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St Georges Care Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 29 March 2017

St Georges Care Home provides accommodation, care and support for up to 35 older people, some living with dementia. There were 28 people living in the service when we carried out an unannounced inspection on 19 January 2017.

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 2008 and associated Regulations about how the service is run.

At our comprehensive inspection of 13 and 21 July 2016, we found there were breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Improvements were needed regarding staffing, safe care and treatment, person centred care and respect and dignity. A warning notice was served to the provider and registered manager for failing to comply with good governance.

We met with the provider’s nominated individual and the registered manager 13 October 2016 to discuss their action plan in response to our inspection findings. We were given assurances that the shortfalls would be addressed.

During this inspection we found that improvements had been made in the service and were ongoing. Although the warning notice had been met, further improvements to staffing arrangements and people’s meal time experience were required. The registered manager had made improvements in how the service monitored and checked the quality of care provided but this was a work in progress. These measures need to be sustained and embedded into practice.

People and relatives were complimentary about the care and support provided. Staff respected people’s privacy and dignity and interacted with people in a kind and compassionate manner. They were knowledgeable about people’s choices, views and preferences and acted on what they said.

There was a positive culture within the service; staff was aware of the provider’s values and understood their roles and responsibilities. The atmosphere in the service was friendly and welcoming.

Staff were trained and supported to meet the needs of the people who used the service. They knew how to minimise risks and provide people with safe care. Procedures and processes guided staff on how to ensure the safety of the people who used the service. These included checks on the environment and risk assessments which identified how risks to people were minimised.

Appropriate arrangements were in place to ensure people’s medicines were obtained, stored and administered safely. People were encouraged to attend appointments with other health care professionals to maintain their health and well-being.

People and or their representatives, where appropriate, were involved in making decisions about their care and support arrangements. As a result people received care and support which was planned and delivered to meet their specific needs. Staff listened to people and acted on what they said.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Staff understood the need to obtain consent when providing care. 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.

Improvements to people’s care records had been made and were ongoing to ensure they were accurate and reflected individual needs and preferences.

People were provided with the opportunity to participate in activities and to pursue individual interests.

Processes were in place that encouraged feedback from people who used the service, relatives, and visiting professionals. People knew how to make a complaint if they were unhappy with the service.

Inspection areas

Safe

Requires improvement

Updated 29 March 2017

The service was not consistently safe.

Improvements in staffing levels and deployment were ongoing to meet people’s needs safely. The systems for the safe recruitment of staff were robust.

The likelihood of harm had been reduced because risks had been assessed and guidance provided to staff on how to manage risks and keep people safe.

People were provided with their medicines when they needed them and in a safe manner.

Effective

Requires improvement

Updated 29 March 2017

The service was not consistently effective.

People were not consistently supported to have a positive meal time experience.

Staff were trained and supported to meet the needs of the people who used the service.

The service was working within the principles of the Mental Capacity Act.

People were supported to maintain good health and had access to appropriate services which ensured they received ongoing healthcare support.

Caring

Good

Updated 29 March 2017

The service was caring.

Staff knew people who used the service well, respected their preferences and treated them with dignity and respect.

People and their relatives were complimentary about the effective relationships that they had with the management and the staff.

People and their relatives were involved in making decisions about their care and these decisions were respected.

Responsive

Good

Updated 29 March 2017

The service was responsive

People’s care and support needs were regularly assessed and reviewed. Where changes to their needs and preferences were identified these were respected and acted upon.

People were provided with the opportunity to participate in activities.

Feedback including comments, concerns and complaints were investigated and responded to and used to improve the quality of the service.

Well-led

Requires improvement

Updated 29 March 2017

The service was not consistently well-led.

Improvements were being made and were ongoing in the quality assurance system. However these measures needed to be sustained and fully embedded into practice to drive improvement in the service.

The service provided an open culture. People, relatives and staff were encouraged to contribute to decisions to improve and develop the service.