St George's Hotel

Updated 15 November 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was completed by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

St George’s Hotel is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. St George’s Hotel is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 10 October 2022 and ended on 14 October 2022. We visited the service on 10 and 11 October 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with six people, seven staff, including the registered manager and provider, and one professional. We reviewed three people’s records as well as two people’s medicines records, and records used to monitor and improve the quality of the service. We spoke with four relatives by phone.

Updated 15 November 2022

About the service

St Georges Hotel is a residential care home providing personal care for up to 22 people. The service provides support to older people, some of whom are living with dementia. At the time of our inspection there were 17 people using the service.

People’s experience of using this service and what we found

Checks and records were not all completed to ensure the safety of the people living at the service. Practice fire evacuations had not been completed and information to monitor people’s health needs had not always been recorded correctly. Action taken following advice from a healthcare professional was not always recorded. This meant it could not be monitored.

Medicines were not always managed, administered or checked in line with best practice. This increased the risk of errors.

Staff had received training appropriate for their role; however, when practical in-house training had been delivered, there were no records staff had received this. Some improvements were required in relation to safe staff recruitment.

The new provider had completed audits and checks of the service including engaging an external consultant to complete a mock inspection of the service. They had used the results of these to produce an action plan to improve the service; however, some improvements identified in the inspection had not been highlighted in the provider’s checks.

People felt safe living at the service and staff understood their responsibilities for keeping people safe and reporting any concerns. Staff understood people’s health needs and sought external support promptly when necessary.

People told us they liked the food but people who had specific dietary needs or wishes sometimes had limited options available to them.

People’s rooms were personalised to reflect their tastes. The provider had a plan in place to improve the premises and decor.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff knew people well and were responsive to their needs. People and relatives told us staff were caring and kind. One person told us, “I couldn't be looked after better.” Staff described how they protected people’s privacy and dignity and promoted their independence where possible. The provider told us they were in the process of increasing the opportunities and activities available to people.

The provider had ensured people, relatives and staff had been consulted about the quality of the service and had listened to and acted upon any changes suggested.

People, staff and relatives gave positive feedback about their experience of the service. Staff felt supported in their roles and were positive about the registered manager and the provider.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

This service was registered with us on 6 September 2021 and this is the first inspection. The last rating for the service under the previous provider was good, (published 29 May 2018).

At that inspection we recommended that the provider reviewed their systems for infection prevention and control, involved people in the content of their care plans and sought their agreement to its content. At this inspection we found these areas had improved.

Why we inspected

We completed this inspection to provide a rating for this previously unrated service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a breach in relation to the safety of people’s care and treatment at this inspection. Please see the action we have told the provider to take at the end of this report.

We also made recommendations in relation to recruitment practices, how staff training and care provided to people is evidenced and how people’s dietary needs and preferences are catered for.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.