St Christopher’s Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

St Christopher's Care Home accommodates up to 52 people in one adapted building. At the time of our inspection, the service was providing support to 39 people .

At the last inspection in February 2016, the service was rated Good. At this inspection on 21 March 2018 we found the service remained Good overall, however improvements were required under the ‘well led’ domain.

The provider had systems in place to monitor the quality of the service. We found that whilst all areas of the service were monitored, actions were not always taken and improvements were not always made.

The service did not always notify the Care Quality Commission of certain events and incidents in a timely way.

There was a registered manager 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 2008 and associated Regulations about how the service is run.

Staff had a good understanding of abuse and the safeguarding procedures that should be followed to report abuse and incidents of concern. Risk assessments were in place to manage potential risks within people’s lives, whilst also promoting their independence.

The staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service. Adequate staffing levels were in place. Staffing support matched the level of assessed needs within the service during our inspection.

Staff induction training and on-going training was provided to ensure they had the skills, knowledge and support they needed to perform their roles. Specialist training was provided to make sure that people’s needs were met and they were supported effectively.

Staff were well supported by the registered manager and senior team, and had regular one to one supervisions. The staff we spoke with were all positive about the senior staff and management in place, and were happy with the support they received.

People's consent was gained before any care was provided. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice

Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes. Care plans reflected people’s likes and dislikes, and staff spoke with people in a friendly manner.

People were involved in their own care planning and were able to contribute to the way in which they were supported. People and their family were involved in reviewing their care and making any necessary changes.

A process was in place which ensured people could raise any complaints or concerns. Concerns were acted upon promptly and lessons were learned through positive communication.

This inspection took place on the 8 February 2016 and was unannounced. The service is registered to provide accommodation for people who require personal care for up to 54 people. The service caters for older people and at the time of our inspection there were 44 people living there.

There was a registered manager in post at the time of our inspection. 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 2008 and associated Regulations about how the service is run.

Systems were in place to ensure people were protected from abuse; staff had received training and were aware of their responsibilities in raising any concerns about people’s welfare. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

The provider had robust recruitment systems in place; which included appropriate checks on the suitability of new staff to work in the home. Staff received a thorough induction training to ensure they had the skills to fulfil their roles and responsibilities. There were enough suitably skilled staff available to meet people’s needs.

People’s care was planned to ensure they received the individual support that they required to maintain their health, safety, independence, mobility and nutrition. People received support that maintained their privacy and dignity and systems were in place to ensure people received their medicines as and when they required them. People had opportunities to participate in the organised activities that were taking place in the home and were able to be involved in making decisions about their care.

There was a stable management team and effective systems in place to assess the quality of service provided.

We went back to review the improvements that had been made following an inspection visit during February 2013.

We spoke with five people living at the home and two of their relatives. We also spoke with a regular visitor to the home and five members of staff. We reviewed three people’s care records.

The people and relatives of people living at the home told us that the care at St Christopher’s Home was of a good standard. Three people also told us that when they needed assistance from the staff they could use their call bell and the staff responded to their needs quickly. A regular visitor to the home told us that the home had a “happy atmosphere” and that there were lots of daily activities taking place such as yoga and tai chi. Most people told us that they enjoyed the range of activities that took place at the home and that they were encouraged to socialise with one another.

We found that the registered manager had made improvements to the way the home managed people’s medicines and to reviewing the performance of staff working at the home. We also found that there were procedures in place to safeguard people from the risk of abuse and that people were looked after in line with their care needs. We found that there were systems in place to make sure that people received a good quality service.

We spoke with four people that used the service. They all told us that they liked living at St Christopher's Home. One person told us "I wouldn't want to live anywhere else" and another person told us "There's a good atmosphere and there's always something going on".

We spoke with three staff members who worked at the service. They all told us that they felt well supported in their roles. When we asked them about the standard of care that people who used the service received, one staff member told us "It's excellent". Another staff member told us "It's really good care and all of the staff are very caring".

We observed staff treating people who used the service with respect and providing them with choices of meals. We found that people's needs were assessed and care plans were put in place to ensure that their needs were met. We observed that medication was given to people appropriately but we had concerns over the records of stock medication that were kept.

We found that staff were provided with regular training but we were concerned that they did not receive annual appraisals.

Six people told us about the care they receive at the home. All spoke highly of their care and of the staff. One person told us that she was “very happy and could not imagine living anywhere else.”

One person told us that she was very happy living at the home and that staff showed “nothing but kindness.” She said that there are always enough staff around to offer her help if she needed it. Three other people living in the home told us that staff were helpful and available if they needed anything. One person told us “they do anything for you.”

One person told us she was very happy with the food and that the cook was very good. She explained that she is always given a choice of food.

One person told us that she likes to go out in the evenings with her friends. She explained that staff always ask what time she will be coming home and are ready to meet her on her return with a warm drink.

Three people who live at the home told us that their visitors are always made to feel welcome.

One person told us that the home is “very clean and comfortable.” She said that her bedroom is cleaned regularly and that her bed linen is “always clean and fresh.”