Georgian House Nursing Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good

Good: This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Clear processes were in place to ensure these were reviewed, outcomes were monitored and analysed for themes and trends. These were used to support learning and improve safety and care across the service. These were regularly reviewed by the provider and used to identify any additional training required.

People and their families told us they could raise concerns about their care and overall knew who to speak to. A person told us, “I would speak to a carer or someone higher up if I was worried.” A family member told us, “I never had to raise anything but would go to the manager. They are very approachable.”

Staff told us they could speak up and raise concerns. A staff member told us,” I would be happy to speak up and I have done it in the past.”

There were processes and policies to support a learning culture. We saw evidence of some learning and action undertaken for example following people’s increase in falls. Areas of improvement were also discussed during staff meetings and during staff supervisions. The registered manager promptly followed up on the concerns and areas of improvement we raised with them during the inspection.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

An assessment of people’s needs was undertaken before they moved to the service to help ensure the continuity of care. This was a comprehensive assessment of people’s health and personal care needs identifying the level of support the person needed. People were supported to access the health care support they needed relevant to their needs. Relatives told us they had been kept informed when their relative had gone into hospital and staff had supplied all the relevant information needed to make sure the person was supported safely. A relative told us, “Yes, I do feel [person] is safe here because the whole family think the home is very contained, appears well staffed and the staff are not constantly changing. It feels like continuity of care.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

Managers and staff understood how to safeguard people. Staff were up to date with safeguarding training and could demonstrate they understood how to raise safeguarding concerns. A staff member told us, “I would tell the nurse in charge or go straight to the manager. If they didn’t do anything about it I would go straight to the local safeguarding team.” A system for reporting, managing and recording safeguarding concerns was in place. The registered manager demonstrated how they learnt from incidents and shared theses with staff in team meetings.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Care plans were person centred and risks and mitigations were clearly identified in the assessments. Care plans and risk assessments were completed with people and their families and we saw evidence of their involvement and consent. We reviewed daily notes and observations made by staff after each care call and care was delivered in line with care plans and people were happy with the care they received.

Risks were managed with people and their relative’s involvement.

The provider worked with people and their families to involve people in managing their risk. Appropriate professionals had been consulted to provide specialist advice and support.

The provider effectively identified and managed potential risks within the care environment. They ensured that equipment, facilities, and technology supported the safe delivery of care, and appropriate risk assessments were conducted for both the home and its equipment.

During our inspection, we observed that a gate at the side of the property had not been securely locked, despite having a padlock attached. This posed a potential risk of unauthorised access. We notified the registered manager about the unlocked gate and highlighted the vulnerability of relying on a single lock. The manager took immediate action by securing the gate with the padlock. After the inspection, the manager provided photographic evidence confirming that the gate had been upgraded with a double-sided keypad lock to control both entry and exit.

The home was clean and well-maintained, with fire alarm signs and fire action plans clearly displayed. Staff completed online fire safety training, and regular fire drills were conducted. A staff member shared, “We have a new system in place—the exit is at the front of the building. We do fire drills and recently conducted a full drill at night, including the use of stair beds. We receive fire training online and participate in regular drills.”

Special consideration had been given to residents living with dementia. Outside each room, orientation boxes were thoughtfully placed, containing the resident’s photograph, personal history, and images of things they enjoy.

Residents and their relatives expressed positive views about the home’s environment. Feedback included:
“Within the building itself, the cleanliness is very good. Every morning, I see rooms being hoovered and every toilet being cleaned. During the summer, the garden is beautifully maintained, creating a pleasant atmosphere.”
And: “It is all very clean. When someone gets up from a chair, there is always someone cleaning up. His bedroom is spotless.”

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. On top of the care certificate and mandatory training each staff member had a specialist training. For example; a staff member recently completed Level 5 Adult and Social Care Training, Adult Social Care Level 3 and Best Interest Assessment course.

People and their relatives were positive about the staff and felt they had the right skills to support them. A person told us, “Oh, absolutely. Since my long stay here, I have come to know almost every carer and have had an opportunity to see them talking to and looking after almost every resident. They are qualified to look after each resident's needs.”.

During lunchtime we observed a resident calling for help, who appeared distressed and confused. Staff were quick to reassure the person and a member of staff went over to support them. Staff went down to the person’s level to ask them if they were ok and whether they were ready for lunch. The person seemed more settled after the interaction with the staff member.

Care was observed to be supportive and caring. Staff supported people with their meals and there were plenty of staff to support people during lunch time.

Processes in place ensured staff had been recruited with a range of checks including references and disclosure and barring checks (DBS). Staff had been trained appropriately and were up to date with training. Staff received regular supervisions and appraisals.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. The home was clean and free from the spread of infection throughout. Robust cleaning schedules were in place and regularly reviewed by staff and the management team. A relative told us, “I think so [the home is clean and hygienic]. I always find the home clean, and [person’s] room is always spotless. The staff sanitise their hands the whole time and in general walking round it seems well kept and clean.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

There were comprehensive medication policies and procedures in place.

Medicines were stored safely and there were well-organized medication storage systems. There was suitable temperature monitoring being carried out. Staff training and competency checks were in place and documented. There were regular medicines audits and regular medication reviews with healthcare professionals. Staff appeared knowledgeable about medication. The fridge was cleaned monthly, and temperature thermometers were placed in the treatment room, one in the room and the other attached to the fridge.