was regularly sought from people, relatives and staff. ‘Residents’ and staff meetings were held on a regular basis which provided a forum for people to raise concerns and discuss ideas. Monthly newsletters were sent to staff and staff received on-going professional development.

There were systems in place to protect people from abuse and harm. Staff had a clear knowledge of how to protect people and understood their responsibilities for reporting any incidents, accidents or issues of concern.

People were cared for, or supported by, sufficient numbers of suitably qualified and experienced staff. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.

Staff were responsive when people needed assistance and interacted with people in a friendly manner. People’s health and wellbeing was continually monitored and the registered manager regularly liaised with healthcare professionals for advice and guidance.

The provider and registered manager were committed to delivering care that was centred on the need of the individual and was personal to them. People’s privacy and dignity was respected and upheld. Staff were seen smiling and laughing with people and joining in activities in the home. From observing staff interact with people, it was clear staff had spent considerable time with people, getting to know them, gaining an understanding of their personal history and building friendships with them.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report

We spent a day at St Christopher’s Residential Home. We spoke with four people who lived there, four visiting relatives, three of the care staff and the two provider’s, one of whom is the registered manager. We looked at care plans and records for the people we spoke with.

People’s descriptions to us of the care they received matched the contents of their care plans. People told us staff were attentive to health needs and communicated well. Records showed GP visits to the home were requested promptly in response to health concerns.

All people we spoke with considered the home a safe place to live. Staff were clear about indicators of possible abuse, and their responsibilities should they identify any concerns about people’s safety.

Medicines were safely stored and were administered only by staff who had been trained in safe handling of medicines.

There was an appropriate system for checking that prospective staff were suitable for working with vulnerable people. Newly appointed staff received an induction followed by time shadowing experienced staff before starting to work on their own. This was to enable them to develop confidence and for people living in the home to get to know them.

The provider communicated with people in the home both informally and through meetings. An annual quality survey of people in the home and visitors showed high levels of satisfaction. People saw management as approachable. We saw they were responsive to good practice guidance and to individual comments and preferences.

There were 14 people who used the service at the time of our visit. We observed the care provided, and looked at supporting care documentation. We spoke with both of the providers one of whom is also the registered manager (and who is referred to as manager in the report), two care workers, a domestic assistant, four people who used the service, and two relatives of another.

This told us people or their representatives had been able to express their views about the care provided, and where possible people who used the service had been involved in making decisions about their care and treatment.

People’s care needs had been assessed and care and treatment had been planned and delivered in line with their individual care plan.

People’s care had been provided by care workers who understood their care needs. Comments received included, “We are very happy”,”They (the managers) are very hands on,” “They go the extra mile,” “The staff are nice, the food is good, it’s clean and warm. I have no complaints”, and “Staff think about our privacy and dignity.”

People knew who to talk with if they had any concerns about the care provided.

The provider had systems in place to regularly audit the care provided.