Archived: Georgiana Care Home

Updated 10 June 2023

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.

Inspection team

This inspection was completed by three inspectors.

Service and service type

Georgiana Care Home 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. Georgiana Care Home 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was a manager in post who had started the processing of registering with the CQC.

Notice of inspection

This inspection was unannounced. Inspection activity started on 01 February 2023 and ended on 16 February 2023. We visited the service on 01 February 2023.

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 and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 17 people who used the service and 7 relatives about their experience of the care provided. We spoke with 16 members of staff including care workers, senior care workers, housekeeping staff, the cook and members of the management team.

We reviewed a range of records. This included 4 people’s care records and numerous medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 10 June 2023

About the service

Georgiana Care Home is a residential care home providing personal and nursing care to up to 72 people. The service provides support to people who may be living with a physical disability, mental health needs or dementia. At the time of our inspection there were 54 people using the service.

Georgiana Care home is split across two floors and three wings. People have access to their own personalised bedrooms and en-suite toilets and share communal areas such as lounges, bathrooms, dining areas and a garden.

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

People were not always kept safe using the service. Risk assessments were not always completed for known risks to people or were not detailed to guide staff to support people safely. People’s medicines were not being managed safely and systems were not effective in identifying where errors were being made. Some information from staff recruitment checks were missing. Whilst there were enough staff to support people safely, staff did not spend time supporting people outside of essential care tasks.

Staff were not being supported with supervision and competency assessments to make sure their training had been effective. It was not always clear how people who required support to eat and drink were having this monitored effectively by staff. We have made a recommendation the provider ensures people are supported effectively with this. We could not be sure people were receiving support with oral care. People’s needs were assessed before they started living at the service, but these assessments did not always focus on people’s preferences, likes and dislikes. People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.

People were not always treated with kindness and compassion and staff did not always respect people’s privacy and dignity. Staff did not always support people in a person-centred manner in line with their preferences likes and dislikes. People’s support plans did not focus on how people would like to be supported as individuals with their own preferences. People were not being supported to take part in social pastimes or follow their interests and were not a part of the local community. People were not being supported in line with their communication needs. People did not always have detailed end of life care plans in place and we recommend the provider reviews these plans for people.

The management team were not effectively monitoring the quality of the service and audits were either not in place or did not pick up on areas where improvements were needed. People and relatives’ feedback was gathered but not used to improve the service. The provider did not visit the service to ensure people were receiving good quality care. There had been a failure to learn lessons from inspections of the providers other services meaning improvements could not be made or sustained at the service.

Despite our findings people and relatives were happy with their support. One relative said, ‘‘I cannot fault the staff team. [Family member] has gone from strength to strength and has their life back since they started living at Georgiana Care Home.’’

People and relatives felt they/ their family member were safe living at the service. The service looked and smelled clean and staff followed good infection control measures. People were supported to see health professionals if this support was necessary. Plans were in place to continue to improve the environment for people living at the service.

We also saw some kind and caring interactions between people and staff. Some staff knew people well and staff wanted what was best for people. People’s complaints were listened to and taken seriously. The manager was passionate about improving the service and took immediate action in areas identified as needing improvement at this inspection.

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)

The last rating for this service was requires improvement (report published 16 April 2021). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this 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 have identified breaches in relation to safe care and treatment, people not being treated with dignity and respect, person centred care, and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.