St Georges

Updated 3 February 2022

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 19 January 2022 and was unannounced.

Updated 3 February 2022

About the service

St. Georges is a residential care home providing personal and nursing care to 34 older people and people living with dementia, at the time of inspection. The service can accommodate up to 36 people in one adapted two-storey building.

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

The provider's systems and processes used to monitor quality and safety were not used robustly to manage the service effectively. Quality assurance systems had not identified the issues and concerns we found.

There were not enough staff to provide quality care and support to people. The service had been consistently short staffed and staff deployment was not managed effectively. The regional director addressed the staff shortages for the day but further action was needed to maintain safe staffing levels.

People, staff and visitors were not always protected from risk of infection. Some areas of the service were not always cleaned promptly. Staff did not always wear face masks correctly. The manager took action immediately to address this.

Risk to people had been assessed and care plans provided guidance for staff to manage those risks such as falling or swallowing difficulties. These needed further improvements to ensure the impact of people’s health condition such as dementia, had been taken into account and the role of staff to support them. Records did not fully reflect whether essential care had been provided.

People felt safe with the staff and the care provided. Staff recruitment procedures ensured that appropriate pre-employment checks were carried out. Staff understood what abuse was and how to report concerns.

People received their medicines safely. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The manager and staff team worked with external health and social care professionals and followed recommendations made.

The manager had begun the process to be registered with the Care Quality Commission (CQC). People, relatives and staff spoke positively about the manager, who they described as approachable, supportive and addressed issues as soon as practicable.

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 Good (published 18 April 2018).

Why we inspected

The inspection was prompted in part due to concerns received about staffing levels. We made a decision to inspect and examine those risks. 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.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements in relation to staffing and quality monitoring and governance. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting ‘all reports’ linked for St Georges on our website at www.cqc.org.uk

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.