This inspection took place on 5 and 6 April 2018 and was unannounced. At the last inspection completed on 24 May 2017 we rated the service as requires improvement. At this inspection we found the service had made the required improvements and was good.

St Georges Park is a ‘care home’. 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. St Georges Park accommodates up to 70 people in one adapted building. At the time of the inspection there were 55 people living in the care home.

There was not a registered manager in post at the time of the inspection. The provider had appointed a manager and they planned to make an application to register. 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.

People were protected from abuse and had their risks assessed, identified and managed appropriately. The home and equipment were maintained to minimise the risk of cross infection. People were supported by sufficient safely recruited staff. People received their medicines as prescribed and there were systems in place to learn when things went wrong.

People had their needs assessed and care plans were in place which staff followed to provide consistent care, with access to relevant health professionals as required. Staff had their competency checked and received updates to their training. People had a choice of meals and were supported in an adapted environment. 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 received support from caring staff. People were supported to make choices and retain their independence. People were treated with dignity and respect.

People received personalised care and support from staff that understood their needs. Peoples life history and interests were understood and they had access to activities which were of interest to them. People were supported at the end of their life. People understood how to complain and these were responded to.

People and their relatives had the opportunity to share their feedback. Staff felt supported by the management team and there were systems in place to monitor the quality of the service people received.

This comprehensive inspection took place on 24 May 2017 and was unannounced. St Georges Park is registered to provide residential accommodation for people who require nursing or personal care or the treatment of disease, disorder or injury. They provide care for up to 70 older people with dementia and nursing needs. At the time of the inspection there were 39 people living at the service.

On 6 and 9 February we carried out an unannounced focussed inspection to check on the safety and wellbeing of people living at the service. This was because an unannounced comprehensive inspection of the service on 31 October and 1 November 2016 found there were breaches of legal requirements and the overall rating for the service was 'Inadequate'. This meant the service was placed in 'special measures’; services in special measures are kept under review. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for St Georges Park on our website at www.cqc.org.uk

This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

During this inspection we found the provider had made the required improvements and met the regulations. However there were areas which still required improvement, for example quality checks were in place and had identified areas for improvement but these had not been fully delivered at the time of the inspection. There were improvements required in peoples experience at meal times, the delivery of person centred care, and the provision of activities required further improvements.

There was not a registered manager in post at the time of our inspection, however the provider had made an appointment to the manager post and there was a plan in place for them to register. 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.

People told us that they felt safe living at the service and we found staff that could recognise any potential signs of abuse and protected people from harm. Staff managed risks to people and the registered manager had effective reporting and monitoring of accidents in place. The provider had recruitment practices, which kept people safe, and there were sufficient staff to meet people’s needs. People received their medicines as prescribed. Medicines were stored appropriately and there were systems in place to monitor people’s medicine administration.

People received support from a staff team who received the training and support they needed to carry out their roles. People were asked for consent to the care they received, where people lacked capacity the principles of the Mental Capacity Act 2005 were followed. People told us they enjoyed the food and drink they received which met their nutritional needs and preferences. People had access to health care and received support to maintain their health.

People received support from a staff team who were kind and caring and helped them understand and make choices about their care and support. People had their privacy and dignity respected and were encouraged to maintain their independence. People were supported to maintain relationships that were important to them.

People received the care and support they needed and however staff did not always demonstrate a good understanding of people’s preferences or personal histories. People and their relatives were involve

We carried out an unannounced comprehensive inspection of this service on 31 October and 1 November 2016. Breaches of legal requirements were found during this inspection. The overall rating for the service was 'Inadequate' and the service was placed in 'special measures'. Services in special measures are kept under review. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for St Georges Park on our website at www.cqc.org.uk

On 6 and 9 February we carried out an unannounced focussed inspection to check on the safety and wellbeing of people living at the service. St George’s Park is registered to provide residential accommodation for people who require nursing or personal care or the treatment of disease, disorder or injury. They provide care for up to 70 older people with dementia and nursing needs. At the time of the inspection there were 44 people living at the service.

A manager was in post at St Georges Park; however they had not registered at the time of the inspection. The provider was planning to register the manager with CQC. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 had made significant improvements and had met the requirements of the law for providing safe care and treatment and having sufficient staff. There were sufficient staff to meet people’s needs and staff were safely recruited. People were supported to manage risks to their safety and were safeguarded from abuse. Staff did not always use the systems in place to ensure people were receiving their medicines as prescribed and there had been some medicine errors, however the provider was working to ensure these issues were addressed.

The provider had made significant improvements to the leadership and management of the home. They had improved staff knowledge of safeguarding procedures and reassessed risks to people’s health and wellbeing. The provider had notified us of significant incidents and events as required by law. The services last inspection rating was on display in the home as required by law.

However further improvements were required to the governance arrangements in order to meet the requirements of the law. Staff did not always recognise where their practice created a risk to peoples safety. Systems in place to check on the quality of care people received were not always used effectively to drive improvements. Staffing levels were not routinely assessed to ensure there continued to be enough staff to meet people’s needs. People’s feedback was not routinely sought.

This inspection took place on 31October 2016 and the 1 November 2016 and was unannounced. This was the first comprehensive ratings inspection following registration of the service under the current provider.

St Georges Park is residential accommodation for people who require nursing or personal care or the treatment of disease, disorder or injury. They provide care for up to 70 older people with dementia and nursing needs. At the time of the inspection there were 60 people living at the service.

The registered manager had resigned from their post in August 2016. 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.

People were not protected from the risk of abuse. Staff did not always identify potential abuse, which meant incidents were not investigated and reported to the local safeguarding authority. People did not always receive their medicines safely. Medicines were not always available to people. Where people were at risk, staff did not understand how to manage the risks to keep people safe. People did not always have their needs met, as there was not enough staff to meet people’s needs.

People received support from staff that did not have the knowledge to support people safely. We found not all staff understood how to provide some aspects of people’s care. People were not always supported in a way that protected them from unlawful restrictions. Principles of the Mental Capacity Act had not been followed when people lacked capacity to make specific decisions. Care was not always provided in a ‘least restrictive’ way. People did not always have their food and fluid intake managed safely. Staff did not always make sure people had enough to eat and drink. Staff did not always seek support for people from health professionals when they needed it.

People did not have meaningful relationships with staff. Although some staff were seen engaging with people positively, in a most staff were too rushed to speak with people and sometimes missed the opportunities for interaction. People were not involved in making decisions about their care and support. Staff did not always treat people with respect and ensure their dignity.

People did not have their needs met in the way they preferred and choices they had made were not met. Staff did not always understand people’s needs and preferences. People had access to group activities, but there was little evidence of people being able to follow their individual interests. Some people did not know how to make a complaint.

People did not always feel they had an understanding of who was leading the service. Staff did not have clear leadership and were unsure who was in charge. The provider had failed to monitor the quality of service provided and to ensure people were protected from risks to their health, safety and well-being. People told us they had meetings to raise concerns; however, it was not always clear what happened as a result. The provider did not always notify us of incidents, which occurred at the service.

During this inspection we identified 8 breaches of the of the Health and Social Care Act 2008. You can see what action we told the provider to take at the back of the full version of the report.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this ti