St Georges Nursing Home

Updated 15 November 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 Care Act 2014.

Inspection team

This inspection was carried out by 3 inspectors.

Service and service type

St. Georges Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

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

Notice of inspection

Inspection activity started on 26 September 2023 and ended on 26 October 2023. The inspection visit took place on 9 October 2023 and was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and health professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke in person with the registered manager, and deputy. We spoke with 1 relative, and 7 staff to get their experience and views about the care provided. We continued to seek clarification from the provider to validate evidence found. We requested additional evidence to be sent to us after our inspection regarding financial viability prior to closure. We received the information which was used as part of our 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.

Updated 15 November 2023

About the service

St Georges Nursing Home is a care home that provides nursing and personal care for up to 28 older people. At the time of our inspection visit there were 14 people using the service including those living with dementia. As of 23 October 2023, the last person using the service had moved out and the service became dormant, pending the provider’s application to cancel their registration. The care home accommodates people in three period town houses across five storeys, with a day room and two dining areas in the basement.

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

The home was not always safe for people to live in. The registered manager, deputy and staff assessed and reviewed risks to people daily. There were sufficient, appropriately trained staff to meet people’s needs safely, on a basic level. People received their medicines at the correct time. The medicines were administered by trained staff. The home used Personal Protection Equipment (PPE), as required effectively and safely and the infection prevention and control policy was in line with current guidance.

The home was not always effective. Whilst people received care and support that met their basic needs, due to limited staff numbers, people did not receive care above this. Instead of having meals in dining areas as previously happened, they now had their meals in their rooms. Staff protected people from nutrition and hydration risks, and they were encouraged to choose healthy and balanced diets that also met their likes, dislikes, and preferences. However, the system had changed from having a chef to meals being delivered that were then oven heated, although still nutritious and people still had choices. People were not subject to discrimination and their equality and diversity needs were met. Staff were well trained and supervised by the registered manager and deputy. People were encouraged by staff to discuss their health needs, and any changes to them or concerns were passed on to the registered manager and appropriate health care professionals. This was also being done as part of the structured transitioning to other services, as the home was closing imminently. The home was kept adequately clean by the care staff, as there were no cleaners employed at the time of the inspection.

The home was not always well-led. Although the home was well-led by the registered manager and deputy, there was a complete breakdown in communication from an operational and senior management level, particularly regarding purchasing resources and securing agency staff cover. Staff told us the home’s senior management and leadership had not been transparent, open, and honest with them about the imminent closure of the home. Staff wages had been delayed for September and staff were not confident if or when they would receive their October payments. They were also unsure about the arrangements regarding redundancies. As a result, what had previously been a positive culture was now the reverse. Positive working partnerships were established between the registered manager and placing authorities to make the transitions to new accommodation as smooth as possible for people. Healthcare professionals told us that the service was well managed by the registered manager and met people’s basic needs in a professional, open, and friendly way.

Although people were mostly being cared for in their rooms, they were still supported to have as much choice and control of their lives as possible. Staff supported people 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

The last rating for this service was Requires improvement (published 30 June 2023). The overall rating for the service remains Requires improvement. This is based on the findings at this inspection.

Why we inspected

We received concerns in relation to the home no longer being financially viable to remain open. Because of this, we were concerned about people's overall safety and wellbeing; whether there were sufficient appropriately skilled staff to continue supporting people day and night; if people were provided with sufficient food and drink and whether daily costs were being met for the running of the home. We were also concerned about future financial viability if the provider decided to remain open. As a result, we undertook a focused inspection to review the key questions of safe, effective, and well-led.

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 did not inspect the key questions of caring, and responsive.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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

Enforcement We have identified a continued breach of regulation in relation to good governance. Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service closure.