St George's Nursing Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At the last inspection, we rated this key question as requires improvement. At this inspection this key question has remained requires improvement. This meant people’s needs were not always met.

This service scored 57 (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 did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Care and support were not always provided when needed. We found that pressure care plans were not always followed and therefore the correct and consistent care could not be demonstrated. In addition, we found that people who required modified foods, all received this at the same consistency. Staff were not aware of the differences. This meant a person who was able to eat foods soft and bite sized, may receive a pureed meal which they did not need impacted on their experience and mealtime making it less enjoyable and hinder their appetite.

Some care plans were personalised, however, others needed further development. Further work was needed to ensure plans were all reviewed regularly, they covered all support needs and the content was consistent throughout. For example, regarding preferences, risk assessments and updates including what stage a DoLS was at.

People looked clean and comfortable. Most people were being cared for in bed. The provider told us people were offered the choice of getting up or staying in bed. This was not clear from people’s care notes. However, if everyone had wanted to get up, there would not be sufficient space for them in communal areas as this could only accommodate a small number of people.’

Most people were unable to express their views. Those who were able felt their needs were met in a way they liked. A person said, “I have everything I need.” Relatives told us they were happy with the care provided. A relative said, “I do feel my [person’s] needs are met and the staff are very supportive to them.”

We spoke with staff, and some were knowledgeable about the people they were supporting and the support they required.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. However, they were not always able to demonstrate this in records or assessments of care needs.

People with varied care needs were living at the service. Staff worked with visiting health and social care professionals to help ensure this support met their needs. However, assessments completed in the home were not always consistent throughout plans or followed consistently.

A visiting healthcare professional stated there was appropriate access to health and social care professionals

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs

Since 2016 all organisations that provide publicly funded adult social care are legally required to follow the Accessible Information Standard. The Accessible Information Standard tells organisations what they have to do to help ensure people with a disability or sensory loss, and in some circumstances, their carers, get information in a way they can understand it. It also says that people should get the support they need in relation to communication.

People were unable to tell us if they had access to information as they needed it. Relatives told us communication from the home was good. A relative said, “[Manager] is on the ball, send out emails and we have monthly meetings.”

The manager told us information was available and provided through meetings and handovers. We reviewed the records of resident and relative meetings. The provider told us, 'During the preadmission assessment, communication needs are discussed and any information regarding adaptations required for providing information are requested at this time. Communication needs are then reassessed when the individual arrives at the service to ensure that their needs are met. Information is provided in a format that is suitable for each resident and this is included in their communication care plan. This can include ensuring staff are aware that residents need hearing aids and what type of environment is optimum with providing information. Care plans also highlight the need to repeat information and to speak slowly and clearly giving residents time to process information and formulate a response. Information can be given in large print if required as well as Braille. At this time, these tools are not required with the current residents in the home.'

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People told us they felt they could speak up or make a complaint if they needed to. Relatives told us they were involved and listened to. A relative said, “We talk about the care plan if they’re not sure of anything, or we talk if I have any worries. We sit and try and find a way forward.”

Complaints were investigated, with an outcome recorded.

The provider supported people to provide feedback via meetings and surveys. Staff told us people were able to speak up and had opportunities to share their views.

There was an electronic tablet available for people, relatives and staff to log their views and feedback. There was a prompt to share feedback when signing in and out of the home.

We saw there was a record of residents’ meetings. These covered subjects including meals and activities.

Newsletters were shared to show what had been going on in the home and any updates.

Relatives’ surveys were sent for feedback. There were 4 responses, most feedback was positive. One noted they would like more communication.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People who were able to share their views and relatives told us they received the care, support and medical support when needed.

The management team had systems in place in the home to help give them assurances everyone had the same access to health and support services, care and social engagement and activities.

There were systems in place to help ensure people had access to external health and social care professionals, including out of hours or in an emergency.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

People with a variety of needs, backgrounds and cultures were supported by the home.

Staff told us people were treated equally and as individuals. A staff member said, “The goal of person-centred care is to put the individual at the heart of their support involving them in their own care planning and respecting their needs value and choice.”

There were opportunities for people to give feedback about their care and support.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Further development was needed in the end of life care plans. The service supported people at the end of their lives. Care plans included end of life care plans in most cases. There was a record of any Do Not Attempt Cardiopulmonary Resuscitation (DNACPR). However, the information was basic and needed further development to ensure there was a holistic approach when a person approached the end of their lives.

Staff told us what good end of life care looked like. A staff member said, “Prioritise comfort, dignity, and the individual's wishes, involving comprehensive support for their physical, emotional, spiritual, and practical needs.”