George Edward Smart Homes

Updated 12 April 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

George Edward Smart Homes is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. George Edward Smart Homes is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 4 people using the service and 9 relatives. We spoke with 8 staff members including the registered manager, a care manager, 4 care staff, a maintenance person, and a domestic staff. We reviewed 4 care plans and 4 staff files. We reviewed processes to manage and administer people’s medicines and looked at records associated with accidents, incidents, risk and quality assurance processes used to check the service.

Updated 12 April 2023

About the service

George Edward Smart Homes is a residential care home providing regulated activity of personal care to up to 60 older people. At the time of our inspection there were 44 people using the service.

People’s experience of using this service and what we found

A range of audits and quality checks were completed. However, there was no clear strategy in place at provider level and no operational plan to ensure systems and process remained established to maintain accurate and complete records of people’s care.

Risk assessments and associated support plans used by staff as a point of reference were not always up to date or completed which put people at risk of otherwise avoidable harm. There was limited use of systems to take a holistic view of people’s needs, to record, manage and report concerns about risks, safety and incidents.

People told us they received their medicines safely. However, medicine audits failed to look holistically at medicines management and administration resulting in areas of incomplete record keeping.

People received support from a range of health professionals when required. However, care plans including risk assessments and support plans were not routinely updated to reflect any required changes for staff to use.

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.

The home was well maintained, clean with access to large outside garden and seating areas. Staff had good access to personal protective equipment to manage the risks associated with the spread of infection including Coronavirus and adhered to government guidance to protect people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People told us they felt safe and were happy with their care. Enough suitably trained staff were employed who were knowledgeable and skilled. Staff received appropriate training and support to carry out their roles.

The manager was aware of the improvements required. Observations and feedback confirmed the failings we found had a low impact on people at the time of the inspection, but people were at risk if the required improvements were not quickly implemented.

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 3 January 2019).

Why we inspected

We received concerns in relation to the management of the home, provider oversight, management of risks and staffing. As a result, we undertook a focused inspection to review the key questions of safe and well led only. 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.

We have found evidence the provider needs to make improvements. Please see the safe and well led sections of this full report.

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 George Edward Smart Homes on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to the management of the service and provider oversight (including risk management and governance checks).

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.