CQC report explained · a nursing home
What the CQC found at St. George’s Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found current risk assessments, safe equipment checks, improved medicines systems and effective infection control. Staff knew how to respond to accidents or suspected abuse.
- Effective?
- Good
- People's needs and preferences were assessed and reviewed. Staff had training and supervision, meals were adapted to people's needs, and health referrals were made when needed.
- Caring?
- Good
- This area was not looked at during this focused inspection. Its earlier rating was carried forward into the overall rating.
- Responsive?
- Good
- This area was not looked at during this focused inspection. Its earlier rating was carried forward into the overall rating.
- Well-led?
- Good
- Inspectors found supportive management, regular checks on quality and medicines, staff supervision, and links with health and social care professionals.
What inspectors found, December 2021
St. George’s Nursing Home is rated Good; inspectors found major improvements in safety, medicines and management since the last inspection.
This was an unannounced focused inspection on 25 and 27 October 2021. One inspector spoke with seven people, one relative and seven staff. Records about care, medicines, staffing and management were also checked.
The home was rated Good overall. Safe, Effective and Well-led were rated Good. Inspectors found people were safe, medicines were managed much better, the home was very clean, and care plans reflected people's needs and preferences.
The home had previously been rated Requires Improvement, with two breaches of regulations. Inspectors found the required improvements had been made and the home was no longer in breach.
This inspection did not assess Caring or Responsive. The earlier ratings for those areas were carried forward when the overall rating was calculated.
Safer medicines
The electronic medicines system gave managers daily information and helped them follow up omitted or refused medicines. Nurses administered medicines in a way that reflected people's choices.
“The EMAR system was intuitive and gave daily updates.” from the report
Clean environment
The home was extremely clean, with housekeeping staff cleaning throughout the inspection. Infection control measures and visiting arrangements were in place.
“The service was extremely clean, housekeeping staff were busy throughout our inspection cleaning all areas” from the report
Personalised care
Care plans recorded people's needs, preferences and choices. Meals and equipment were adapted to support individual needs.
“Alongside people's needs, records were maintained of preferences and care plans devised to provide care according to peoples wishes if possible.” from the report
Supportive leadership
Staff had access to managers, regular supervision and opportunities to give feedback. Management had clinical and administrative experience.
“Staff were encouraged to speak with the management team at any time” from the report
Improvement since last inspection
The home addressed the earlier problems with equipment and medicines. Inspectors said it was no longer in breach of the regulations.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulations.” from the report
Training dates slipped
minorSome staff training was not completed on time during the pandemic. The provider supplied alternative online training and rearranged many courses.
“Staff training was current, there had been some slippage of dates due to the pandemic” from the report
Recruitment was ongoing
needs fixingThe home had lost some staff because of vaccination requirements and was still recruiting to rely on contracted or bank staff. It also used regular agency staff.
“There was ongoing recruitment to ensure the service could run using just contracted or bank staff” from the report
Small recruitment record gaps
minorInspectors found small gaps in the employment histories of two staff members. The manager corrected these immediately and changed the interview templates.
“We noted small gaps in two staff members employment histories and the registered manager immediately corrected this” from the report
- 01How have you kept the medicines checks and electronic records accurate since the inspection?
- 02Has the ongoing recruitment been completed, and how many agency or bank staff are currently used?
- 03Are all staff training and refresher courses now up to date?
- 04What are the current ratings or recent feedback about caring and responsiveness, which were not assessed during this inspection?
- 05How do you check that the improvements made after the previous inspection have continued?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not assessed, and their previous ratings were carried forward. This explanation was written from the published report of 15 December 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.
What inspectors found, December 2019
Rated Requires Improvement; inspectors found kind and responsive care, but medicines, equipment safety and management checks needed improvement.
This was an unannounced planned inspection on 8 and 9 October 2019. Inspectors spoke with people living at the home, relatives, staff and the manager. They also reviewed records, training information and quality checks.
The home was caring, effective and responsive, all rated Good. People were treated with kindness and dignity, had suitable food and healthcare support, and could take part in activities and decisions about their care.
Safety and leadership were both rated Requires Improvement. Air mattresses were not always set or recorded safely. Medicines were not always managed or recorded correctly. Management checks had not found these problems before the inspection.
The overall rating fell from Good at the previous inspection to Requires Improvement. The provider was told to improve safe care and treatment, and CQC said it would continue to monitor the home.
Kind and respectful care
People said they felt cared for. Inspectors saw friendly interactions, and staff respected privacy, dignity and personal preferences.
“We observed staff interacting with people in a friendly and caring way.” from the report
Enough staff
Inspectors found suitable staffing levels for people's needs. People said staff responded promptly when they used their call bells.
“People's needs were met by suitable numbers of staff.” from the report
Food and healthcare
People enjoyed the food and were supported with special diets and eating needs. The home also helped people access relevant healthcare professionals.
“People were supported to eat and drink enough and people enjoyed their meals.” from the report
Activities and personal choice
People could choose where to eat, when to get up and how to spend their time. Activities included trips out, clubs, entertainers and animal displays.
“Activities included a book club, Scrabble club, visiting singers and entertainers and animal displays.” from the report
Open culture and improvement work
The manager encouraged staff to raise concerns and had started an action plan covering care plans, supervision, policies and audits.
“The registered manager had identified areas which they felt needed improvement and created an action plan.” from the report
Air mattress safety
seriousSome mattress settings were wrong, missing or recorded unclearly. This increased the risk of tissue damage and pressure ulcers.
“This meant the mattress pressure was too hard and put the person at an increased risk of tissue damage.” from the report
Medicines management
seriousMedicine stocks did not always match electronic records. There was also no written guidance for some medicines given when needed, and the process for administering medicines was not clear.
“Medicines were not always managed safely.” from the report
Checks did not find problems
needs fixingThe home's governance systems had not identified the mattress and medicines issues before inspectors found them. Care plans were also not as detailed as they could be for personal care.
“Governance systems were not always effective at identifying issues.” from the report
Incomplete recruitment records
minorOne recruitment file did not show that the reasons for leaving previous care jobs had been checked. The manager changed the recruitment policy for future staff.
“Checks had not been completed to evidence the reasons why the staff member had left previous care jobs, as far as reasonably possible.” from the report
- 01How are air mattress settings now checked against each person's current weight, and who reviews the records?
- 02How do you make sure medicine stocks match the electronic records every day?
- 03What written guidance is now in place for medicines given when needed?
- 04What changes have been made to the governance audits so safety and medicines problems are found promptly?
- 05How have personal care plans been made more detailed since the inspection?
This was an unannounced planned inspection that considered the care home, its premises and care, and rated all five key questions. This explanation was written from the published report of 6 December 2019 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 Nursing Home
3 rated inspections over 5 years: the service has held its Good rating throughout.
- December 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodWell-led: Requires improvement
- February 2017GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 21 January 2011.
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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