CQC report explained · a nursing home
What the CQC found at Georgian House Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, January 2023
Georgian House Nursing Home rated Requires Improvement; inspectors found kind care but important safety, personalised care and management problems remained.
This was an unannounced focused inspection on 26 October and 1 November 2022. Inspectors spoke with 10 people, eight staff and four relatives, and reviewed care records, medicines records, staff files and management records.
The home was not always safe. Medicines were managed better than at the previous inspection, but medicines and hazardous products were left unsecured. Inspectors also found that bedrails continued to be used for one person despite advice not to use them. There was no evidence that people had been harmed, but inspectors said there was an increased risk of harm.
Care was not always personalised. Some care plans lacked clear guidance, meaningful activities were limited, and some people were not supported well during meals or to move around. Staff were described as kind, trained and helpful, and people could access healthcare services.
The overall rating is Requires Improvement. Safe, Effective, Responsive and Well-led were all rated Requires Improvement. Caring was not inspected in this visit, so the report does not give a new rating for it. The home remains in breach of regulations about person-centred care, safe care and good governance.
Kind staff
People and relatives told inspectors that staff were kind and understood people's needs.
“People and their relatives told us people were cared for by kind staff who knew the needs of the people they cared for.” from the report
Medicines management
The previous medicines-related shortfall had improved. Staff were trained and medicines records and stock checks were accurate.
“Medicines were managed consistently and safely in line with national guidance.” from the report
Staff training
Staff received induction, supervision and training, including training linked to the needs of people living in the home.
“Staff were supported to develop their professional practice through an induction, training, one to one supervisions and team meetings” from the report
Healthcare access
The home made timely referrals and worked with healthcare professionals to support people's health and wellbeing.
“Care plans recorded evidence of the provider working with external agencies and making referrals to other professionals in a timely manner” from the report
Unsecured hazards
seriousInspectors found an open medicines cupboard, unlocked sheds containing lighter fuel and an open electrical cupboard. These could have allowed people to reach dangerous items.
“The ground floor medicines cupboard had been left open, it was not secured and contained multiple prescribed medicines and creams.” from the report
Unsafe bedrail use
seriousOne person was at high risk of falls and had climbed over bedrails. The bedrails were still being used despite advice from the falls clinic not to use them.
“the bedrails were still being used against the advice of the falls clinic and continued to pose a risk to the person.” from the report
Care plans and meals
needs fixingSome care plans lacked personalised guidance. Inspectors also saw people waiting for help with lunch, with food becoming cold or not being eaten.
“Care plans were not always person centred and some lacked personalised details.” from the report
Weak quality checks
seriousThe home's audits did not identify several of the safety and care problems found by inspectors.
“We found no evidence that people had been harmed. However, systems were not used effectively to monitor service delivery.” from the report
- 01What has been done to secure the medicines cupboard, garden sheds and electrical cupboard?
- 02How are you now managing the risks for people who use bedrails, especially where a falls professional has advised against them?
- 03How will you make sure care plans give staff clear, personalised guidance about behaviour, mobility and end of life wishes?
- 04What daily activities and one-to-one support are now available for people who are not able to join group activities?
- 05How do you make sure people receive prompt support with meals and that food is still suitable if there is a delay?
This was a focused inspection of Safe, Effective, Responsive and Well-led; Caring was not inspected and its previous rating was carried forward when calculating the overall rating. This explanation was written from the published report of 20 January 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, July 2021
Georgian House Nursing Home was rated Requires Improvement; inspectors found kind care but unsafe medicines management and gaps in care planning.
Inspectors visited without notice on 11 March 2021. They spoke with people, relatives and staff, and reviewed care records, medicines records, staff files and management records.
The home was rated Good for Effective and Caring. People said staff were kind, respectful and met their needs. Inspectors also found suitable staffing, good infection control, healthcare support and improvements to the environment for people living with dementia.
The home was rated Requires Improvement for Safe, Responsive and Well-led. Medicines records contained several discrepancies, some care planning information was not detailed or respectful, and the home's checks had not found these problems.
The home had been rated Requires Improvement at the previous inspection in 2019 and remains at that rating after two consecutive inspections. The provider was still in breach of Regulation 12, and was asked to provide an action plan.
Kind and respectful care
People and relatives were positive about the care. Inspectors saw staff supporting people calmly, discreetly and with respect.
“Throughout the day, we saw staff attending to people in an unrushed manner.” from the report
Good infection control
The home had robust infection control arrangements, including PPE, cleaning schedules, testing and vaccination offers. No positive COVID-19 cases had occurred at the home.
“The provider had robust systems and processes to help prevent and control infection.” from the report
Staffing and training
Inspectors found enough staff on duty to meet people's needs. Staff received induction, training, supervision and competency checks.
“There were enough staff on duty at any one time to meet people's needs and keep them safe.” from the report
Support for health needs
Staff monitored people's health and made referrals when needed. They worked well with healthcare professionals and followed their advice.
“The staff had good working relationships with healthcare professionals involved in the care of the people who used the service.” from the report
Improved dementia-friendly environment
The home had added memory boxes, clearer signs, sensory items and personalised bedrooms. This addressed an earlier breach about the environment.
“At this inspection, we found improvements had been made and the provider was no longer in breach of this regulation.” from the report
Medicines records were not reliable
seriousInspectors found several differences between recorded and actual medicine stocks, missing pain relief tablets and a medicine continued beyond the recorded period without a written update. This increased the risk that people would not receive medicines as prescribed.
“Medicines were not always managed in a safe way.” from the report
Quality checks missed problems
needs fixingThe home's medicines and care audits had not identified the issues found during the inspection. The provider made changes after receiving feedback, but stronger checks were needed.
“However, these had not always identified where improvements were needed, for example medicines audits and care audits had not picked up some of the concerns identified during our inspection visit.” from the report
Some care planning needed improvement
needs fixingOne end of life plan lacked important detail, including religious needs and information about pain and anticipatory medicines. Some wording in another care plan was not respectful or person-centred.
“The language used in one person's care plan was not always respectful or person-centred.” from the report
- 01What changes have you made to medicines stock checks and medicines administration records since the inspection?
- 02How do you now make sure prescribed medicines are stopped or changed only when the written instructions are updated?
- 03How have you improved audits so they identify medicines and care planning problems before they affect people?
- 04How do you make sure end of life plans include each person's pain relief, religious needs and other personal wishes?
- 05What has changed since the inspection for people who need support with activities, communication and family contact?
This was a planned, unannounced inspection covering all five CQC questions, including care, medicines, the environment and infection control; the report also compares the findings with the previous inspection in October 2019. This explanation was written from the published report of 2 July 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Georgian House Nursing Home
5 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- January 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2021Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2019Requires improvementdown from GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2017Goodstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 16 December 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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