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Georgina House Requires improvement

The provider of this service changed - see old profile

Reports


Inspection carried out on 28 March 2019

During a routine inspection

About the service: Georgina House is a residential care home that was providing personal care to 4 people at the time of the inspection.

People’s experience of using this service: The people who could communicate with us in ways which we could understand spoke positively about the staff who supported them and the new manager. One person said, “It’s good I have a key worker, [name of member of staff] has helped me.” One person spoke positively about their room. We saw other people engage well with the staff, they looked happy and at ease with the staff around them.

When we inspected the service last time we found many issues which led to multiple breaches of the Health and Social Care Act 2008 and the service was placed in Special Measures. At this inspection we found improvements had been made.

Plans had been made to help staff manage some of the key risks which people faced. People were being supported to access health support or seek professional advice about their needs. Improvements had been made to promote people’s safety in the home when they accessed the kitchen.

Staff now supported people to have their medicines in a safe way. Improvements had been made in terms of keeping the home clean, but we still found issues relating to infection control risks at the home. The manager did start to act to address these issues.

The provider had now had completed full employment checks to ensure people were safe around new members of staff. The staff we spoke with had a good and complete knowledge about how to protect people from potential abuse. They also knew how to promote people’s rights in terms of experiencing discrimination.

Plans were in place to ensure staff had competency checks so the manager could address shortfalls in their knowledge and be assured if staff were competent in their work. We saw that staff knowledge and practice had improved, but this was still a working progress, to ensure all staff were effective in their roles.

Progress had been made to enable people to have choice with their food and drinks and promote healthy options. We saw staff encouraging people to go out for walks and plans had started to be made to support people to eat healthier food.

Staff and the manager were making efforts to help people who could not communicate easily, to have a voice. Referrals to specialist health professionals had been made and care plans were updated so staff knew how to meet people’s needs.

Improvements had been made in terms of supporting people to consider goals but further work was needed to fully explore people’s interests, ambitions, and improve their environment and experiences.

There was now a management structure in place which had good oversight about the previous issues and what they needed to do to make improvements. There was now a better culture at the home. Further work was needed to make these improvements and show these had been sustained.

The home had not previously been fully developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. Further work was needed to fully meet these values.

Rating at last inspection: Inadequate the report was published on 26 September 2018.

Why we inspected: This inspection was planned based on the previous rating.

Follow up: We will inspect the service again to check improvements have been made and in the mean time we will monitor the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Inspection carried out on 11 July 2018

During a routine inspection

We inspected this service in January 2016 and rated the home as ‘Good’ overall. When we inspected the service on 11 July 2018 we rated the service as Inadequate overall. This is the first time Georgina House has been rated as Inadequate overall. This inspection was announced the day before we visited. This was to ensure a member of staff would be present to let us into the home.

Georgina House is a ‘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.

Georgina House provides personal care and accommodation for people who have a range of learning disabilities. Georgina House can provide care for up to four adults. At the time of the inspection three people were living at the home. Georgina House comprises of accommodation over two floors.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.” Registering the Right Support CQC policy

There was not a registered manager in place when we inspected the home. 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. An application had been submitted to the CQC by the current manager at the home.

The leadership and the provider of the service were not taking timely action to ensure people were safe. Insufficient action was taken to respond to the health needs of a person who had become unwell early this year. No meaningful review had been completed to improve the person’s wellbeing. We needed to discuss these concerns further with the provider after our inspection.

We found issues with staff practice which had the potential to put people at risk of harm. These included poor infection control practices. One person’s bathroom had mould growing in their shower and a dirty extractor fan. We also observed unsafe staff practices when administering people their medicines and with the storage of people’s prescribed creams.

Staff recruitment checks were not thoroughly completed to ensure people were safe around staff. The provider and leadership of the service were not monitoring or checking the competency of staff. The provider did not have strong assurances that staff were effective in their work. Staff had not received suitable support and leadership from the management of the home.

People were not being supported to have real choice with what they ate. People were not always being involved in planning what they ate or the preparation of their food. Healthy alternatives were not being promoted at the home. The meal time was not a social experience. People’s cultural dietary needs were not being met by staff.

People’s health needs were not always being responded to in a timely way. People’s rights and interests in this area were not being promoted and championed by the service.

The service was not compliant with the Mental Capacity Act 2005 (MCA). This provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. People’s relatives and professionals were not being consulted with when people could not make certain decisions themselves.

When people’s freedom of movement was restricted, there was no checking if these met the requirements of the Deprivation of Liberty Safeguards (DoLS).

People were not always treated in a kind, caring and respectful way. We observed peo

Inspection carried out on 16 October 2015

During a routine inspection

The inspection took place on the 16 October 2015 and it was announced. We last inspected the service in April 2014 and had found them to be meeting each of the standards we assessed.

The service provides accommodation and personal care for up to three people with learning disabilities and autism. At the time of our inspection, there were three people using the service.

The home has 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 & Social Care Act and associated regulations about how the service is run.

People were kept safe and had detailed and personalised care plans in place to meet their needs. Risk assessments had been completed to ensure that staff were able to keep people using the service safe. The service employed enough staff to meet people’s needs. Medicines were managed safely.

People enjoyed a varied and personalised menu, with food that met both their nutritional and cultural needs. People were supported to attend all relevant healthcare appointments.

Staff were knowledgeable and enthusiastic about the people they supported. People and their families were actively involved in care and support planning.

People’s dignity and privacy was respected and confidential information relating to people’s care was stored securely. Interactions between staff and people using the service were positive and caring.

Staff, relatives and people using the service spoke highly of the management team. The service had robust systems in place to monitor the quality of people’s care, with regular audits by senior management.

Inspection carried out on 17 April 2014

During a routine inspection

In this report the name of a registered manager appears who was not in post and not managing the regulatory activity at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

When we visited Georgina House on the 17 April 2014, we gathered evidence to help us answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

We always ask the following five questions of services.

Is the service safe?

We observed people were treated with respect and dignity and there were good interactions between people and staff. People looked relaxed and comfortable in the company of staff. We saw staff demonstrated genuine warmth, care and concern for people.

The home had a system in place to ensure that people’s risk assessments were kept under regular review. Arrangements were in place to monitor accidents and incidents that occurred. This meant that measures were put in place to prevent a recurrence.

Staff spoken with said that there was no one at the home on the day of our inspection whose liberty was being deprived. We saw evidence which confirmed that staff had been provided with training on the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Staff were able to describe what measures the home had in place to promote people’s safety and how they would protect people if they felt their human rights were being breached.

The home had infection control processes in place to ensure that it was clean and hygienic. People were protected against the risk of acquiring infections.

Is the service effective?

Staff told us that people had access to an advocate if required. There was a notice displayed in the home to remind staff how to access the local advocacy service. This meant that if required people could access additional support.

We found that people’s care plans provided detailed information on how they wished to be supported with their care needs. Health action plans had been developed for people. These were appropriately maintained to ensure if required, a new member of staff or agency worker would be able to deliver care safely and effectively.

We found that people’s health care needs were kept under regular review. They had access to health care professionals such as the GP, dentist, optician and district nurse. This meant that people were supported to keep healthy and well.

The home had an effective recruitment and selection procedure in place. This meant that people’s health and welfare needs were looked after by staff who were fit and appropriately qualified to undertake their job.

Is the service caring?

We observed staff talking to people in a kind and respectful manner. Staff demonstrated genuine warmth, care and concern to people. Staff spoken with were knowledgeable about people’s care needs. It was evident that staff responded to people in a caring manner.

Is the service responsive?

We found that people were supported to express their views and be actively involved in making decisions about their care treatment and support. We found where people did not have the capacity to make decisions, best interest meetings were held involving the GP, an advocate and the home’s staff.

We saw evidence that regular care plan reviews took place. This meant that people’s care needs were current and kept under regular review.

We found that where appropriate staff enabled people to have access to outside activities that were important and relevant to them. It was evident that people were protected from becoming isolated and were provided with activities to meet their diverse needs.

Is the service well led?

Staff spoken with said that they felt supported by the interim manager and were provided with regular staff meetings. At these meetings they were able to raise questions and make suggestions relating to the provision of care. This meant that staff felt supported and well-led.

The home ensured that the complaints procedure was available in a suitable format to meet people’s diverse needs. Arrangements were in place to monitor complaints, accidents and incidents. This meant that lessons were learnt from mistakes, incidents and complaints investigations to ensure improvements with the service delivery.

Inspection carried out on 7 May 2013

During a routine inspection

When we visited Georgina House on 7 May 2013 we spent time with the three people who lived there and spoke with two staff members. Two of the people had very limited verbal communication. We observed through people’s facial expressions and gestures that they were relaxed in the company of staff. For example, people smiled when staff interacted with them. We observed people’s clothing was appropriate to suit the weather.

A person who was able to communicate with us said, “I like living here, the staff are kind to me”. The person also said, “I make my own breakfast and I help staff with washing the dishes. Staff take me shopping and I choose what food I like to eat”.

We found people were provided with sufficient food and drink to meet their needs. Where possible staff enabled people to maintain their independence and to prepare their own meals. People lived in premises that were adequately maintained. We found the garden was overgrown and staff supervision and appraisal was not consistent. Records relating to people’s safety and the environment were appropriately maintained.

Inspection carried out on 4 April 2012

During an inspection to make sure that the improvements required had been made

We spent time with all three people who lived at Georgina House when we visited on 04 April 2012. They all had very limited verbal communication, however when we spoke with them, they were able to demonstrate through facial expressions and gestures that they were happy living there and that they felt safe. People looked clean and well cared for, and where they needed support or assistance with personal care this was done in private to protect their dignity.

We observed that the staff interacted with them in a caring and respectful way. They used verbal communication supported by sign language to offer people choices.

Where people were able, they had signed their care plans to indicate that they understood and agreed with them. People had Health Action Plans in place which indicated that appointments with other health professionals such as opticians, dentists and chiropodists were made for them at regular intervals or when required.