St Georges Care Home

Updated 26 October 2023

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 Health and Social Care Act 2008.

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

This inspection was carried out by 4 inspectors.

Service and service type

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

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We also discussed the service with the local authority safeguarding team and health professionals who visit the home.

During the inspection

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with 9 people who lived in the home and one relative. We spoke with the registered manager and 10 members of staff, including the deputy, nurses and care staff. Two managers from other services were also present. We reviewed records relating to people’s care and how the service was run.

Updated 26 October 2023

About the service

St George’s is a residential care home providing personal and nursing care to up 68 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 53 people using the service. People were accommodated over two floors with the upper floor being used for people living with dementia.

People’s experience of using this service and what we found

People told us they felt safe and that staff treated them well. We received comments such as staff being “brilliant” and they “go above and beyond”. However, we did receive feedback consistently from both staff and people in the home that staffing levels were at times challenging. This didn’t impact on people’s safety, however it did mean that staff weren’t always able to provide the level of personalised care they would have liked to. The home were actively recruiting to fill the hours of cover required but in the interim were reliant on agency staff.

We found that some improvement was required to ensure that the service was person centred in nature. The environment of the floor for people living with dementia needed to be addressed to provide an environment more suited to people’s needs. This included for example making different areas of the floor and individual rooms, more easily identifiable. Some repair and decoration was also required, as identified in the provider’s own audit.

The registered manager and provider were working with stakeholders to make improvement. There was recognition that it would take time to embed changes and stabilise the staff team. However, the provider was proactive at sharing progress with CQC and the local authority in the form of their action plan. The registered manager was receiving support from other registered managers in the organisation and the area manager.

People were protected from the risk of abuse because staff were trained and knew how to report concerns if they had them. There were safe recruitment practices in place, including Disclosure and Barring service checks (DBS).

Risk assessments were used to identify areas where people’s safety was at risk. Where a risk was identified, measures were in place to manage that risk such as support to reposition people where pressure damage was a concern.

People were supported to have maximum choice and control of their lives and staff supported not support them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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

Rating at last inspection and update

The last rating for the service under the previous provider was good published on 1 April 2021.

At this inspection we found improvements were required and the home was rated requires improvement.

Why we inspected

The inspection was prompted in part due to concerns received about how the home were meeting people’s clinical needs. A decision was made for us to inspect and examine those risks.

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 COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St George’s Care home on our website at www.cqc.org.uk.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

Enforcement

We found one breach of regulation in relation to staffing levels. We made a recommendation in relation to the home environment.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.