CQC report explained · a nursing home
What the CQC found at St George's (Wigan) Limited
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that people were protected from abuse and avoidable harm. Medicines, staffing, recruitment, risk assessments and infection control were managed safely.
- Effective?
- Good
- People's needs and preferences were assessed before they moved in. Staff had suitable training, and people received support with food, drink, healthcare and decisions about their care.
- Caring?
- Good
- Staff knew people well and treated them with kindness, dignity and respect. People were supported to make choices and maintain their independence.
- Responsive?
- Good
- Care plans were personalised and regularly reviewed. People were supported with communication, activities, relationships, complaints and end of life wishes.
- Well-led?
- Good
- The management team had stronger audits and oversight than at the previous inspection. Staff and relatives described the management as supportive and approachable.
What inspectors found, December 2021
Rated Good; inspectors found safe, kind and person-centred care, with improvements since the previous inspection.
Inspectors visited on 3 and 4 November 2021. They spoke with relatives and staff, observed care, and checked care, medicines, recruitment and management records. They also checked infection control arrangements.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines management, suitable care plans and good support with health, food, activities and communication.
The rating had improved from Requires Improvement at the previous inspection in December 2020. The home had completed an action plan, and inspectors found it was no longer breaching Regulation 17 about good governance.
Safe medicines
Medicines care plans had been rewritten with more detailed instructions. Staff were trained and their competence was checked.
“Medicines were managed safely, and people received their medicines as prescribed.” from the report
Kind and respectful care
Staff formed genuine relationships with people and tailored support to their wishes. Inspectors saw positive interactions and people appeared comfortable with staff.
“People were treated with dignity and respect and their independence was promoted as much as possible.” from the report
Personalised support
Care plans included people's histories, likes, dislikes and communication needs. Relatives and people were involved in planning and reviewing care where possible.
“Care files contained a range of person-centred information.” from the report
Activities and relationships
The home provided daily activities and helped people stay in contact with relatives during the pandemic through calls and visits.
“People were supported and encouraged by care staff to undertake activities and maintain social relationships to promote their wellbeing.” from the report
Improved oversight
The home had strengthened its audits, meetings and follow-up systems since the previous inspection. These systems helped managers identify and act on issues.
“The provider's audit systems were now more robust and supported good service delivery.” from the report
Phone communication
minorOne relative said communication could sometimes be slow because the phone was not always answered quickly. This was described alongside an account that staff did share important updates.
“Communication can be variable, sometimes you have to wait a while for the phone to be answered but they [staff] let us know if [my relative] has had a fall or anything.” from the report
- 01How quickly are relatives' calls usually answered, and what is the best way to receive updates?
- 02How will you keep my relative's medicines care plan accurate, especially for as-required or covert medicines?
- 03How will you assess and review my relative's risks, including falls, nutrition, hydration and moving and handling?
- 04What activities and communication methods would suit my relative's interests and abilities?
- 05How will my family be involved in care planning and decisions, including end of life care if needed?
This was a planned inspection based on the previous rating; inspectors assessed all five key questions and also checked infection prevention and control under Safe. This explanation was written from the published report of 1 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 2020
St George's (Wigan) Limited is rated Requires Improvement; inspectors found good care in some areas, but medicines and quality checks were not consistently safe or effective.
This was a focused inspection on 12 and 17 November 2020. Inspectors looked at Safe, Effective, Responsive and Well-led. They reviewed care and medicines records, staff files, audits and other documents, and spoke with people, relatives and staff.
The home was clean and had enough staff. People were protected from abuse, risks were assessed, and infection control arrangements were effective. Staff supported people's choices, health needs, meals and activities. The Effective and Responsive ratings were Good.
However, medicines were not always recorded or given safely. Some care plans were out of date. The checks used by managers had not found all the problems. Safe and Well-led were rated Requires Improvement, and the overall rating fell from Good at the previous inspection in 2017.
Enough staff
Inspectors found enough staff to meet people's needs, and recruitment checks were carried out.
“There were enough staff on duty to meet people's needs.” from the report
Infection control
The home had arrangements for PPE, testing, distancing, cleaning and managing possible outbreaks.
“We were assured that the provider was using PPE effectively and safely.” from the report
Personalised care
Care plans recorded people's preferences, abilities and communication needs. Staff were seen respecting people's choices.
“Care plans were person-centred and contained specific individual details about people and how they wanted to be supported.” from the report
Health support
Staff worked with health and social care professionals and followed advice to support people's health.
“People had access to healthcare professionals and were referred appropriately to services to support their needs.” from the report
Medicine records and safety
seriousSome medicine records were not properly signed or coded. Care plans did not always give enough information about medicines, including medicines hidden in food or drink and higher-risk medicines.
“Some entries on medicines administration records (MARs) had been handwritten by staff, but these had not been double signed in line with the provider's policy.” from the report
Risk of choking
seriousOne person's care plan did not accurately describe the required thickness of fluids or match the product being used. Inspectors said this created a risk of choking.
“This meant there was risk of the person choking.” from the report
Weak quality checks
seriousThe home's audits did not identify all the medicine problems found during the inspection. This led to a breach of the regulation on good governance.
“Quality assurance systems needed to be improved to ensure any concerns were identified and acted upon in a timely manner.” from the report
Out-of-date care information
needs fixingSome care plans and consent records did not contain the latest information. Two people's pre-admission records were also not up to date.
“People and their relatives, where appropriate, had been involved in the care planning process, however, some care plans had not been updated with the latest information.” from the report
Communication with relatives
minorSome relatives were not given clear or timely information about visiting arrangements during pandemic restrictions. One relative also said information about the home and the contract pack was delayed.
“Some relatives told us communication from the home about visiting arrangements could have been better and they were unsure when they could visit the home.” from the report
- 01What changes have you made to medicine records, double-signing and coding since this inspection?
- 02How do you now check that medicines given when needed or hidden in food or drink are safe and properly recorded?
- 03How do you make sure care plans and consent records are updated when people's needs change?
- 04What evidence can you show that your audits now find and resolve problems promptly?
- 05How will you keep relatives informed about visiting arrangements and changes to their relative's care?
This was a focused inspection of Safe, Effective, Responsive and Well-led; Caring was not inspected during this visit, and ratings for questions not inspected were carried over from previous comprehensive inspections. This explanation was written from the published report of 24 December 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.
Every inspection of St George's (Wigan) Limited
7 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- December 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2020Requires improvementdown from GoodSafe: Requires improvementEffective: GoodResponsive: GoodWell-led: Requires improvement
- October 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2017Requires improvementstayed Requires improvementSafe: GoodResponsive: Requires improvementWell-led: Inadequate
- November 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2016Requires improvementstayed Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 28 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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