CQC report explained · a nursing home
What the CQC found at St George's Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found effective safeguarding arrangements, detailed risk assessments, safe medicines management and good infection control. Staff deployment needed some improvement at key times, including mealtimes.
- Effective?
- Good
- People's health, nutrition and hydration needs were supported, and staff worked with health professionals. Inspectors saw that some people waited for lunch during a disorganised lunchtime in the main dining room.
- Caring?
- Good
- People and relatives spoke positively about staff. Inspectors saw staff treating people with kindness, dignity and respect, while supporting independence and involvement in decisions.
- Responsive?
- Good
- Care was personalised and staff knew people's preferences. People were supported with communication, activities, relationships, complaints and end of life care.
- Well-led?
- Good
- Inspectors found experienced leadership, open communication and regular checks on quality and safety. The home worked with health and social care professionals and used feedback to improve.
What inspectors found, January 2020
St George's Care Home was rated Good; inspectors found kind, safe and personalised care, with some delays at busy mealtimes.
The inspection was unannounced and took place on 17 December 2019. Inspectors reviewed care plans, staff records, medicines and management records. They spoke with people living at the home, relatives and staff, and observed care.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people were protected from abuse, medicines were managed safely, staff were trained, and people's health and dietary needs were supported.
People and relatives described staff as kind and supportive. Inspectors saw positive relationships, respect for people's privacy and efforts to support individual choices, communication needs, activities and end of life wishes.
There were enough staff overall, but some people waited longer for help in dining rooms at mealtimes. The provider was reviewing staffing levels and recruiting to vacant posts. The overall rating remained Good, as it had been at the previous inspection published in June 2017.
Kind relationships
Inspectors saw positive relationships between staff, people and relatives. People were treated with patience, kindness, dignity and respect.
“Throughout our inspection we observed staff interacted well with people and had formed good relationships with them and their relatives.” from the report
Safe care
The home had safeguarding procedures, detailed risk assessments and systems for learning from accidents and incidents. Medicines and infection control were also found to be safe.
“There were effective safeguarding systems in place and the registered manager had good oversight and knowledge of safeguarding within the home.” from the report
Personalised support
Care plans recorded people's wishes and preferences, and staff knew how individuals liked to be supported. The home also adapted communication for people's needs.
“People received personalised care from staff that knew them well.” from the report
Activities and relationships
People could take part in activities chosen around their interests and maintain relationships with relatives and the local community.
“People were supported to access and participate in meaningful activities that were relevant to them.” from the report
Quality oversight
Managers used audits, meetings and feedback to monitor the service. Staff said management support was available when needed.
“There were effective systems in place to assess and monitor the quality of the service.” from the report
Delays at mealtimes
needs fixingInspectors saw that some people waited longer for support in dining rooms, particularly during lunch in the main dining room. The manager said this would be reviewed.
“However, we observed that lunch time in the main dining room was a little disorganised and some people waited periods of time for their lunch whilst others on the same table ate.” from the report
Staffing arrangements under review
needs fixingThere were enough staff overall, but staff deployment needed improvement at key times. The staffing tool was being reviewed and the home was recruiting to vacant posts, including to support people whose behaviour challenged the service.
“The registered manager also told us they were currently recruiting more staff to fill vacant posts.” from the report
- 01Has the review of staffing levels and deployment been completed since the inspection?
- 02How do you make sure people receive timely help during busy mealtimes?
- 03Have the vacant staff posts mentioned in the report been filled?
- 04How do you provide enough time and support for people whose behaviour requires additional support?
- 05What changes were made after inspectors found lunchtime in the main dining room was disorganised?
This was a planned inspection covering the overall quality of the care home, including all five CQC questions, the premises and the care provided; all five previous Good ratings remained the same. This explanation was written from the published report of 22 January 2020 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, June 2017
Rated Good; inspectors found safe, kind and personalised care, with some reliance on agency staff and a medicines assessment issue.
This was an unannounced inspection on 24 May 2017. Inspectors spoke with people, relatives, staff and a health care professional. They reviewed care records, medicines records, staff supervision records and the home's quality records.
The home provided nursing and residential care for up to 63 people, mainly people living with dementia. There were 51 people living there during the inspection. Inspectors found that people were safe, treated with dignity and supported by staff who understood their needs.
Care plans were detailed and personalised. People had choices about food, activities and daily care. Inspectors also found good support with medicines, nutrition, health care, mental capacity and activities.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The previous inspection on 27 April 2016 had found no concerns.
Kind and respectful care
Inspectors saw staff being patient, attentive and gentle. People were offered choices and supported at their own pace.
“Staff treated people with dignity and respect. Support was provided in accordance with people's wishes.” from the report
Personalised support
Care plans included people's routines, communication needs, preferences and health needs. People and relatives were involved where appropriate.
“There was evidence in people's care plans that people and relatives (where appropriate) were involved in the planning of their care.” from the report
Support for people with dementia
The layout, signs, memory boxes, garden and sensory features were designed to help people living with dementia move around and engage with familiar activities.
“The environment was set up to meet the needs of people living with dementia.” from the report
Good food and health support
People had choices of meals, regular drinks and support with nutrition. Staff worked with a range of health professionals when needed.
“People had enough to eat and drink and there were arrangements in place to identify and support people who were nutritionally at risk.” from the report
Open management
The manager and senior staff were visible. The home sought feedback from people, relatives and staff and used it to make changes.
“The registered manager actively sought, encouraged and supported people's involvement in the improvement of the service and used this to improve the quality of care.” from the report
Reliance on agency staff
needs fixingSeveral staff had recently left, so the home relied more on agency workers while recruiting. Staff said this could be difficult when agency workers lacked experience of the people living there.
“With permanent staff you can cope but using agency it can be a struggle with their lack of experience with people that live here.” from the report
Pain assessments
needs fixingInspectors told the manager that pain scale charts were not being used as often as they should be. The manager said this would be addressed straight away.
“We did raise with the registered manger that pain scale charts were not being used as often as they should be to assess the level of pain people may be in.” from the report
Staff morale
minorStaff morale had fallen after the recent departure of some staff. The report says this did not stop staff working well as a team.
“Due to the recent departure of some staff the staff morale was not as good as it had been.” from the report
- 01How many permanent care and nursing staff now work here, and how often is agency cover still needed?
- 02How do you make sure agency staff understand each person's needs, routines and dementia support?
- 03Are pain scale charts now used consistently, and how do you check this?
- 04How are people and relatives involved in reviewing and changing care plans?
- 05What changes have been made since the inspection following feedback about staffing and activities?
This was an unannounced inspection covering the overall service and all five CQC areas: Safe, Effective, Caring, Responsive and Well-led. This explanation was written from the published report of 20 June 2017 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 St George's Care Home
4 rated inspections over 4 years: the service has improved, from Inadequate to Good.
- January 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2016Requires improvementup from InadequateSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2015InadequateSafe: Requires improvementEffective: Requires improvementCaring: InadequateResponsive: InadequateWell-led: Inadequate
- November 2014
Report published without a new overall rating.
- July 2014
Report published without a new overall rating.
- May 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 15 November 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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