CQC report explained · a residential care home
What the CQC found at Chrissian Residential Home Limited
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and managed, staffing and recruitment were safe, medicines were managed properly and infection control had improved. People said they felt safe.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used in the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used in the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used in the overall rating.
- Well-led?
- Good
- Inspectors found a new registered manager, better records, clearer communication and effective checks covering areas such as medicines, health and safety and care records.
What inspectors found, November 2022
Rated Good after improvements; inspectors found people were safe, supported by enough staff and living in a better-managed home.
This was an unannounced focused inspection. Inspectors visited on 31 October 2022 and gave feedback on 14 November 2022. They spoke with people, staff and a relative, observed care and checked records, medicines, recruitment, infection control and management systems.
The home was rated Good for Safe and Well-led. People said they felt safe. Inspectors found enough staff, safe recruitment, suitable risk assessments, safe medicines systems and improved infection control. The home was clean and equipment and premises were being checked and maintained.
The home had previously been rated Requires Improvement, with breaches relating to safe care and treatment and good governance. Inspectors found that the provider had acted on those concerns and was no longer in breach. The overall rating changed to Good, although this inspection did not assess all five key questions.
Better risk management
The home had improved how it assessed and managed risks, including falls, specialist equipment and emergencies. Staff understood people's needs and how to keep them safe.
“People's care plans included risk assessments, which demonstrated how the risks in their daily living were assessed.” from the report
Safe medicines
People received medicines as prescribed, including time-sensitive medicines. Staff were trained and medicines were securely stored, checked and recorded.
“People received their medicines as prescribed including those on time sensitive drugs.” from the report
Enough suitable staff
Inspectors found enough staff to meet people's needs. Recruitment records showed that background checks had been completed.
“A review of staff recruitment files showed background checks were carried out.” from the report
Improved leadership
A new registered manager was working with the provider. Quality checks, action plans and clearer handovers gave managers better oversight of the home.
“Effective quality assurance processes had been implemented.” from the report
Warm relationships
People and relatives gave positive feedback about staff being caring, supportive and welcoming. Inspectors also saw people who appeared comfortable with staff.
“We received complimentary feedback from people who lived in the home about how caring and compassionate the staff team were.” from the report
Improvement work was still ongoing
minorThe provider was continuing work to improve the environment and outside areas. The report does not say that this created an immediate safety risk at the inspection.
“Improvements had been made and were ongoing to ensure the premises and equipment were maintained in a safe, comfortable and clean condition.” from the report
- 01What environmental and outside-area improvement work was still outstanding after the inspection?
- 02How do you check that falls risks, movement sensors and specialist equipment remain properly assessed and managed?
- 03How are medicine audits followed up when a discrepancy is found?
- 04How has the new registered manager continued the action plan and quality checks since the inspection?
- 05What were the previous ratings for Effective, Caring and Responsive, and when will these areas next be fully inspected?
This was a focused inspection of Safe and Well-led to check previous concerns and legal requirements; the other ratings carried over from the previous inspection. This explanation was written from the published report of 22 November 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, July 2022
Chrissian Residential Home Limited is rated Requires Improvement; inspectors found safety, infection control and management weaknesses, although medicines and staff care had strengths.
This was an unannounced focused inspection on 25 May and 1 June 2022. Inspectors looked mainly at Safe and Well-led, following concerns about risk management, records, safe care and how the home was managed. They spoke with people, relatives, staff and managers, observed care, and checked care, medicine, recruitment, infection control and management records.
Inspectors found hazards and infection control problems in the building. These included unsafe access, concerns with the stairs, trip hazards, damaged bathroom areas, poorly stored slings and mould. Risk assessments and care records did not always give staff enough information to keep people safe. Staffing arrangements were also not always clearly organised around people's needs.
The home's checks and management systems had not identified or dealt with these problems reliably. The report says the provider had started an action plan, environmental works and external support after the visits. Some hazards had been addressed by the second visit, but inspectors said improvements needed to be fully put into practice and maintained.
The overall rating fell from Good at the previous inspection, published on 2 May 2018, to Requires Improvement. Safe and Well-led were both rated Requires Improvement. The other key questions were not inspected during this visit, so their previous ratings were used when calculating the overall rating.
Medicines
People received medicines as prescribed, including time-sensitive medicines. Records, storage, staff training and checks were found to be in place.
“People received their medicines as prescribed including those on time sensitive drugs.” from the report
Safeguarding and recruitment
Staff had safeguarding training and knew how to raise concerns. Recruitment records showed checks intended to reduce the risk of unsuitable staff being employed.
“Staff were recruited safely, had received safeguarding training and knew how to protect people from potential harm.” from the report
Kind care
People and relatives gave positive feedback about the kindness and respect shown by staff. Inspectors also saw this in their observations.
“We received positive feedback from relatives and people using the service about how caring the staff team were.” from the report
Family communication and visiting
Relatives said they could visit and were kept informed about changes in their family member's health and wellbeing.
“Relatives told us they were kept updated by the home and felt informed about their family member's health and wellbeing.” from the report
Action started
The provider began an action plan, environmental improvement work and external mentoring after inspectors raised concerns.
“We were encouraged by the action the provider was taking to address the shortfalls in the home and reduce the risk of people not receiving safe quality care.” from the report
Environmental safety
seriousInspectors found unsafe access, concerns with both staircases and several slips, trips and other hazards. Some risks were addressed during the inspection period, but wider improvements were still needed.
“Both stair cases in the building were a concern, the risk of falls had not been identified with adequate mitigation put in place.” from the report
Infection control
seriousThe home had damaged bathroom areas, mould, a cracked skylight and slings stored in a way that could increase cross-infection risk. These problems had not been found by local audits.
“There were infection control issues which had not been identified and mitigated in the home.” from the report
Risk assessments and care records
seriousSome records did not properly assess, plan for or review individual risks. Information about equipment, distress, emergency evacuation and shared-room risks was incomplete or unclear.
“People's care records did not consistently reflect adequate assessment, planning and evaluation of their individual risks to protect them and keep them safe.” from the report
Management checks
seriousGovernance and audit systems did not identify important safety, infection control and record-keeping problems. Records were not always accurate, dated or easy to find.
“Governance and monitoring systems were not robust and had failed to identify the shortfalls we found and ensure prompt appropriate action was taken.” from the report
Staff deployment
needs fixingInspectors were not assured that staff were organised on shifts in a way that fully supported people's needs and safe movement around the home. Relatives gave mixed views about whether there were enough staff.
“We were not assured that staffing arrangements, including the organisation and deployment on shifts considered the environmental concerns of the home we had found and safely supported people to move around the home.” from the report
- 01Which environmental hazards identified by inspectors have now been repaired, including the stairs, bathrooms, skylights and trip hazards?
- 02How are individual risks now assessed and reviewed, including risks linked to motion sensors, shared bedrooms and air flow mattresses?
- 03How do you organise staff on each shift to support people to move safely around the home?
- 04How will you check that care records, emergency evacuation plans and equipment instructions are accurate, current and easy for staff to use?
- 05What evidence can you show of progress against the action plan, and how are improvements being kept in place?
This was an unannounced focused inspection of Safe and Well-led, with infection prevention and control also considered; the other key question ratings were carried over from the previous inspection. This explanation was written from the published report of 1 July 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Chrissian Residential Home Limited
6 rated inspections over 7 years: the service has held its Good rating throughout.
- November 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Chrissian Residential Home Limited →
- July 2022Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
Read what inspectors found at Chrissian Residential Home Limited →
- May 2018Goodup from Requires improvementSafe: GoodWell-led: Good
- March 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- April 2016Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- May 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 13 December 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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