The Inspection took place on 19 September 2016 and was unannounced.

Abbeyfield St George’s House is registered to provide accommodation and personal care without nursing for up to 26 older people. There were 25 people living in the service on the day of our inspection.

There was 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.

People received their care and support in a way that ensured their safety and welfare. Staff had a good knowledge of how to safeguard people and they knew the actions to take to protect them from harm. People were supported to take everyday risks and staff knew the measures required to keep them safe. There were sufficient numbers of staff who had been safely recruited, were well trained and supported to meet people’s assessed needs. People received their medication as prescribed and there were safe systems in place for receiving, administering and disposing of medicines.

Staff had the knowledge and skills to care for people safely and had access to guidance and support to help them in their work. The registered manager and staff had a good understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and had made appropriate applications when needed. People had enough good quality food and drink to meet their individual needs and preferences. People’s healthcare needs were monitored to ensure they remained healthy and staff sought advice and guidance from healthcare professionals when needed.

Staff were kind, caring and compassionate and they knew the people they cared for well. They ensured that people were treated respectfully and that their privacy and dignity was maintained at all times. People expressed their views and opinions and participated in activities of their choosing. People were able to receive their visitors at any time and their families and friends were always made to feel welcome. Where people did not have family members to support them advocacy services were available. An advocate supports a person to have an independent voice and enables them to express their views when they are unable to do so for themselves.

People’s care needs had been fully assessed and their care plans provided staff with the information they needed to meet people’s assessed needs and to care for them safely. People were encouraged and supported to follow their individual hobbies and interests. Complaints had been dealt with effectively and people were confident that their concerns or complaints would be listened to and acted upon.

People had confidence in the registered manager and staff felt supported and valued. There was an effective system in place to assess and monitor the quality of the service and to drive improvements.

We spoke with people who used the service. We spoke with two staff members and the registered manager. We looked at four people's care records. Other records viewed included audits, minutes of meetings, staff training records, health and safety checks, and satisfaction questionnaires. We considered our inspection findings to answer questions we always ask: Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found:

Is the service safe?

When we arrived at the service the staff asked to see our identification. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.

We saw records which showed that the health and safety in the service was regularly checked. This included regular checks on such equipment as well as checks on the environment. This told us people were looked after safely.

We saw that the staff were provided with training in safeguarding vulnerable adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). This meant that staff were provided with the information that they needed to ensure that people were safeguarded.

Is the service effective?

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information about how people's needs were to be met.

Is the service caring?

We saw that people were relaxed in the company of each other and staff. We saw that staff were attentive to people's needs. Staff we spoke with were able to demonstrate they knew people well. We saw staff treated people with dignity and respect.

Is the service responsive?

People who used the service were provided with the opportunity to participate in activities which interested them. People's choices were taken in to account and listened to. This was demonstrated in minutes we saw, which related to meetings with people who used the service. People's care records showed that, where appropriate, support and guidance was sought from health care professionals, including a doctor, optician, chiropodist and district nurse. This told us that the service worked well with other professionals and that people's needs were met.

Is the service well-led

The service had a number of quality assurance measures in place. The manager was proactive in monitoring and looking for ways to improve the service. We saw the quality of the service had been maintained.

We spoke with five people using the service and four staff. People told us they felt safe living at Abbeyfield-St George’s House and that the care was good. People told us the service was clean and they felt comfortable to raise any complaints or queries they had. Comments included, “You just can’t fault them [staff].” “They [staff] are very helpful.” “People here are very kind.” “They are very caring and friendly whatever their job.”

We found that the provider had systems in place for ensuring the service was well led and systems were effective. For example, there were routine audits for infection control, systems for reviewing care plans, risk assessments and any complaints. There were effective recruitment and selection processes in place.

We spoke with six people using the service. They told us that the care was good and that staff gave them support. Comments included, “I’m quite happy.” “It’s all very lovely here.” “There’s a lot to be thankful for.” “Staff are good and kind and helpful.” “Staff are excellent.”

We spoke with two relatives. One told us, “The care is excellent.” Another said, “X loves it here.”

People told us that staff gave them choices and involved them in decisions.

We reviewed four people’s care plans and found for three people that they were not always protected from the risks of unsafe or inappropriate care.

People were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

We spoke with five staff who told us they had enough support from senior staff and opportunities to develop their skills and knowledge.

The provider had systems in place to regularly assess and monitor the quality of service that people receive.