Archived: St George's Care Home

Updated 4 August 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the registered provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 11 and 12 March 2015 and was unannounced. The inspection was completed by two adult social care inspectors

Prior to the inspection we spoke with the local safeguarding team and the local authority contracts and commissioning team about their views of the service.

We spoke with the acting manager, a senior care worker, two care workers and a cook. We also spoke with three relatives of people who used the service, two visiting health professionals and the Court Appointed Administrator who was now overseeing the service.

We looked at five care files which belonged to people who used the service. We also looked at other important documentation relating to people who used the service such as medication administration records [MARs]. We looked at how the service used the Mental Capacity Act 2005 and Deprivation of Liberty code of practice to ensure that when people were deprived of their liberty or assessed as lacking capacity to make their own decisions, actions were taken in line with the legislation.

We looked at a selection of documentation relating to the management and running of the service. These included two staff recruitment files, the training record, the staff rotas, minutes of meetings with staff and people who used the service, quality assurance audits and maintenance of equipment records.

Updated 4 August 2015

We undertook this unannounced inspection on the 11 and 12 March 2015. The last full inspection took place on 16 and 17 July 2014 and the registered provider was non-compliant in all 10 of the areas we assessed. These included care and welfare, safeguarding vulnerable people from abuse, cleanliness and infection control, safety and suitability of the premises and equipment, staff recruitment, staffing numbers and how the service was managed overall. We also had concerns regarding the financial viability of the registered provider and we commenced enforcement action.

In February 2015, due to financial issues, the Court appointed an Administrator to manage the service until it could be sold and enforcement action was put on hold. The local authority continued to have an embargo on placements at the service and a voluntary suspension on all admissions to the service was still in place with the Care Quality Commission [CQC]. The local authority continued to make monitoring visits to the service.

During the writing of this report on the 23 March 2015, the Administrator decided to close the service and people who lived in St George’s Care Home were moved to alternative placements the following day. Despite the closure of the service we have a duty to report on what we found during our inspection. During this current inspection we found some improvements had been made but there remained concerns regarding several areas including the management of the service. We decided to continue with our enforcement action. This was to cancel the registered provider's registration to carry on the regulated activity of accommodation for persons who require nursing or personal care. The registered provider withdrew their appeal to the decision to cancel their registration and this will now take place.

St Georges Care Home is a two storey building situated on the outskirts of the village of Broughton. It is registered to provide accommodation and personal care to 22 older people. On the day of the inspection there were nine people living in the home. Communal areas such as two sitting rooms, a conservatory and the dining room are located on the ground floor, whilst bedrooms and bathrooms are located on both floors.

The acting manager had been employed at the service since October 2014 and was not registered with CQC. The service is required to have a registered manager. A registered manager is a person who has registered with CQC 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.

During the inspection we had concerns about the overall management of the service. We found the acting manager, despite their kind and caring approach, did not have the skills and experience required to manage the service. This had impacted on certain areas of safety, care and welfare and we are considering our regulatory response.

We found there continued to be concerns with the way staff were recruited and not all employment checks were in place before new staff started work. We found there continued to be insufficient staff on duty at all times to meet the current needs of people who used the service. This placed people at risk of receiving inadequate care and support.

Staff had not received sufficient induction, supervision and development.

We found there was a lack of understanding about risk management and responding to incidents to prevent reoccurrence.

People had plans of care but they did not have sufficient guidance and information for staff in how to support people. Important information was lacking which could place people at risk of receiving inadequate care.

There was a quality monitoring system, including policies and procedures which had been purchased and was contained in folders in the acting manager’s office. However, this had not been utilised although a survey of the views of six people who used the service and some checks of the environment had taken place. The checks undertaken had not identified shortfalls so they could be rectified. Records used for the management of the service were not always present, up to date and accurate.

We found staff were kind and caring to people who used the service and they were treated with respect and dignity. However, one person’s dignity had been compromised due to a lack of important moving and handling equipment.

People’s nutritional needs were met and they received their medicines as prescribed.