St Georges Court Care 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 Inadequate. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 78 (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 was previously in breach of regulation 13 (Safeguarding service users from abuse and improper treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this assessment we found improvements had been made in relation to the providers oversight of safeguarding. They had introduced effective systems to protect people from abuse and the provider was no longer in breach of this regulation.

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.

People and their relatives had opportunities to feedback their views about the service and quality of the care they received. The manager and senior managers had oversight of accidents and incidents that occurred in the home. Accidents and incidents were documented in detail. Systems, including clinical weekly meetings and daily dashboards were in place to review and analyse these to identify any patterns or trends. This ensured that appropriate action could be taken to minimise any further risks to people. Staff told us they had opportunities to learn when anything went wrong.

Supervision meetings were held with staff to give opportunities to discuss development needs and encourage improvement in practice. The provider had processes in place to investigate and report safety events. Records showed that staff followed processes when reporting incidents and made sure people were kept safe.

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.

The registered manager and staff team worked with professionals and partner agencies to ensure there was continuity of care for people, including when they moved between different services. Records we reviewed showed that when people were placed in St Georges Care Home, their needs were assessed and reviewed to ensure they were suited to the environment and living with other people. Staff worked alongside other social care and health organisations to ensure people received appropriate care. There was regular contact with the local authority (LA), social workers, and doctors.

People and relatives told us that staff knew people well and we observed this during our visit. We were also told how the transition for people into this service was a positive experience for many, as all staff were friendly and took time to get to know people and understand how people wanted to be supported. One person spoke of how even the housekeeper had taken time to introduce themselves.

Relatives confirmed their family member had access to healthcare professionals who addressed their health needs.

People were supported to maintain their health and attend appointments both inside and outside of the service. People's care records showed referrals had been made to healthcare professionals where concerns had been identified.

The provider was previously in breach of regulation 13 (Safeguarding service users from abuse and improper treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection, we found improvements had been made in relation to the providers oversight. They had introduced effective systems to protect people from abuse and the provider was no longer in breach of this regulation.

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.

People told us they felt safe at St Georges Court care home. People were protected from the risk of abuse, and their rights were upheld. The provider had a safeguarding procedure so that concerns could be reported to the appropriate safeguarding authorities immediately.

Records showed staff had received safeguarding training; staff understood what to recognise and how to report concerns of a safeguarding nature. Staff were aware of the provider’s safeguarding and whistleblowing policies and knew which agencies to contact if they felt the provider was not acting on their concerns.

Safeguarding concerns were shared with the Local Authority (LA) and staff worked with the LA’s safeguarding teams to safeguard people.

Records showed concerns were logged, reported, and monitored to show what actions were taken and the outcomes from each case following safeguarding investigations. Relatives described how staff worked closely with them and kept them informed through any safeguarding matters.

People were protected from non-authorised restrictions to their liberty. There was a clear understanding of the Deprivation of Liberty Safeguards (DoLS). A system was in place to ensure DoLS referrals were appropriately made and reviewed when a person’s circumstances changed.

The provider was previously in breach of regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities). At this inspection, we found improvements had been made and risks to people were assessed more effectively and the provider was no longer in breach of this regulation.

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.

People’s risks were assessed before and after their admission. Risk assessments and care plans outlined what people’s risks were and the actions staff needed to take to reduce these. Risks were also assessed regarding bedrooms and personal belongings to ensure people were safe in their living environment. We were told how one person moving into the service wanted to bring a large collection of personal items. To enable this, they were supported to bring in display cabinets to ensure their items remained safe and accessible. People were receiving support to manage risks associated with old age, living with dementia as well as other medical conditions.

The provider was previously in breach of regulation 15 (Premises and equipment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection, we found improvements had been made to the adaptation, design, and safety of areas within the service and the provider was no longer in breach of this regulation.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

People and relatives had no concerns about the safety of the environment. There were arrangements in place for the upkeep of the building, including the internal and external environments.

There were appropriate checks and maintenance of the environment, and the home was clean and tidy. The registered manager completed regular walk round checks of the environment and maintenance staff completed regular health and safety checks of the environment.

Significant improvements had been made to the environment since our last visit. This was also echoed in feedback we received. One person told us, “[The] Home is also improved, all freshly painted and all clean - we are so happy [relative] is here.” The provider told us that people were given the opportunity to be involved in certain decision making, regarding environmental changes, such as room layouts and lighting. The provider had also introduced an onsite electronic reporting system. This meant that any person with a mobile phone was able to report any maintenance or safety issue using their device which would avoid any delay in it being addressed.

The provider was previously in breach of regulation 18 (Staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection, we found improvements had been made and there were enough skilled, experienced, and competent staff to ensure people's safety and the provider was no longer in breach of this regulation.

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. The registered manager reviewed the needs of people at the service regularly, which enabled them to identify how many staff were required in line with their staffing procedures.

People and relatives generally felt that there were enough staff. “I think we have more stable staff now and there are more of them, I would say it’s enough staff”. People told us that staffing levels can be changeable depending on the needs of people in the service, or unforeseen circumstances such as staff illness. Some people and relatives described staff as being very busy, which sometimes meant certain tasks were missed, or that they had to wait for staff to respond to them. However, these comments did not change how positive people were when talking about the staff that supported them.

There were arrangements in place to ensure staff completed induction training, kept up to date with mandatory training and staff received supervision from their line manager.

The provider was previously in breach of regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities). At this inspection, we found improvements had been made in relation to the provider promoting safety, through the layout and hygiene practices of the premises, and the provider was no longer in breach of this regulation.

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.

We found notable improvements during this assessment, which were also recognised by people and relatives we spoke with. The home was free of odours and domestic staff made sure areas were sanitised, clean, hygienic and fresh.

Staff had sufficient supplies of personal protective equipment (PPE). They received training to help them maintain good standards of infection control. Staff told us they followed procedures for the use and disposal of their PPE. People and relatives also confirmed staff followed safe infection control practices.

The provider was previously in breach of regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities). At this inspection, we found improvements had been made in relation to safe and effective medicine management and the provider was no longer in breach of this regulation.

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

The safety of medicines management had improved since our last visit. We observed that staff supported people to take their medicines safely and in a kind and respectful way. People were involved in decisions, and staff explained what the medicines were for. Medicines, including controlled drugs (medicines requiring additional control due to the potential for misuse), were stored securely, and administration records showed people received their prescribed medicines as intended.

Medicines audits were carried out routinely to check that systems were safe. Staff had received training, and their competence was assessed regularly. Staff engaged with other healthcare professionals and took part in regular multidisciplinary meetings to review people’s medicines.

Topical medicines, including patches, were recorded appropriately, with clear body maps in place to support application and site rotation. Where people received medicines through[FC1] an enteral feeding tube, records showed care was delivered safely in line with clear instructions.

Records relating to covert administration (medicines given in a disguised format, such as in food or drink) showed that appropriate assessments were made with relevant professionals, and guidance was available for staff. However, this was not always clearly documented on medicines administration records. The service told us they planned to update these records.

Guidance was in place for 'when required' (PRN) medicines, such as pain relief and medicines to alleviate distress. While staff demonstrated a good understanding of when and how to administer these, some written protocols lacked detail. For example, these did not always specify which medicine should be used first when more than one was prescribed for the same condition.