Georgina House

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 our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement.

This meant people’s needs were not always met.

The provider was previously in breach of the legal regulation in relation to person-centred care. Improvements were not found at this assessment, and the provider remained in breach of this regulation.

This service scored 61 (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 make sure people were at the centre of their care and treatment choices.

People living at the service attended monthly meetings with their ‘key worker’ (a named member of support staff who is the person’s primary contact) to communicate about various aspects of their care. This included goals and aspirations, thoughts on new activities both at home and in the community, life skills, making choices, relationships, family, any improvements in the care provided, health advice and exercise, safety, any positive changes that could be made and whether the person had any concerns to highlight. However, over a period of 3 months, we saw no actions taken for 2 people living at the service. For example, two people had expressed their wish to replace broken furniture in their bedrooms. However, the registered manager had not considered either of these wishes.

The general appearance of the home did not present in a person-centred way. Several pieces of mixed, unmatched furniture were in people’s personal spaces. We also found broken furniture in two bedrooms. Neither the front nor the back garden was welcoming. There were weeds on the driveway and doorstep to the home, and the grass in the back garden had not been cut. The back garden was not designed to engage and stimulate people’s senses, offering the people living in the home a place to relax, providing a connection with nature and a safe space for sensory stimulation.

However, staff knew people well, including their likes, dislikes, care needs and how to promote their independence. Staff were able to describe what person-centred care meant to them. For example, a staff member said, “Care should be tailored around individual needs. Whatever activity/task you support should be about them [the person] and not you.”

The registered manager confirmed they had allocated funds to buy flowers for the back garden and involve people living at the service in planting them. Following our feedback, the grass in the back garden was cut.

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.

Staff supported people in accessing health appointments and services in the community. When people visit their families, staff ensure all relevant medication and personal belongings are packed and ready for their visit.

The registered manager confirmed he had been fortunate to have a consistent staff team, having worked at the service for several years. This meant people received care from a staff who knew them well.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Information was not always given in a form that would support people’s understanding. For example, the structure of meetings with people was set out in pictures and photographs. These pictures and photographs, which were used to choose activities and food choices, were exceedingly small. Furthermore, we noted that people’s individual activity planners were not pictorial. The service had a selection of social stories available for people to utilise, such as ‘how to keep safe;’ however, these were generic stories rather than individualised. Social stories offer a structured way to communicate information and foster understanding in a clear and accessible manner.

However, people’s preferred methods of communication and any tools they used to support communication had been assessed and detailed in their care plans. Staff had completed Makaton training to aid everyday communication with people.

The provider was aware of their responsibilities to ensure people with disabilities or sensory loss received information in a way they could understand and support with their communication. The registered manager confirmed that care and support plans could be provided in alternative formats should this be required. Since our assessment, the provider has introduced some new activity planning cards to aid with decision-making.

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. Named key workers met and supported people individually and in group settings.

A person living at the service represented everyone living at the home at an ‘Our Voice, Ask, Listen, Do’ meeting. This provided an opportunity to share people’s complaints, discuss what is going well, and discuss how things could be improved in the home, such as improving the decoration.

The registered manager had recently contacted families to gather feedback on the quality of care provided.

A staff member said they were unaware of any complaints but said if people living at the service were unhappy with the care provided, they would firstly organise a meeting with the relevant key worker and inform the registered manager of the complaint. The provider had a complaints policy in place.

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

Staff understood the needs of autistic people and people with a learning disability and made sure people had access to care and treatment, so people did not experience discrimination because of their disability and individual needs.

Staff were available to support people attending routine appointments or in an emergency. Both staff and management confirmed they could always make health and social care appointments for people living at the service and found no barriers or delays in accessing care and treatment.

Staff monitored people’s safety and health needs and identified when people wanted or needed support from other health and social care professionals. Care plans contained information about how people demonstrated pain or discomfort when they could not verbally inform staff how they felt. The service also had a bed monitor that detects breathing to ensure the safety and wellbeing of a person living at home.

Staff and leaders tailored care and support to ensure people did not experience inequality in experiences and outcomes. However, improvements were required to ensure all people had equal access to activities and engagement in the community.

People were reliant on staff to support them in the community. Several group-based activities included visiting Georgina House’s sister home to use the sensory facilities and attending the ‘21 Club’, a local recreational facility for adults with learning disabilities. Staff encouraged people to foster friendships when accessing day activity groups.

However, a review of the service’s records found that some people did not receive regular support to enjoy activities and interests of their individual choice. This meant people had varying levels of fulfilment and quality of life, and some people spent a lot of time in their personal living areas.

The registered manager told us relatives were approached to plan for important life changes, so they could have enough time to make informed decisions about their loved one’s future, including at the end of their life.

Although end-of-life care plans had been completed, most relatives had chosen not to record detailed wishes despite the registered manager attempting to have these sensitive conversations. The registered manager respected relatives' wishes not to discuss the topic further and will revisit this later. Nobody received end-of-life care at the time of our assessment. Staff had completed palliative training with the local hospice.