George Hythe House

Updated 25 May 2022

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 Care Act 2014.

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 completed by two inspectors.

Service and service type

George Hythe House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the Care Quality Commission. This means the provide alone is legally responsible for how the service is run and for the quality and safety of the care provided. There was an acting manager in place, who was in the process of completing their registration.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Before our inspection, we spoke with the local authority about their experiences of the service. We also reviewed the action plan that the provider sent us on a monthly basis.

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 of this information to plan our inspection.

During the inspection

We spoke with three people who used the service and thee relatives about their experience of the care provided. We spoke with eight members of staff including care staff, chefs and domestic cleaners. We also spoke with the manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included the relevant parts of nine people’s care records and multiple medication records. We looked at two staff files in relation to the safety of recruitment. A variety of records relating to the management of the service, including policies, training records and procedures were reviewed.

After the inspection we continued to seek clarification from the provider to validate evidence found.

Updated 25 May 2022

About the service

George Hythe House is a residential care home that can accommodate up to 43 people across four separate wings, each of which has separate adapted facilities. They are registered to provide personal care to people aged 55 years or over with a range of physical and/or mental health needs including dementia. On the day of our inspection there were 23 people who were living at the service.

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

Care plans provided enough guidance to staff to keep people safe. People received enough food and drink, however we saw one person did not always receive the correct consistency diet.

Staff were not always safely recruited to ensure they were of good character. They had received recent training and had the skills to provide safe care. Lessons had been learnt when things went wrong.

Staff did not always wear personal protective face masks to keep people safe from COVID-19 transmission. However, other infection control procedures were followed. External health and social care professionals had been contacted as needed to help guide effective care.

There were enough staff to support people at the service. We observed some mixed quality of staff interactions. There were some caring staff interactions, other interactions were less caring.

The service had undergone refurbishment since the last inspection. The provider had plans to further improve the physical state of the service. People received activities at the service and the refurbishment allowed people to use more areas of the home than the last inspection.

People were provided with end of life care, and staff were trained to do this. Care plans for end of life care were holistic.

People’s ability to make decisions were not always clearly recorded in required mental capacity assessments. People were suitably referred for deprivation of liberty safeguard referrals when needed

Staff, people and relatives spoke about the improved quality of service. There was no registered manager, but the acting manager was in the process of registering as the manager. We received positive feedback about the quality of their work.

The last inspection report was rated inadequate. The provider had created an action plan and many areas of the service has improved, however governance had not improved: recruitment safety, choking risks and mental capacity assessments. The provider has advised that further changes will be made to make improvements in these areas.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was Inadequate (published 12 January 2022). At this inspection not enough improvement had been made and the provider was still in breach of regulations.

Why we inspected

At the last inspection, we rated the service inadequate. We received positive feedback from the Local Authority that the service had improved. We also received regular action plans from the provider, suggesting that changes had been made. We decided to inspect the service to see what changes had been made.

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.

We have found evidence that the provider needs to make improvements. 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 Hythe House on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment, safe recruitment, consent, and good governance.

Please see the action we have told the provider to take at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The last inspection resulted in the service being in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

At this inspection, the overall rating for this service is now ‘Requires improvement’. We found significant improvements have been made since the last inspection. However, we have identified some ongoing breaches of regulation, which the provider has told us they will take action to resolve.

Due to the improvements made, the service is therefore no longer in 'special measures'. 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.