Background to this inspection
Updated
31 August 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
The inspection was carried out by 1 inspector, a professional specialist advisor with a background in nursing and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. a specialist
Service and service type
St George's Witham Nursing 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 Witham Nursing 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 reviewed information we had received about the service since the last inspection. We used this information to plan our inspection. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
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 also spoke with 1 person and 7 relatives about their experience of the care provided.
We spoke with 7 members of staff including the registered manager, nurses, and care staff. We also received feedback from 3 healthcare professionals who have regular contact with the service.
We reviewed a range of records. This included 7 people’s care plans, 13 people’s medicines records, 3 staff files in relation to recruitment and staff supervisions and a variety of records relating to the management of the service.
Updated
31 August 2023
About the service
St George's Witham Nursing Home is a residential care home providing personal and nursing care to up to 40 people. The service provides support to older people and people with nursing care needs, some of whom may be living with dementia. At the time of our inspection there were 33 people using the service.
People’s experience of using this service and what we found
The provider’s processes for monitoring the quality and safety of the service were not robust and did not always identify areas of concern. The provider had not ensured all staff were appropriately trained and received regular supervisions to support their learning and development.
Risks to people’s safety were not always assessed and documented and people’s care plans lacked detail about their choices and preferences for support. It was not always clear how people and those important to them were involved in the care planning and review process.
People’s medicines were managed by staff who were trained to administer them; however, amendments to people’s medicines records were not always documented correctly. Staff followed safe infection prevention and control practices and the service was in the process of a full refurbishment programme to ensure it was safe, hygienic, and better adapted to meet people’s needs.
Staff were aware of how to recognise and raise safeguarding concerns. People and relatives felt comfortable making complaints or raising any issues with the registered manager. Staff were safely recruited with appropriate checks completed prior to starting work.
People were supported to take part in different social activities; however, there was a lack of information about how to fully engage and support people to enjoy personalised activities of their choice.
People were supported by staff who knew them well and we received positive feedback about the kind and caring support provided by staff. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People, relatives, and staff spoke positively about the culture of the service and the approachability of the registered manager. The provider worked positively with other healthcare professionals to adapt to changes in people’s health needs promptly.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for the service under the previous provider was good [published 22 November 2019]
Why we inspected
We carried out this inspection as the service had not been inspected under the current provider. The inspection was also prompted in part due to concerns received about oversight at the service and the management of medicines. 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.
Enforcement
We have identified breaches in relation to staff training and management oversight at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.