The inspection took place on 12 September 2017 and the visit was unannounced.

George Hythe House is a care service providing accommodation and support for up to 44 people aged 55 years or over with a range of physical and/or mental health needs including dementia. At the time of our inspection there were 39 people who lived at the home.

Accommodation is on two floors with a passenger lift for access. All bedrooms are en-suite and there is one double room. The service is divided into four ‘houses’, each with its own dining room. There is a large communal lounge on the ground floor, a second lounge on the first floor, and secluded gardens to the rear of the service.

At the last inspection on 21 April 2015 the service was rated Good.

At this inspection we found the service remained Good.

At the last inspection we asked the provider to take action as some moving and handling practice was not considered to be safe. At this inspection we found people were safe and moved around the service independently and assisted safely by staff.

People and their relatives felt staff were kind and caring. People felt their privacy and dignity was respected in the delivery of care and their choice of lifestyle. Relatives that commented were complimentary about the staff and the care offered to their relatives. People were aware of their care plans and they were involved in care plan reviews. Staff offered people everyday choices and respected their decisions. People had their care and support needs assessed and were involved in the development of their care plan. Staff had access to people’s care plans and received regular updates about people’s care needs. Care plans included changes to peoples care and treatment, and people attended routine health checks.

People were provided with a choice of meals that matched their dietary needs. Staff ensured people were able to maintain contact with their family and friends and visitors were welcome without undue restrictions. There were sufficient person centred activities provided on a regular basis. People and their relatives felt they could raise any issues with the registered manager or staff.

Staff were subject to a thorough recruitment procedure that ensured staff were qualified and suitable to work at the service. All the staff received a training induction and then on-going training for their specific job role. Staff were informed and were able to explain how they kept people safe from abuse. Staff were aware of whistleblowing and what assistance was available from external bodies to report suspected abuse on to, and follow up alleged incidents. Staff were available in adequate numbers to meet people’s personal care needs.

Staff told us they had access to information about people’s care and support needs and what was important to people. People, their relatives and staff felt they could make comments or raise concerns with the management team about the way the service was run and were confident these would be acted on.

There was a clear supportive management structure within the service, which meant the staff were aware of who to contact out of hours. The provider undertook quality monitoring in the service and was supported by the registered manager and staff. Staff were aware of the reporting procedure for faults and repairs and had access to maintenance services and manage any emergency repairs.

The provider had developed opportunities for people to express their views about the service. These included the views and suggestions from people using the service, their relatives and health and social care professionals. We received positive feedback from the local authority with regard to the care and service offered to people.

We carried out an unannounced comprehensive inspection of this service on 21 April 2015. A breach of legal requirements was found. This was because the provider had not ensured the people using the service were protected from the risk of unsafe care or treatment.

After the comprehensive inspection the provider wrote to us to say what they would do to meet legal requirements in relation to the breach.

We undertook this focused inspection unannounced on 7 October 2016 to check that the provider had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting ‘all reports’ link for George Hythe House on our website at www.cqc.org.uk

George Hythe House is a registered care home providing accommodation and support for up to 44 people aged 55 years or over with a range of physical and/or mental health needs including dementia. Accommodation is on two floors with a passenger lift for access. At the time of our inspection there were 40 people using the service.

The service has a registered manager. This 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.

The service had a warm and friendly atmosphere and staff were attentive and kind. The main lounge was the centre of activity during our inspection visit as people had congregated there waiting for an entertainer to arrive. In other parts of the service some people had chosen to remain in their rooms or in quieter communal areas. Staff checked them regularly to ensure they were safe and content where they were.

People told us they felt safe at the service and relatives agreed. Staff knew how to safeguard people and protect them from harm. Medicines were safely managed. We observed staff supporting people safely in communal and other areas. They were knowledgeable about people’s needs and any areas where they might be at risk. However people’s records did not always contain appropriate and detailed care plans and risk assessments to ensure staff had the information they needed to provide safe care.

This was an unannounced inspection that took place on 21 April 2015.

George Hythe House is a care home providing accommodation and support for up to 44 people aged 55 years or over with a range of physical and/or mental health needs including dementia. Accommodation is on two floors with a passenger lift for access. All bedrooms are ensuite and there is one double room. The home is divided into four ‘houses’, each with its own dining room. There is a large communal lounge on the ground floor, a second lounge on the first floor, and secluded gardens to the rear of the home.

George Hythe House was registered to a new provider, Nottingham Community Housing Association, in April 2015.

The home has a registered manager. 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.

During our inspection we witnessed an example of unsafe moving and handling technique in one of the lounges. This incident could have resulted in a serious injury to the person. This was a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

However we also saw examples of good practice in the home when staff actively kept people safe.

People using the service and relatives said their thought the home was safe and that people were well-supported and encouraged to be independent. People also had the support of a visiting advocacy service so they could talk with people who were independent of the service if they wanted to raise concerns.

There were enough staff on duty to keep people safe. Relatives and staff said they thought staffing levels had improved and there were now enough staff on duty to support people as well as to socialise with them. We observed that staff had to time to do activities with people and spend time talking with them.

People told us they thought the staff were well-trained and supported people effectively. Some staff training was out of date and in need of improvement. The registered manager was in the process of reviewing and improving staff training when we inspected.

We observed lunch being served and people had a choice of what they wanted to drink and eat. If people needed assistance with their meals staff provided this and encouraged people to take their time. The cook said people were regularly asked for their views about the meals and new items were added to the menu if people said they wanted them.

People told us the staff were caring and we observed this in practice. During our inspection we saw many occasions when staff responded to people in a caring manner, providing them with reassurance, and company. The main lounge was the centre of activity in the home and the atmosphere was homely and friendly. The staff we spoke with said they thought the home would pass the ‘Mum’s test’, which means they’d be happy for their family members to live there.

Staff understood the importance of giving people choice and recognised that every person using the service was unique and liked to be supported in a way that was right for them. Relatives said the staff were caring and gave them to opportunity to be involved in their family member’s care if they wanted to be.

During our inspection we saw many examples of staff responding to people’s needs promptly and efficiently. If people needed food, drink, personal support, or company staff provided this. When we spoke with staff about the people using the service they told us interesting things about them and their lives. This showed they had got to know the people they supported and had built up relationships with them.

During our inspection a visiting entertainer played a keyboard and sang with people. This activity proved to be very popular. Staff went round everybody in the lounge encouraging them to take part and no-one was left out. Most people sang or danced but others seemed to enjoy just watching and clapping at the end of each song. The activity gave every person in the room, staff and the people using the service, a boost and the atmosphere was lively and fun.

People using the service and relatives told us they would have no hesitation in speaking out if they had any concerns. They said they would speak with staff or the registered manager if something was wrong and they were confident that it would be put right.

All the people we spoke with said they thought the home was well-run and the registered manager friendly and approachable. People using the service and relatives also had opportunities to share their views through questionnaires, feedback forms, and in person. A local independent advocacy service visited the home and supported people to speak out if they needed to. This helped to ensure everybody living at the home had the opportunity to have a say in how it was run.

There were arrangements in place to regularly assess and monitor the quality of the service and records showed that improvements had been made as a result of these audits.

You can see what action we told the provider to take at the back of the full version of the report.