St George's Nursing Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to good governance.

This service scored 62 (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 had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

Staff felt supported by the management of the service and the service was a nice place to work. They told us, “Both the registered manager and clinical lead are approachable and available” and “Registered manager is available and the nurse. They’re very helpful.” The registered manager and clinical lead held regular meetings with staff along with supervision. Staff had access to various meetings including daily handovers and meetings, clinical meetings and regular staff meetings.

The provider’s management team visited the service. They undertook a range of quality assurance monitoring; this was through various audits and walk arounds. Any actions from these visits were shared with staff, and also the registered manager and clinical lead who would follow up any actions as required.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

The registered manager, clinical lead and staff were supported by a team of senior managers who visited the service regularly. All staff felt able to raise anything with senior managers if needed. The registered manager and clinical lead both demonstrated a passionate approach to supporting people with the best care possible.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

The management within the service were observed during the inspection to seek feedback from people and have general conversations with people about how they were that day. The registered manager, clinical lead and senior managers were available and accessible to people and staff if and as needed.

People, relatives and staff views were sought through meetings and surveys. The registered manager confirmed people had the opportunity to share feedback on the décor within the service and on aspects such as meals and activities and this was sought regularly from people.

Staff could raise any concerns if needed through the providers whistleblowing policies. These were available to staff within their staff room.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The provider employed staff from different backgrounds, and the service had a diverse workforce. Staff were being provided with opportunities to grow and develop and to gain qualifications which increased their employability.

The provider ensured staff were supported through access to their policies and procedures, and they were supported by the registered manager flexibly when the need arose.

Staff were given development opportunities, and some staff had gained professional qualifications whilst working for the service which enabled them to look for other jobs within health and social care. The provider was looking to implement a staff recognition scheme for their contribution to the service, their training and development.

The provider’s governance arrangements were not ensuring systems and processes established were making improvements when identifying shortfalls.

For example, the provider had identified some improvements through their governance arrangements to the documentation of medicines. However, during our inspection we found improvements were still required to four people’s Medicines Administration Charts. As these did not always confirm people had been administered their topical cream and where staff were to apply those.

The provider’s governance systems did not always identify areas where improvements were needed to people’s care documentation as this did not always confirm people had adequately been supported with their assessed need, including where they required repositioning. One person’s moving and handling documentation lacked sufficient guidance, on how staff were to use their equipment.

The registered manager was responsive during our inspection to the concerns raised and started to make improvements to these shortfalls. The provider following our inspection confirmed action taken to update people’s moving and handling documentation and they confirmed monthly checks were now in place to specifically check these as part of people’s care plan review.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The registered manager and clinical lead confirmed they worked in partnership with health and social care professionals although we reviewed some feedback from one health and social care professional who felt some improvements could be made to ensure staff were familiar with people’s individual care planning information and were knowledgeable about people they supported. We raised with the registered manager following our inspection so they could review this feedback.

The service worked with the local GP practice who sent an advanced nurse practitioner to visit the service once a week.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

The provider’s senior management team and managers for the service kept up to date with best practice information and held meetings with staff so they had the opportunity to explore any wider learning from incidents, accidents and the development of other services. They sent regular updates to staff on information, sharing of learning and what was expected of them. The provider was hoping to work with a university as part of a research project around nutrition within care homes. The provider was also going to be developing staff’s understanding of dementia within the service.

Where incidents had occurred, the registered manager confirmed actions taken along with any referrals made. Although actions had been taken there were instances where altercations had occurred that might have been avoided if there was staff intervention. We raised this feedback during our inspection, and more information is also available within the quality statement of safe and effective staffing.