14 August 2022
During an inspection looking at part of the service
Georgian House is registered to provide personal care and accommodation for up to 43 people who may have needs associated with their physical and/or mental health. At the time of the inspection, there were 33 people living at the home. Georgian House is also registered to provide personal care to people in their own homes. At the time of the inspection, there was no one receiving care in their own home, so this activity was not included in this inspection.
People’s experience of using this service and what we found
The majority of people told us they were safe, happy, liked living at Georgian House and were well cared for by kind and caring staff. We received mixed feedback from relatives regarding people’s experiences. Most relatives told us they did not have any concerns for their loved one’s safety. However, two relatives told us they did not have confidence in the care people were receiving or the management team. These concerns are being dealt with under formal complaints and safeguarding procedures and CQC will be informed of the outcome.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
We found the service was not always operating in accordance with the regulations and best practice guidance. Some systems were either not in place or had not been undertaken robustly to identify and monitor the quality of the service and drive improvements. This meant some systems operated by the provider had failed to identify concerns and shortfalls we found during this inspection and could not be relied upon as a source to measure quality and risk.
Safeguarding systems were established and the provider had clear policies and procedures in relation to safeguarding adults. However, we found safeguarding processes did not always operate effectively.
People were not always protected from the risk of avoidable harm. We found where some risks had been identified, enough action had not always been taken to mitigate those risks and keep people safe.
People were not always supported to have maximum choice and control of their lives and staff were not always supporting people in the least restrictive way possible. The service could not always demonstrate they were acting in people’s best interests.
Most medicines were given safely and correctly. Some improvements were needed and these were being implemented.
People did not always receive their commissioned individual support hours.
People were mostly supported by staff who had the skills and experience to meet their needs. However, we found there were gaps in training and some staff had not completed a full induction.
People’s needs were assessed prior to admission.
Staff knew people well and understood how to communicate effectively with people and spoke about people in a dignified and respectful way.
The registered manager was keen to put processes in place to address any areas of concern or improve practice. The provider had identified particular areas such as compliance, staff welfare, learning and development as areas they needed to focus on.
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 27 September 2019).
Why we inspected
This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions of safe, effective 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 see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Georgian House on our website at www.cqc.org.uk.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to safeguarding, safe care and treatment, staffing, the need for consent, notifications and governance at this inspection. We have also made recommendations in relation to Fire safety and person-centred care.
Please see the action we have told the provider to take at the end of this report.
Follow up
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 alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.