Background to this inspection
Updated
14 March 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.
This was an unannounced inspection which took place on 22, 23 and 25 January 2019. The inspection team on the first day of the inspection was made up of an inspection manager, an adult social care inspector and an assistant inspector. The second and third days of the inspection were carried out by an adult social care inspector.
To help us plan our inspection we reviewed information we held about the service. This included the inspection report from our last inspection in November 2017 and the home’s action plan following that inspection. We also reviewed the statutory notifications the CQC had received from the provider. Notifications provide information on changes, events or incidents that the provider is legally obliged to send to us without delay
During our visit we spoke with the registered manager, the provider’s operations manager, the training coordinator, three nurses and four care assistants. We talked with two people who used the service and five relatives. We also spoke with three relatives on the phone to ask their opinion of the service. We looked around the home, checking on the condition of the communal areas, toilets, bathrooms and some bedrooms. On the first day of our inspection we observed lunch being served on three of the units. We also observed how staff interacted and spoke with people.
As part of the inspection we looked in detail at seven sets of care records. These included care plans and risk assessments. We reviewed the medicine administration records (MARs) for people living on Haven and Brookdale units. We also looked at other information about the service, including training and supervision records, staff personnel files, audits, maintenance and servicing records.
Updated
14 March 2019
St George’s Care Centre is a purpose built 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. St George’s is registered to provide care and support to 77 people. At the time of our inspection there were 76 people living there.
St George’s Care Centre is located in the residential area of Moorside, Oldham. It is approximately three miles from Oldham town centre and is situated close to local shops and amenities, with good access to local transport routes.
This was an unannounced inspection which took place on 22, 23 and 25 January 2019. The care Quality Commission (CQC) last inspected St George’s Care Centre in November 2017, when the service was rated as ‘Requires Improvement’ overall. At that inspection we found the service was in breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Safe care and treatment. This was because medicines were not always managed safely. Following our inspection, the service provided us with an action plan which described how they would make improvements. At this inspection we found improvements had been made and the service was no longer in breach of any of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
The service had an experienced registered manager, who was a registered mental health nurse. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The building was secure, clean and well maintained. There were effective infection control and prevention measures within the service. Checks and servicing of equipment, such as for the gas, electricity and fire-fighting equipment were up-to-date.
Staff had been recruited safely. The service had completed all the necessary checks to ensure that staff were suitable to work with vulnerable people. There were enough registered nurses, care workers and support staff to meet the needs of the people who currently lived at the home. There was an on-going recruitment drive with the aim of reducing the use of agency staff.
A safe system of medicine management was in place.
People had individual assessments in place which identified risks in relation to their health and wellbeing. These helped identify if people were at risk from everyday harms, such as falls. Where risks were found, there were plans in place to guide staff, so that people were kept safe.
Accidents, incidents and safeguarding concerns were recorded and managed appropriately. There was clear information detailing any remedial action taken to reduce the likelihood of similar events occurring in the future.
We observed that staff always considered people’s capacity and consent when supporting them with care tasks. People were given choices when making everyday decisions. When people were being deprived of their liberty the correct processes had been followed to ensure that this was done within the current legislation
People were supported by well-trained staff. New staff received a thorough induction to the service and the training matrix showed that all staff had completed face-to-face training in a range of topics. Senior nurses and management carried out regular supervision and observation of staff. This ensured the standard of their work was monitored and gave them the opportunity to raise any concerns or worries.
During our observations we found staff treated people with dignity and respect. Staff showed patience and understanding and interacted with people in a kind and caring manner.
Staff at St George’s monitored people’s health. Where specific healthcare needs were identified, such as weight loss, the service liaised with health care professionals for specialist advice and support. Nursing staff were always available to undertake nursing duties, such as wound care and end of life care. People were supported to eat a well-balanced diet and were offered a choice of home-cooked meals.
People's care records were person-centred and contained detailed information about their preferred routines, likes and dislikes and how they wished to be supported. Providing person-centred care is about ensuring someone with a disability or long-term condition is at the centre of decisions about their life.
People were encouraged to provide feedback through service user meetings, an annual survey and via ‘Quick Response Code’ which was displayed in the reception area. This is a digital method of providing feedback.
The management team provided strong leadership of the service and was committed to maintaining and improving standards. Audits and quality checks were undertaken on a regular basis and any issues or concerns addressed with appropriate actions.