Georgina House

We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

We identified 3 breaches of the legal regulations concerning safe care and treatment, governance, and person-centred care.

The provider was previously in breach of the legal regulations in relation to governance and person-centred care. Improvements were not found at this assessment, and the provider remained in breach of these regulations.

At our last inspection, the provider was in breach of legal regulation regarding the safety of the premises and equipment. However, some improvements were found at this assessment, and the provider was no longer in breach of this regulation.

There was no oversight of incidents, accidents, and safeguarding concerns. Incident reports to inform learning and reduce risks were not always completed, and staff handover records were not always completed.

We identified that people’s care records did not always contain clear information to ensure staff understood how to provide safe and effective care. For example, one person's cognition care plan and choking risk assessment were missing. Medicine records did not always contain clear and robust information, indicating an increased risk of people not receiving their prescribed medicines safely. Medicine competency checks were not always completed in a timely manner.

Staff had not always received the training they needed to develop the skills required to effectively meet the needs of people living at the home.

The environment and infection control practices were not always safe. For example, a significant gap was above a bedroom fire door, between the door and surround, and window restrictors were missing from the first-floor windows. We found severe dampness relating to poor ventilation in one of the en-suite bathrooms and a damaged chair in a person’s bedroom, which posed an infection control risk. Infection control records were not always completed.

Governance and audit systems had not identified the issues we found during this assessment. There was a lack of oversight, monitoring, and action. For example, there was no formal process to monitor the quality of care provided, including care records and daily notes. Audits of health and safety had not prompted the provider to take responsive action, for example, when furniture was broken and required replacement. Improvement was needed in staff recruitment practices. There was no service improvement plan in place.

There were not always enough staff to enable people to do the activities they wanted to do, which would enhance their quality of life. People’s care was not always personalised to reflect their needs and preferences, and people regularly participated in the same activities. This is contrary to the principles of the 'Right support, right care, right culture’ model of care. The whole environment was not person-centred.

However, staff were caring and promoted people’s privacy and dignity. They understood how to keep people safe and how to report concerns. Staff assessed people’s communication needs. When the service identified changes to people’s health and care needs, they worked with external health professionals and sought medical advice appropriately.

Staff supported people in their best interests, needs, and preferences.

The provider acted promptly and addressed all environmental safety concerns during our assessment.

In instances where CQC has begun a process of regulatory action, we may publish this information on our website after any representations and/or appeals have been concluded, if the action has been taken forward.

We have asked the provider for an action plan in response to the concerns found at this assessment regarding person-centred care.