St Georges Care Home is a ‘care home’ for 20 people. 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 home specialises in the care of older people.

This unannounced inspection took place on the 16 and 17 October 2018. At the time of the inspection there were 19 people living at the home.

There is 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 2008 and associated Regulations about how the service is run.

The provider and registered manager effectively monitored the quality of care and made on-going improvements. Improvements made since the last inspection included; refurbishment of a number of communal and personal rooms. Updating the call bell system to minimise the noise impact on people and ensuring response times could be monitored. Upgrading the care planning format to an electronic system and introducing up to date technology to enhance entertainment and communication for people.

People lived in a home which was well led by a registered manager and provider who were committed to ensuring the service respected people as individuals. People told us they were able to maintain their independence and follow their own routines. One person told us, “I have as much control as possible. There are no rules to obey.” Another person said, “You can mostly keep your own routines. Always people to help you if you want things.”

People’s needs were assessed and reviewed regularly. Assessments took account of people’s cultural and social needs in addition to their physical needs. This enabled staff to provide care and support which was tailored to each individual person and fully respected their individual needs and preferences.

People were supported by staff who were very kind and compassionate and people thought staff often went over and above their job roles to ensure their comfort and well-being. One person said, “The staff here are marvellous. They make the place.” During the inspection we heard numerous examples of how staff had gone the extra mile to make sure people had positive experiences.

Throughout the inspection we observed kind and caring interactions and saw staff spent time socialising with people as well as helping them with physical care needs. The provider informed us they had increased staffing levels to enable staff to spend more time with people. This resulted in a happy environment where people were engaged and alert. One member of staff said, “I think of the people here as family and so that’s how I treat people.” One person showed they felt the same by saying, “Staff treat you like family.”

People were involved in decisions about the care and support they received as well as the running of the home. People’s care was always discussed with them and their views were sought through one to one sessions and resident’s meetings.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People’s consent was sought on an on-going basis and staff helped people to make decisions, or ensured decisions were made in the person’s best interests, if they were not able to make a choice.

There was a varied activity programme which took account of people’s abilities and interests. There were group activities but staff knew people well and also made sure people had opportunities to follow their own interests and hobbies. The staffing levels in the home made sure people had on-going opportunities for social stimulation if they wished it.

The provider

This inspection was unannounced and took place on 26 April 2016.

St Georges Care Home is registered to provide care and accommodation to up to 20 people. The home specialises in the care of older people. At the time of the inspection there were 17 people at the home.

The last comprehensive inspection of the home was carried out in December 2014. At that inspection we found improvements were needed to make sure accurate records were maintained. We issued a requirement notice which we followed up in May 2015. We found the provider had taken the necessary action to meet the requirement notice.

There is 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 2008 and associated Regulations about how the service is run.

The registered manager had had put quality assurance systems in place to enable them to monitor the quality of care, maintain people’s safety and plan ongoing improvements.

People were complimentary about the home and the staff who supported them. One person said “I can’t recommend it highly enough. I am extremely happy here.” Another person told us “It’s as good as you would find anywhere. I am comfortable and they look after us all very well.”

There were sufficient numbers of staff to keep people safe. People were complimentary about the staff who supported them. They thought they were kind and well trained. Staff felt well supported and there was high staff morale which made it a happy place for people to live.

There was a robust recruitment procedure which minimised the risks of abuse to people. People felt safe at the home and staff knew how to report any concerns or allegations of abuse.

People received personalised care which enabled them to carry on with their own routines and to make choices about all aspects of their day to day lives. One person told us “I can live my own life here.” Another person said “I carry on with my own routines.”

Care was planned and delivered in a way that met people’s needs and respected their wishes. Staff monitored people’s health and well-being and made changes to the care provided in line with people’s changing needs. People had access to health care professionals according to their individual needs.

People were happy with the food served at the home and were able to choose where they ate their meals. Where people required assistance or encouragement to eat this was provided in a friendly and dignified way.

People’s privacy was respected and people told us staff were kind and gentle when they supported them with personal care. People valued the fact that staff respected their abilities and supported them to maintain their independence where possible.

There were a number of ways for people to share their views and make suggestions. The registered manager and provider were very much part of everyday life at the home and people told us they were very easy to talk to. There were regular meetings where people could make suggestions and discuss issues.

We carried out an unannounced comprehensive inspection of this service on 3 December 2014. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the Health and Social Care Act 2008 (regulated Activities) Regulations 2010. Regulation 20 –Records.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for St Georges Care Home on our website at www.cqc.org.uk

This inspection was unannounced and took place on 19 May 2015.

St Georges Care Home provides accommodation and personal care for up to 20 older people. It is located in a quiet residential area of Taunton. At the time of the inspection there were 15 people using the service.

There is 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 2008 and associated Regulations about how the service is run.

At the last inspection we found care plans and risk assessments were not up to date and did not accurately reflect people’s needs. At this inspection we found a new care plan system had been put in place. New care plans gave clear information about people’s preferences and their abilities as well as their assessed needs. This meant staff had the information they needed to provide appropriate care and support.

Risk assessments were up to date and gave information about how risks to people’s wellbeing would be minimised. For example where someone had been assessed as being at risk of falls there was a plan in place which set out the equipment and number of staff required to minimise the risk.

We could not improve the rating for the service from requires improvement because to do so requires consistent good practice over time. We will check this during our next planned Comprehensive inspection.

This inspection took place on 3 December 2014 and was unannounced. At the last inspection of the home in October 2013 no concerns were identified.

St Georges Care Home provides accommodation and personal care to up to 20 older people. It is located in a quiet residential area of Taunton. At the time of the inspection there were 16 people using the service. This included one person who was having a short respite stay.

The manager had been in post since July 2014 and had applied to the Care Quality Commission to be registered. 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.

We found improvements were needed to ensure records were reviewed and up dated to make sure staff had adequate information about people’s care needs. During the visit we found risk assessments, including manual handling assessments, were not up to date and could potentially place people at risk of receiving inappropriate care.

We also found improvements were needed to make sure the quality monitoring systems in place were fully effective in identifying and addressing shortfalls in practice which could affect the well-being of people.

People described the new management team as very approachable. The manager had a clear vision for the home which had been communicated with, and adopted by, staff.

People told us they felt well cared for and their needs were met by staff who were competent in their roles. Comments included “Staff are all very good and certainly know what they are doing” and “The staff are excellent. They help when you need help and let you be independent too.”

The risks of abuse to people were minimised because all staff were thoroughly checked before they began work. Checks included written references from previous employers and checks to ensure staff were safe to work with vulnerable adults. Staff were aware of what may constitute abuse and how to report it. All were confident that the current management would fully investigate any concerns and take action to make sure people were safe.

People said they continued to make decisions about their day to day lives. People were able to make choices about what time they got up, when they went to bed and how they spent their day.

We were told there were no strict routines in the home and people were free to follow their own life style choices. One person told us “They go along with your routines. You can still live your life the way you want to.” Another person said “I don’t regret moving here. I do as I please but I feel safe.”

People received meals in line with their needs and preferences. People were happy with the food provided and many praised the chef. Minutes of resident’s meeting showed that food and menus were always discussed and people were able to make suggestions about meals they would like to see on the menu. The menu offered a good variety of food and catered for specialist diets and preferences.

People received support with medicines from staff who had appropriate training to carry out the task safely. One person said “I prefer the staff to do my tablets. They do them properly and I get them at the right time every day.”

People had opportunities to express their views through resident’s meetings and one to one conversations with staff. Some suggestions made at meetings had been acted upon and resulted in changes in the home.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

This small residential home was able to provide individualised care for people to meet their needs and wishes. We spoke with six people in their rooms and met with other people in the dining room and sitting room.

There had recently been some management changes at the home. We met the new manager who had been in post for three months and the deputy manager who had been appointed from within the staff team.

People living in the home praised the staff. They told us they were kind, patient and always willing to help. They were able to talk to staff and knew someone in the home who would listen to any concerns they had.

People were able to express their views and were involved in making decisions about their care and treatment. They told us they were able to make choices about their day to day lives. One person told us "It is fine here. They are very nice people. Very kind and gentle. I am able to do as I please. I like reading. I have a lot of books. I do go out occasionally. We have a bus and we can go on trips. It is really very good.”