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St Georges Care Home Requires improvement

The provider of this service has requested a review of one or more of the ratings.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 11 April 2019

About the service: St Georges Care Home is a residential care home that is registered to provide accommodation and personal care to a maximum of 35 people. At the time of our inspection, 25 people were living there.

People’s experience of using this service:

¿ People told us and we observed that staff were kind and caring in their interactions with them.

¿ The systems for checking the quality and safety of the service had again failed to identify where improvement was required. Audits were not sufficiently robust to identify concerns we found during this inspection. This put people at risk of potential harm.

¿ Further improvement was needed to ensure identified risks contained clear guidance on how these should be managed. Some risks, such as choking, did not have an associated plan of care to guide staff on how to reduce the risk, and action to take if a person was to choke. Where people had health conditions such as epilepsy or diabetes, there were not always risk assessments in place so staff knew how to recognise signs that they were becoming unwell and how to support them if their health condition deteriorated.

¿ Care plans were now more person-centred and included information on people’s life history and what their preferences were in relation to how their care was delivered. However, we found that care plans were not always sufficiently detailed where people had health conditions, and sometimes there was conflicting information contained within them.

¿ Food and fluid charts were in place for people at risk of malnutrition or dehydration so staff could monitor this. However, we found some conflicting information in care plans relating to people’s dietary needs.

¿ The Mental Capacity Act 2005 Deprivation of Liberty Safeguards were not fully understood by the registered manager. Applications to deprive people of their liberty had not been made in line with this Act to ensure care was lawful.

¿ People received their medicines by staff who had received relevant training. However, medicine administration records were not always completed in line with best practice, and we found two medicines in use had expired. Staff were not periodically assessed for competence in managing people’s medicines.

¿ Staff received training relevant to the people they were caring for. However, other areas of required training, such as diabetes, management of challenging behaviours and end of life care had not been planned.

¿ Staff understood the need to keep people safe from abuse and what was required to do this. Staff had received training in this area, and were clear they would report concerns to a manager or appropriate outside agency without delay. However, referrals had not always been raised by the registered manager.

¿ The overall rating for this service remains ‘Requires Improvement’. The rating for well-led is inadequate. This is the second consecutive inadequate rating for well-led, which means the service will now enter special measures.

¿ Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will act in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so

Inspection areas

Safe

Requires improvement

Updated 11 April 2019

The service was not always safe

Details are in our Safe findings below.

Effective

Requires improvement

Updated 11 April 2019

The service was not always effective

Details are in our Safe findings below.

Caring

Requires improvement

Updated 11 April 2019

The service was not always caring.

Details are in our caring findings below.

Responsive

Requires improvement

Updated 11 April 2019

The service was not always responsive

Details are in our Responsive findings below.

Well-led

Inadequate

Updated 11 April 2019

The service was not well-led.

Details are in our well-led findings below.