St George's Nursing Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question as requires improvement and the service was in breach of legal regulation as the provider was not ensuring good governance of the service. At this assessment the rating has changed to good although we found the provider was still in breach of the legal regulation as the providers governance arrangements needed improving. We also found improvements were needed to having accurate and up to date contemporaneous records.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The service was managed by a manager and clinical lead. People, relatives and staff were positive about the management of the service and staff told us they felt supported. One person told us, “Manager comes around and knows me.” Another person told us, the manager was new and, “I like him.” One relative told us, “Manager is brilliant and knows everyone.” Another relative told us, “Manager is very approachable and always listens.” All staff we spoke with felt able to raise concerns with the manager, more senior staff and if needed wider within the organisation.

The manager wanted to improve the service and provide good care to people. They told us, “It’s about getting the culture right.” The provider had organisational values for staff. These included, respect, kindness, integrity and unity. The provider also had a service philosophy that included enhancing the individual with well-being, promoting purpose in daily living, creating meaningful connections. They also felt it was important to give choice, form strong relationships between staff and residents, treating people kindly and celebrating joy and teamwork. Staff we spoke with felt it was a nice place to work and they felt valued, supported and it was a good staff team.

The service worked in partnership with various health and social care professionals and there was a positive community involvement. Various activities were planned with the local community such as, visits from local children’s groups, different churches and festive events for different faiths, cheese and wine evenings, coffee mornings and singers. The service encouraged visits from relatives and friends. The manager felt this was important and something to be encouraged.

The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

The provider’s senior management team supported the manager and clinical lead with regular visits to the service. These visits were a combination of support visits and quality visits. There were daily meetings where staff could discuss with the manager and the clinical lead important concerns such as important updates and how people were.

Staff were supported by the provider to gain further skills, knowledge and fulfil their potential. Some staff had undertaken further training so they could work in a more qualified position.

The manager confirmed whilst recruiting new staff it was important these staff promoted a positive culture. They had a consistent nursing team in place with a clinical lead and they were undertaking recruitment to fill the 5 care staff vaccines they had in the service.

The service fostered a positive culture where people felt they could speak up and their voice would be heard. All people, relatives and staff felt able to raise concerns with the manager and the senior leadership team. Staff told us if needed they could raise concerns above the manager if needed.

The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them. Some staff were employed on a sponsorship arrangement. The service supported all staff to achieve their potential and to undertake qualifications, some staff were now in a more senior position because of this. The provider sought staff feedback about the service through satisfaction surveys. The manager confirmed they wanted to ensure there was a career pathway for all staff so they could progress to other roles either within the service or in health and social care.

The service did not always have robust governance arrangements in place that were effective at identifying specific shortfalls found during our inspection. Improvements were also needed to people’s care planning documentation.

For example, the governance arrangements in place for the service had failed to identify the following: improvements needed to people’s care plans and associated information such as to their risk assessments for mobility. Some people needed a Mental Capacity Assessment- and Best Interest decision for equipment and vaccinations. One person needed information in their care plan around the support they needed from staff with their skin integrity and repositioning. Care plan reviews and individual audits had not identified all these shortfalls.

The provider’s staff training report had failed to identify where two staff were new to the service and needed practical moving and handling training. Audits and walk arounds had failed to identify where the arrangements for hot food was not within the recommended guidance from the Food Standards Agency.

The manager and senior management team were responsive to our concerns raised during and after the inspection and most actions were taken to address the issues we identified. The service had a new manager and clinical lead in post and the provider had also made changes to the senior management team for the service. Some areas of improvement had been identified by the service prior to our inspection. This included, improvements to staff training, supervision and appraisals, to undertake monthly care plan reviews and audits and action had been taken to remove topical creams that posed a fire risk. Although the provider had identified improvements needed to these areas of the service the providers individual audits, systems and processes were not effective to allow the provider to have effective oversight of all the concerns identified as part of this inspection.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement. For example, the serviced worked with the community including local schools and nurseries, churches, clubs and groups. The manager confirmed how they liaised and worked with health and social care professionals when needed, the local authority, the GP practice and the pharmacy team. The manager gave a positive example of how they were working in partnership with one person and their professionals to ensure the person got the right support they needed. Feedback we gained from one health and social care professional confirmed, the service is responsive, effective and efficient at handling referrals, queries and any enquires they had. They also said the manager worked in partnership with them to ensure new admissions were suitable for the service.

The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contribute to safe, effective practice and research. During our inspection people and their visitors spoke positively about the care and support. Compliments about the care were displayed in the service and the manager kept a log of compliments and complaints the service had received. Some compliments for the service included thanking all the staff including the management for the work they do along with the improvements being made to the service.

The manager and senior management team had various improvements they wanted to make to the service. This included developing staff knowledge and training in supporting people with dementia as well as making improvements so it enhanced people’s daily living experiences.