St George's House

Updated 11 August 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.

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 carried out by 1 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. They joined us at the service and spoke with people and relatives to ask their views about the service.

Service and service type

St George's House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement dependent on their registration with us. St George's House 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 registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before 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 asked for feedback from health and social care professionals who support people at the service. We used all this information to plan our inspection.

During the inspection

We met with people who lived at the home. We spoke with 6 people who could tell us about their experience and views about the home. Some people were unable to fully express their views to us as they were living with dementia. We therefore spent time observing care in the main communal area and the interactions between people and staff.

We spoke with 5 members of staff. We also spoke with the registered manager and the nominated individual The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included 2 people's care records and a sample of medication records. We looked at a variety of records relating to the management of the service, including training records, staff recruitment, incident records, quality assurance processes and various policies and procedures.

We emailed the GP who support people at the service to ask their views.

Updated 11 August 2023

About the service

St George’s House is a residential care home providing personal care to up to 19 people. The service provides support to people aged 65 and over. At the time of our inspection there were 13 people using the service.

St George’s House is a detached period property in the market town of Tiverton. The home has accessible access to the garden and communal areas. People’s bedrooms are on the ground and first floor, which people access using a stair lift.

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

People lived in a home where the providers system was not always effective to identify and address concerns and shortfalls in the service. During the inspection we identified issues relating to people’s records, policies and procedures and medicine management. The provider and registered manager took prompt action to resolve the concerns we found. We have recommended they continue to seek reputable guidance to continue to establish and maintain effective quality assurance systems to embed improvement into practice.

People had not always been protected from environmental risks at the home. The provider took prompt action to the concerns we found. We have recommended the provider continue to regularly monitor health and safety risks at the home.

People’s medicines were not always being managed in a safe way. Improvements were made during the inspection to make medicines safe regarding concerns we identified. We have recommended the provider continue to review their practice in relation to safe and effective use of medicines

People were protected from the risk of abuse because the provider had effective safeguarding systems in place. We observed kind, compassionate and caring interactions between people and staff. People looked comfortable and relaxed with staff who supported them. People spoke positively about the care provided.

Staff told us there were usually enough staff to safely meet people's needs. We identified concerns about the early evening staff levels which we discussed with the registered manager. They told us they would look into the staff levels at this time.

Infection control practice followed national guidance and sought to keep people safe from infection. We signposted the provider to resources to develop their approach further.

The provider worked well with healthcare professionals to ensure good outcomes for people.

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 providers policies and systems were being reviewed to ensure staff had clear up to date guidance. The registered manager welcomed support, advice and guidance to achieve compliance. They consented to being contacted by the local authority quality improvement team to continue to improve the service.

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

Rating at last inspection

The last rating for this service was good (published 22 May 2018).

Why we inspected

We received concerns in relation to the management of the service and risks to people. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St George’s House on our website at www.cqc.org.uk.

Follow up

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