CQC report explained · a nursing home
What the CQC found at St George's Nursing Home (Oldham)
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, March 2019
St George's Nursing Home (Oldham) was rated Good; inspectors found kind, safe care and improvements to medicines management.
This was an unannounced inspection over three days in January 2019. Inspectors spoke with people living at the home, relatives and staff. They observed care and mealtimes, looked around the building, and checked care records, medicines records, staff files, training and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff for the people living there, safe recruitment, suitable risk assessments, good infection control and a safe medicines system.
Staff were described as kind, respectful and patient. Care records reflected people's needs and preferences. People received support with food, health care, activities and end-of-life care, and complaints were recorded and responded to.
The home had been rated Requires Improvement at the previous inspection in November 2017 because medicines were not always managed safely. Inspectors found that the improvements had been made and that no regulations were being breached at this inspection.
Improved medicines safety
The home had addressed the medicines problems identified at the previous inspection. Medicines administration records checked by inspectors were accurate, and staff had training and competency checks.
“At this inspection we found improvements had been made and the service was no longer in breach of this regulation.” from the report
Kind and respectful staff
Inspectors saw staff explain care, give people time to respond and offer reassurance. People were treated with dignity and supported in a patient and caring way.
“During our observations we found staff treated people with dignity and respect.” from the report
Personalised care
Care records included people's routines, likes, dislikes and support needs. Staff were knowledgeable about the people they cared for and updated plans when needs changed.
“Care records contained information about people's support needs, including mobility, communication, nutrition and hydration, behaviour and end of life wishes” from the report
Strong quality checks
The home carried out regular checks on areas such as medicines, cleanliness, falls, infections, complaints and nutrition. Inspectors found that identified issues were acted on.
“We found there was a robust system of quality assurance and governance processes.” from the report
Medicines paperwork
minorProtocols for medicines given when needed were kept separately from the matching medicines record on two units. Inspectors said it was best practice to keep them together.
“However, on both units the protocols were kept separately from the corresponding MAR sheet.” from the report
Staffing for activities
needs fixingThere was only one activities coordinator at the inspection because of sickness and a staff departure, although the home was recruiting and care staff were helping with activities.
“However, due to sickness and one person leaving the service, there was only one activity coordinator working at the time of our inspection.” from the report
Some redecoration needed
minorSome corridor paint was chipped and skirting boards needed repainting. A redecoration programme was in place.
“The paintwork in some corridors was chipped and skirting boards needed repainting.” from the report
Feedback analysis pending
minorThe home had received responses to its latest survey, but the analysis had not yet been completed when inspectors visited.
“Analysis of the survey had yet to be completed, although many good comments had been received.” from the report
- 01How are medicines given when needed recorded, and are the protocols now kept with the medicines administration records?
- 02How many permanent and agency staff are currently working on each unit, and what happens when there are staff absences?
- 03Has the full-time activities coordinator vacancy been filled, and what activities are available on each unit?
- 04Has the planned redecoration of the chipped corridors and skirting boards been completed?
- 05What did the October 2018 survey show, and how were the results used to improve the home?
This was an unannounced comprehensive inspection covering all five CQC questions; the previous overall rating was Requires Improvement in November 2017. This explanation was written from the published report of 14 March 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.
What inspectors found, January 2018
Rated Requires Improvement; inspectors found kind care and major improvements, but medicines were not always managed safely.
This was an unannounced inspection on 8 and 9 November 2017. Inspectors spoke with people living at the home, relatives and staff. They looked at care records, medicines, staffing, training, the building, food and quality checks.
There had been considerable improvement since earlier inspections. The home was clean and well maintained. Staff were caring and people had detailed care plans, activities, food choices and access to health professionals.
However, medicines were still not managed safely in every case. Some medicines were stored at the wrong temperature, two people's eye drops were past their recommended expiry date, and there were problems with medicines hidden in food and with drink thickeners. The overall rating was Requires Improvement. Effective, Caring and Responsive were rated Good. Safe and Well-led were rated Requires Improvement.
Kind and respectful care
Inspectors saw staff treating people kindly and respectfully. Staff offered choices and responded patiently to people's needs.
“We observed kind and caring interactions between staff and people who used the service.” from the report
Staff training
New staff had a thorough induction, shadowing and a probationary period. Staff also received refresher training and supervision.
“New staff received a thorough induction and staff received regular refresher training in a variety of subjects.” from the report
Clean and maintained home
Inspectors found all six units clean, well decorated and free from unpleasant odours. Equipment checks, fire arrangements and infection control procedures were in place.
“At this inspection we found everywhere was clean and there were no unpleasant odours.” from the report
Medicine storage
seriousSome medicine storage areas and fridges were outside the recommended temperature range. This could affect how well medicines work.
“Medicines were not always stored at the correct temperature.” from the report
Expired and unclear medicines
seriousEye drops for two people had been opened for longer than recommended. Some instructions for medicines given when needed were unclear, and advice from a pharmacist was not recorded for covert medicines.
“We found eye drops, used to treat glaucoma, for two people that had been opened for longer than the recommended four weeks.” from the report
Drink thickeners
seriousThickener was not always recorded when added to drinks. On one unit, one person's supply was used for three people, creating a risk if the wrong amount was given.
“There is a risk of choking if an incorrect amount of thickener is administered and prescribed thickeners should not be shared.” from the report
Audits missed problems
needs fixingThe home carried out regular medicine audits, but these checks did not identify or prevent the issues found by inspectors.
“The audits did not highlight or prevent the issues we found at this inspection.” from the report
- 01How are medicine room and fridge temperatures checked now, and what happens when a reading is outside the recommended range?
- 02How do you make sure no medicines are used after their expiry date?
- 03When medicines are given hidden in food or drink, what pharmacist advice is recorded for each medicine?
- 04How do you make sure each person receives the correct drink thickener and that this is recorded?
- 05What changes have been made to the audits so they identify medicine safety problems promptly?
This was an unannounced inspection to check improvements and rate the service across all five CQC questions. This explanation was written from the published report of 11 January 2018 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 (Oldham)
4 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- March 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at St George's Nursing Home (Oldham) →
- January 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at St George's Nursing Home (Oldham) →
- April 2017Requires improvementstayed Requires improvementSafe: InadequateWell-led: Requires improvement
- December 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2014
Registered with the Care Quality Commission on 30 June 2014.
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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