We carried out a review of the data available to us about The Priory Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Priory Care Home, you can give feedback on this service.
People’s experience of using this service:
People were positive about how the home was managed. The registered manager had driven through improvements in the environment and checks on the care provided, with support from the provider. The registered manager understood their responsibilities and acted to inform CQC of important events at the home. People benefited from living in a home where they and staff felt listened to.
Staff had further enhanced how people’s rights to privacy was promoted and people were treated with dignity and respect. People enjoyed their life at the home and had developed strong bonds with the staff who supported them.
Staff understood the risk to people’s safety and acted to reduce these. There were enough staff to care for people and staff promptly supported people when they wanted assistance. Staff supported people to have their medicines safely and checks were undertaken to ensure these were administered as prescribed.
People told us staff knew how to look after them and staff assisted people to achieve the best health and well-being possible, including when people were at the end of their lives. People were supported to have enough to eat and drink so they enjoyed the best health possible. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this.
People were consulted when people’s care was assessed, planned and reviewed, so people’s needs continued to be met. People had opportunities to do things which they enjoyed, and their communication needs were considered when their care was planned.
Rating at last inspection and update: The last rating for this service was requires improvement (published 4 August 2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations
Why we inspected: This was a planned inspection based on the rating at the last inspection.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
The Priory Care Home is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Priory Care Home is registered to provide accommodation for up to 30 people, including older people and people living with dementia. On the day of our inspection 28 people were living at the home. People have access to communal areas within the home and access to the home's gardens.
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. A registered manager was in post and supported the inspection process over the two days of the inspection.
At our last inspection on 01 December 2015, we gave the service an overall rating of Good. At this inspection, we have rated the key questions Safety, Caring and Well-led as Requires Improvement which has meant the overall rating has changed to Requires Improvement.
The provider had not fulfilled their regulatory responsibilities in submitting notifications about people’s deaths to us. This meant they were in breach of Regulation 16 of registration Regulations.
There were aspects of the provider’s and registered manager’s quality checking arrangements which were not consistently effective in identifying practices which required improving to show continual development of the service.
We found staff did not always promote or maintain people's dignity. People’s personal information was not consistently stored and or when staff were working on care documents they were left in communal areas so unauthorised people could potentially access these thus not maintaining people’s confidentiality.
People benefitted from being supported by kind and caring staff who assisted people to be as independent as possible and involved in their care.
People's individual risk assessments were reviewed and updated to take account of changes in their needs. Staff knew how to recognise and report any concerns to keep people safe from harm. People’s medicines we made available as prescribed and were supported to take these by staff who had the knowledge to do this in a safe manner. The registered manager had identified shortfalls in safe medicine storage for people's prescribed creams and had taken action to remedy the situation.
People were supported by staff who knew how to reduce the risk of infections and people were complimentary about how clean the home environment was and from any unpleasant odours. The registered manager took immediate action to remove a shower chair and ensured slings were for personal to each person to further assist in the prevention of cross infections.
There was evidence of organisational learning from significant incidents and events. Formal complaints were rare and any informal concerns were handled effectively with learning taken to continually improve care.
Staff worked well together in a mutually supportive way and communicated effectively. Training and one to one support systems were in place to provide staff with the knowledge and skills they required to meet people's needs effectively. There were sufficient staff to meet people's care and support needs without rushing.
People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice
People were provided with food and drink of good quality which they enjoyed and met their individual needs and preferences. Staff worked closely with local social and healthcare services to ensure people had access to any specialist support they required. The environment and facilities in the home were being refurbished and redecorated to reflect people’s requirements. People liked their own rooms and they furnished these with personal items so it felt homely.
People were provided responsive care and support which met their individual needs. There was a planned programme of things for people to do for fun and interest. Staff spent time with people on a spontaneous basis chatting about their families and lives. Staff knew people really well and had built up trusting relationships. Staff provided end of life care in a sensitive and personalised way.
The registered manager was well known to, and respected by, everyone connected to the home. They were supported by the provider who ran the home as a family concern which people appreciated.
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.
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.
Further information is in the detailed findings below.
The provider of The Priory Care Home is registered to provide accommodation and personal care for up to 30 people. At the time of this inspection 29 people lived at the home.
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.
Staff obtained people’s consent before providing them with support by asking for permission and waiting for a response, before assisting them. People’s liberty was not restricted and the registered manager had followed the legal requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) where people’s safety needed this.
People told us they felt safe living at the home. People were kept safe because the registered manager and staff understood their responsibilities to identify and report potential harm and abuse. The registered manager consistently reviewed accidents and incidents to reduce the possibility of people being harmed. Risks to people’s health and wellbeing were known by staff and well managed. The registered manager and staff maintained close links with external health care professionals to promote people’s health.
People and staff said there were sufficient numbers of staff available to meet people’s needs. The registered manager kept staffing levels under review alongside people’s individual needs to reduce risks to people’s wellbeing. The registered manager made all the appropriate checks on new staff’s suitability to work at the home. People’s medicines were managed, stored and administered by staff who had received the training to promote safe practices.
Staff understood people’s needs and abilities because they read care plans and received an induction where they shadowed experienced staff until they knew people well. Staff received training and support to develop their skills and knowledge. Staff had opportunities to reflect on their practice and learn from other staff so that people’s needs were effectively met and promoted.
People were offered meals which were suitable for their individual nutritional needs and met their preferences to keep people healthy and well. People told us the meals were good and were supported to eat and drink enough by staff who understood the importance of assisting people to maintain a balanced diet.
People were cared for by staff who knew them well and who they described as kind and caring. Staff knew about people’s individual preferences for care. Staff respected people’s dignity and privacy and responded to people’s likes and dislikes to support people in following their own interests. Staff made sure people obtained advice and support for health professionals to maintain and improve their health or when their needs changed.
People knew how to raise any concerns and who they should report any concerns to. The registered manager responded to people’s complaints and took action to improve the service as a result of complaints.
The registered manager was aware of their responsibilities and had developed systems to monitor the quality of the service people received. There was evidence of learning from incidents and investigations took place and changes were put in place to improve the service people received. The registered manager was continually looking at how they could provide better care for people. In doing so they valued people’s views about the services provided and used these to drive through improvements and further develop services people received.
People we spoke with were complimentary about the care and support that they received. People told us, 'I really enjoy it here, the carers are wonderful' and 'The staff are brilliant, very caring'.
We found that proper steps had been taken to ensure that individualised care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.
Staff had been recruited in an appropriate way and checks had been undertaken that ensured they were suitable to care for vulnerable people.
We found that any comments and complaints people made had been responded to appropriately and ensured that people were listened to.
Following that inspection, we issued compliance actions to ensure that the provider took action to comply with the regulations in order to protect the health, safety and welfare of people who used the service.
We received an action plan from the provider detailing the actions they were going to take and when they planned to achieve compliance.
On 11 October 2012 we carried out an inspection at The Priory Care Home to see if the provider had complied with the compliance actions.
During this inspection we spoke with the manager, the deputy manager and two other members of staff.
We found that action had taken place with regard to improvements to the management of medication and supporting staff and that the provider was compliant.
While at The Priory we observed people's care and support to help us understand the experiences of people living at the service. We spent time talking with several people in the lounge, the dining room and in some people's own bedrooms.
We saw that members of staff helped people to walk as well as encouraged people with meals. There was a friendly and relaxed atmosphere within the service.
Staff were seen to courteous and respectful. Staff knew people living at the home well as they were able to tell us details about their likes and dislikes. One person told us that staff are 'always there for us' and that they were 'willing to help'.
At the time of our visit the service had recently introduced new care plans and risk assessments. The care plans covered a range of areas of potential need such as mobilisation, diet, elimination, oral health and well being as well as other personal care tasks. We saw evidence of monthly reviews involving the person's key worker. One person living at the service confirmed that staff had shared the contents of her care plan with her.
We spoke with care staff on duty and they had a good understanding of their responsibilities to report actual or potential abuse within the service.
We found medicines were being stored securely. There was no system in place to monitor the temperature of the room where medicines were stored to ensure that were kept in line with manufactures instructions for the safe keeping of items. The medication trolley was clean and well organised which made items easy to find.
We carried out some audits to ensure that the number of tables remaining balanced with the records maintained. On the majority of occasions we were able to balance the number of tablets or other medicines remaining against the records. This was not however always the case. The records did not show the carry forward amount for each item although the homes internal audit did assist in some incidents.
We looked at the information which was available regarding moving and handling. The home had had two members of staff able to train care staff however their own certificates ran out at the end of April 2011 therefore almost one year prior to our visit. The manager informed us that staff should receive an up date in moving and handling on an annual basis. The records seen showed that one member of staff last received training in September 2007. A further two members of staff received training during September 2009 and another one during April 2010.
An undertaking was given to us that training would be arranged and that a full audit of training would be undertaken to see whether any other shortfalls in core training requirements could be identified.
We were informed that satisfaction surveys were recently sent out to people's relatives. These had not been collated at the time of our visit. The feedback within those we saw was generally positive. Some concerns were apparent regarding the laundry however the service was already aware of these issues and working to resolve them.
We observed some interactions between staff members and people living at The Priory. Staff were seen to be respectful and kind. One person told us that staff 'always look after me'. Other people were equally complementary about members of staff.
We saw evidence that the home requests support from medical professionals as needed in order to met people's health care needs.
Care plans were in place however the ones available to care workers were not always the most up to date version and therefore potentially contained different information. Other records completed by care workers contained gaps and did not always evidence that personal care needs were carried out.
Staff had received in-house training to ensure they had knowledge about their responsibilities regarding safeguarding people against abuse. Recruitment procedures were carried out to check staff suitability to work with vulnerable people.
We found that there is a risk that people do not receive medication as prescribed, because the home was not ensuring that records were accurate and that staff completed them fully.
Systems to ensure that the home was providing a safe service were not effective.