Archived: St Georges Residential Care Home

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found -

Is the service safe?

We saw a safeguarding policy had been reviewed in 2014. We looked at the training matrix and saw staff had completed safeguarding training during their induction period.

The provider does not employ any ancillary staff but expects care staff to undertake all tasks within the home such as caring, cooking and cleaning. During our inspection, we observed one staff member carrying out cleaning duties on an upper floor. This meant one staff member was left alone downstairs with people who used the service. This could have impacted on the safety of people who used the service. The provider does not employ staff in sufficient numbers for all these roles within the home to be properly covered which could impact on the safety of people who used the service.

Deprivation of Liberty Safeguards (DoLS) become important when a person is judged to lack the capacity to make an informed decision related to their care and treatment. The provider told us no applications for DoLS authorisations had been made but knew the procedure to be followed if an application needed to be made. On the day of our inspection, no person who used the service was subject to a DoLS.

There were several areas of the care home which required immediate attention. The boiler was not dependable and had previously broken down which resulted in no hot water in the home. On the first floor, a shower tray was dirty and required replacing. On the upper floor, a broken window was a risk to people who used the service and required immediate attention. Although a patio area provided people with a place to sit, there were parts of the garden area which had not been maintained and provided a risk to people who wanted to access it.

Is the service effective?

Each person`s likes and dislikes, choices and preferences had been recorded. This reflected a person centred approach to providing care and showed people were involved in creating their care plans.

There was an advocacy service available if people needed it. This meant that, if required, people could access additional support.

Is the service caring?

We spent time in communal areas, including the dining room at lunchtime. Some people required assistance eating their meals and we saw staff supporting them in a patient, unhurried manner.

We spoke with two family members who were visiting on the day of our inspection. One told us, "Oh it`s brilliant here. All the staff, especially the manager are wonderful."

Is the service responsive?

GP and other professional visits were recorded in care plans which showed a multi-disciplinary approach to providing care. This helped ensure people received appropriate care and support when they needed it.

We saw accidents and incidents had been recorded appropriately and a copy was kept in people`s care plans. We looked at a random sample of reports and found them to be completed in line with the provider`s policy. We saw a complaints policy was displayed on the walls of the care home. A copy was also kept in people`s care plans.

Is the service well led?

The service had a registered manager. However, the manager had been absent from work for three weeks. The provider had made arrangements for a senior qualified staff member to deputise for the manager during their absence.

Procedures were not in place which monitored the quality of service being provided to people who used the service. Lack of effective management and maintenance meant areas of the home were not safe. We were told by one visitor that, at times, the food could be better. We were also told by a staff member that on occasions, mainly at weekends, there was insufficient food available to provide people with a meal. However, on the day of our inspection, we saw there was an adequate supply of food items stored in the fridge and freezer.

The provider was aware of the notifications to be forwarded to the Care Quality Commission (CQC). We saw the required procedures were followed appropriately in July 2014 when a possible safeguarding incident was identified by the provider. However, we asked for, but did not see the required notification to CQC related to the breakdown of the boiler. No arrangements had been made to replace the boiler.

We spoke to people living in the home during the visit but mostly their comments did not relate to the standards we were looking at.

One person did say that "the food here is alright".

We found that there was sufficient food available and being purchased regularly and that the people received wholesome and nutritious food.

We found that the standard of cleanliness had improved since our previous visit. Bathrooms had been refurbished. There were cleaning schedules which were being followed and the home was clean.

There had been a programme of repairs and improvements since our last visit, which meant that the home was now compliant with the standard relating to premises.

We found that St George's now had sufficient staff to meet the needs of people living in the home.

The provider had an infection control policy but they had not ensured the environment was maintained and fit for purpose so that cleaning could take place in line with the policy. There were not enough staff to support the people who used the service because the service did not have a Registered Manager in place and designated cleaning and maintenance staff were not employed by the service.

The provider had an infection control policy but they had not ensured the environment was fit for purpose so that cleaning could take place in line with the policy. There were enough staff to support the people who used the service although their was limited cleaning support. The provider had a clear complaints process in place but they had not received any formal complaints in the last year.