Background to this inspection
Updated
15 May 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
This inspection was conducted by one inspector.
Service and service type
St George’s nursing home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We received feedback from the local authority. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with two people who used the service and one relative about their experience of the care provided. We spoke with 11 members of staff including the registered manager, nurses and care staff.
We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data, supervision data, care plans and quality assurance records. We contacted five professionals who regularly visit the service, but we received no feedback. We spoke with four members of staff and three relatives.
Updated
15 May 2021
About the service
St George's Nursing Home provides accommodation and nursing care for up to 44 people. The service is located in three period town houses across five storeys, with a day room and two dining areas in the basement. At the time of our inspection there were 20 people using the service. Some of the people living at the home were living with dementia.
People’s experience of using this service and what we found
Since our last inspection the registered manager had worked hard to make many improvements such as medicines management, reviewing care and support documentation, policies and procedures and the overall management of the service. However, there was some work which was still outstanding such as staff training, building and maintenances issues. There were lots of improvements in quality assurance and monitoring. On the whole staff and relatives spoke positively of the progress made so far and staff in particular felt more supported.
The home followed good infection control practices. It was clean and tidy; a refurbishment programme was underway. There was outstanding building work since the last inspection that still needed urgent attention. We saw evidence of the registered manager trying to address these issues. We made a recommendation to the provider regarding repairs.
Medicines were managed safely. People were protected from abuse and were treated with care and respect. The registered manager had introduced training for all staff, but many staff had not completed the mandatory training. The registered manager was reviewing how training would be delivered to staff going forward. People spoke well of the service and they enjoyed living at the home. Since the last inspection the home had no safeguarding concerns and staff understood how to keep people safe.
Since the last inspection the registered manager had recruited one staff member and this was conducted in a safe way.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update.
We undertook this targeted inspection to check whether the provider had met the requirements of the Warning Notices in relation to regulations 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) 2014. The last rating for this service was requires improvement published 22 December 2020 and there were multiple breaches of regulation for safe care and treatment, staffing and good governance. At this inspection we found improvements had been made and the provider was no longer in breach of regulations. This service has been rated requires improvement for the last six consecutive inspections. We will meet with the provider and continue to work alongside the provider and the local authority to monitor ongoing progress.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St George’s nursing home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information, we may inspect sooner.