Background to this inspection
Updated
15 April 2021
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.
As part of CQC’s response to the coronavirus pandemic we are looking at the preparedness of care homes in relation to infection prevention and control. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.
This inspection took place on 2 March 2021 and was announced.
Updated
15 April 2021
St Georges Hotel is a care home which offers care and support for up to 22 predominantly older people. At the time of the inspection there were 20 people living at the service. Some of these people were living with dementia.
This unannounced comprehensive inspection took place on 8 May 2018. The last comprehensive inspection took place on 18 February 2016 when we found the service was in breach of one of the legal requirements. The service was rated as Good at that time. On the 13 February 2017 we carried out a focused inspection to check on the action taken by the provider to meet the requirements of the regulations. We found the service had taken appropriate action and had addressed the concerns we had found in February 2016. The service was found to have remained Good at this inspection
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 is required to have a registered manager and at the time of the inspection there was a registered manager in post. 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 and associated Regulations about how the service is run.
We spent time in the communal areas of the service. Staff were kind and respectful in their approach. They knew people well and had an understanding of their needs and preferences. People were treated with kindness, compassion and respect. People’s bedrooms were personalised to reflect their individual tastes.
People told us, “I am happy here and feel safe” and “I have two friends that visit each week. When we have visitors we see them in the quiet lounge or I could see them in my room if I wanted.” Relatives told us, “It’s a home from home here and feels like that from the moment you walk in; they’re all wonderful.”
The premises were well maintained. People’s bedroom doors held a number and their name in small print to help people identify their own rooms. The premises were regularly checked and maintained by the provider. The service was comfortable and appeared clean with no odours. Equipment and services used at St Georges were regularly checked by competent people to ensure they were safe to use.
The soap dispensers in all bathrooms were open topped and being regularly topped up as needed. This posed a potential infection risk as the residual soap in the dispensers was not being regularly emptied and filled entirely with new soap. Best practice is for soap to be dispensed from sealed cartridges. The provider addressed this issue immediately and ordered sealed dispensers for all bathrooms.
Care plans were well organised and contained accurate and up to date information. Care planning was reviewed regularly and people’s changing needs were recorded. Records of care and support provided were completed regularly by staff. Risks in relation to people’s daily lives were identified, assessed and planned to minimise the risk of harm whilst helping people to be as independent as possible.
The service had identified the minimum numbers of staff required to meet people’s needs and these were being met. The service had one staff vacancy at the time of this inspection and this was being covered by existing staff. The service had a calm and relaxed feel throughout with staff having time to sit and chat with people regularly. Staff were supported by a system of induction, training, some supervision and appraisals.
There were systems in place for the ordering, storage, management and administration of medicines. The system for monitoring people who self-administered their own medicines was effective. It was clear that people had received their medicine as prescribed. Regular formal medicines audits were not being carried out, however, checks on medicine administration records (MAR) were identifying if any error occurred such as gaps where staff should have signed to evidence they had given prescribed medicines.
Meals were appetising and people were offered a choice in line with their dietary requirements and preferences. Where necessary staff monitored what people ate to help ensure they stayed healthy.
People had access to activities. An activity co-ordinator was not in post but staff and external entertainers provided activities for people regularly. People went out in to the local area and attended appointments supported by staff.
The use of technology to help improve the delivery of effective care was limited. However, people had access to call bells to obtain assistance when needed.
Risks in relation to people’s daily life were assessed and planned for to minimise the risk of harm. People were supported by staff who knew how to recognise abuse and how to respond to concerns. The service held appropriate policies to support staff with current guidance. Mandatory training was provided to staff with regular updates provided. The manager had a record which provided them with an overview of staff training needs.
People's rights were protected because staff acted in accordance with the Mental Capacity Act 2005. The principles of the Deprivation of Liberty Safeguards were understood and applied correctly.
The registered manager spent much of their time working alongside care staff and with people living at St Georges. This meant they did not always have sufficient time to complete some of the managerial tasks needed, such as robust auditing of the service provided and formal staff supervision. The registered manager was supported by the provider and a team of motivated and long standing staff. An external agency was supporting the service to implement appropriate systems and processes to enable them to continually monitor and improve the service it provided.
The staff team felt valued and morale was good. Staff told us, “I am very happy here, we are a good team and it is a relaxed place” and “We all help each other out here, it is good.”
The service had sought the views and experiences of people and their relatives in order to monitor the standards of the care provided to people. The service was being supported by an external agency to begin robust audits of many areas of the service such as infection control and medicines management.
We have made recommendations in this report that the service take advice and guidance on the prevention and control of infection in care homes and involving people in their own care plans.