Background to this inspection
Updated
7 March 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 14 February 2018 and was unannounced. The inspection was undertaken by one inspector.
Before our inspection we reviewed information we held about the service including statutory notifications that had been submitted. Statutory notifications include information about important events which the provider is required to send us. We also reviewed the provider information return (PIR) submitted to us 07 December 2017. This is information that the provider is required to send to us, which gives us some key information about the service and tells us what the service does well and any improvements they plan to make.
During the inspection we observed staff support people who used the service, we spoke with three people who used the service, four staff members, the training manager, the registered manager and two directors. We spoke with relatives of two people who used the service to obtain their feedback on how people were supported to live their lives. Subsequent to the inspection site visit we received feedback about the care and support provided for people from three further relatives.
We received feedback from local authority health and community services. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We reviewed care records relating to two people who used the service and other documents central to people's health and well-being. These included staff training records, medication records and quality audits.
Updated
7 March 2018
This inspection took place on 14 February 2018 and was unannounced.
St George's Nursing Home - Royston accommodates up to 24 people in a traditional 'Town House'. People are accommodated in a range of single and sharing rooms. St George's Nursing Home - Royston is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
At our last inspection in January 2016 we had rated the service as good. At this inspection we continued to rate the service as good however, we found that some improvement was required in relation to the management of people’s medicines. We shared our concerns with the management team who put further checks and monitoring in place to help support safe practice in this area.
People told us that they felt safe living at St George's Nursing Home. Staff had been trained in how to safeguard people from avoidable harm and were knowledgeable about the potential risks and signs of abuse. Where potential risks to people's health, well-being or safety had been identified, these were assessed and reviewed regularly to take account of people's changing needs and circumstances. Staff helped people to move safely using appropriate moving and handling techniques. People, their relatives and staff all told us that there were enough staff available to meet their needs. Safe and effective recruitment practices were followed to help ensure that all staff were of good character and suitable for the roles they performed at the service. The provider had worked closely with the Hertfordshire Fire and Rescue Service to help ensure people’s safety was promoted. The provider had systems in place to help promote infection control.
People and their relatives told us that the care and support provided was effective and appropriate to meet people's needs. Staff received training and supervision to support them to be able to care for people safely. The service was working within the principles of the Mental Capacity Act 2005 (MCA). All staff had completed relevant training and understood their role in protecting people's rights in accordance with this legislation. People were provided with a good choice of food. Assessments had been undertaken to identify if people were at risk from poor nutrition or hydration. People’s health needs were met in a timely way and they had access to health care and social care professionals when necessary.
People, and their relatives, told us they were happy with the staff that provided their care. Staff respected people's dignity and supported people in the way they wished whilst enabling them to remain as independent as possible. People's individual bedrooms were personalised with many items that had been brought in from their home such as cushions and pictures. Staff had developed positive and caring relationships with people they clearly knew well. People's care records were stored in a lockable office in order to promote their dignity and confidentiality. Visitors were encouraged at any time.
People and their relatives where appropriate had been involved in developing people's care plans which were reviewed regularly to help ensure they continued to meet people's needs. Staff were knowledgeable about people's preferred routines, likes and dislikes, and used this to good effect in providing them with personalised care and support. Regular meetings were held to support people and their relatives to give feedback about the service and facilities provided at St Georges Nursing Home. There were a variety of activities provided for people who used the service. Concerns and complaints raised by people who used the service or their relatives were appropriately investigated and resolved. A number of compliments had been made about the service provided for people who lived at St George’s Nursing Home.
The registered manager demonstrated an in-depth knowledge of the staff they employed and people who used the service. Relatives of people who used the service told us they felt the home was well managed. Staff told us that the management team was approachable and that they could talk to them at any time. There were a range of checks undertaken routinely to help ensure that the service was safe. The provider played an integral role within the daily running of the home supporting an experienced management team.