We carried out a review of the data available to us about Abbeyfield - St George's House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Abbeyfield - St George's House, you can give feedback on this service.
St George's House provides personal care and accommodation for up to 25 older people. At the time of our visit 14 people were being accommodated. The service is provided in a purpose-built building set over two floors with access to garden areas. It is located near a main town.
People’s experience of using this service and what we found
People told us they were happy living at the service and with the care and support they received.
One person said, “I can’t fault anything here.” Another person said, “The staff are kind.”
Care and treatment were planned and delivered in a way that was intended to ensure people's safety and welfare. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. Staff had received appropriate training. There were systems in place to minimise the risk of infection and to learn lessons from accidents and incidents. Medicines were dispensed by staff who had received training to do so.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.
People were supported to eat and drink enough to ensure they maintained a balanced diet and referrals to other health professionals were made when required. The environment was well maintained and suitable for people.
People were supported to follow their interests and participate in social activities. The provider responded to complaints received in a timely manner. People were supported to make plans for the end of their life.
The provider had been successful in driving improvements at the service. Systems had been put in place to monitor the service and improve outcomes for people.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 20 June 2019) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of the regulations.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Abbeyfield - St George's House on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection program. If we receive any concerning information we may inspect sooner.
People’s experience of using the service: People told us that they were happy living at the service and that they received very good care from the staff.
Care plans needed to be regularly reviewed and kept up to date to reflect people’s current needs. Further work was required to ensure the consistency of recording in care plans.
There was a lack of regular planned activities to support people’s well-being whilst living at the service. Activities on offer need to match the needs of the people living at the service.
Systems for governance and oversight were not sufficiently robust to address the issues highlighted at inspection. The manager needs to develop systems to give them clear overview of the service including checking all audits are acted on and kept up to date.
Staff had been recruited safely with the right recruitment checks. People spoke positively about the staff. Staff had the appropriate training.
Medication was managed safely. People got their medicine’s in the right way and at the right time.
The manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.
People were supported to eat and drink enough to ensure they maintained a balanced diet and referrals to other health professionals were made when required.
Staff cared for people in an empathetic and kind manner. Staff had a good understanding of people’s preferences of care. Staff always worked hard to promote people’s independence through encouraging and supporting people to make informed choices.
The manager responded to complaints received in a timely manner. Support was given to people at the end of their life.
Rating at last inspection: Good (report published 4 October 2016)
Why we inspected: This was a planned inspection based on the previous rating.
Enforcement: We identified two breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 relating to person centred care and good governance. Please see the ‘action we have told the provider to take’ section towards the end of the report.
Follow up: We will continue to monitor information and intelligence we receive about the service to ensure good quality is provided to people. We will return to re-inspect in line with our inspection timescales for Requires Improvement services.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Abbeyfield St George’s House is registered to provide accommodation and personal care without nursing for up to 26 older people. There were 25 people living in the service on the day of our inspection.
There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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.
People received their care and support in a way that ensured their safety and welfare. Staff had a good knowledge of how to safeguard people and they knew the actions to take to protect them from harm. People were supported to take everyday risks and staff knew the measures required to keep them safe. There were sufficient numbers of staff who had been safely recruited, were well trained and supported to meet people’s assessed needs. People received their medication as prescribed and there were safe systems in place for receiving, administering and disposing of medicines.
Staff had the knowledge and skills to care for people safely and had access to guidance and support to help them in their work. The registered manager and staff had a good understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and had made appropriate applications when needed. People had enough good quality food and drink to meet their individual needs and preferences. People’s healthcare needs were monitored to ensure they remained healthy and staff sought advice and guidance from healthcare professionals when needed.
Staff were kind, caring and compassionate and they knew the people they cared for well. They ensured that people were treated respectfully and that their privacy and dignity was maintained at all times. People expressed their views and opinions and participated in activities of their choosing. People were able to receive their visitors at any time and their families and friends were always made to feel welcome. Where people did not have family members to support them advocacy services were available. An advocate supports a person to have an independent voice and enables them to express their views when they are unable to do so for themselves.
People’s care needs had been fully assessed and their care plans provided staff with the information they needed to meet people’s assessed needs and to care for them safely. People were encouraged and supported to follow their individual hobbies and interests. Complaints had been dealt with effectively and people were confident that their concerns or complaints would be listened to and acted upon.
People had confidence in the registered manager and staff felt supported and valued. There was an effective system in place to assess and monitor the quality of the service and to drive improvements.
This is a summary of what we found:
Is the service safe?
When we arrived at the service the staff asked to see our identification. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.
We saw records which showed that the health and safety in the service was regularly checked. This included regular checks on such equipment as well as checks on the environment. This told us people were looked after safely.
We saw that the staff were provided with training in safeguarding vulnerable adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). This meant that staff were provided with the information that they needed to ensure that people were safeguarded.
Is the service effective?
People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information about how people's needs were to be met.
Is the service caring?
We saw that people were relaxed in the company of each other and staff. We saw that staff were attentive to people's needs. Staff we spoke with were able to demonstrate they knew people well. We saw staff treated people with dignity and respect.
Is the service responsive?
People who used the service were provided with the opportunity to participate in activities which interested them. People's choices were taken in to account and listened to. This was demonstrated in minutes we saw, which related to meetings with people who used the service. People's care records showed that, where appropriate, support and guidance was sought from health care professionals, including a doctor, optician, chiropodist and district nurse. This told us that the service worked well with other professionals and that people's needs were met.
Is the service well-led
The service had a number of quality assurance measures in place. The manager was proactive in monitoring and looking for ways to improve the service. We saw the quality of the service had been maintained.
We found that the provider had systems in place for ensuring the service was well led and systems were effective. For example, there were routine audits for infection control, systems for reviewing care plans, risk assessments and any complaints. There were effective recruitment and selection processes in place.
We spoke with two relatives. One told us, 'The care is excellent.' Another said, 'X loves it here.'
People told us that staff gave them choices and involved them in decisions.
We reviewed four people's care plans and found for three people that they were not always protected from the risks of unsafe or inappropriate care.
People were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.
We spoke with five staff who told us they had enough support from senior staff and opportunities to develop their skills and knowledge.
The provider had systems in place to regularly assess and monitor the quality of service that people receive.