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Priory Rookery Hove Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 4 April 2019

This inspection took place on 21 January 2018 and was unannounced.

The provider runs and manages a wide range of services for people, including hospitals, rehabilitation services and longer stay facilities. They generally specialise in providing services to people who have mental health conditions or who are living with a learning disability.

Priory Rookery Hove 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 Priory Rookery Hove provides care and support for up to 13 younger adults living with Asperger’s Syndrome or associated conditions. Priory Rookery Hove is not a home for life, but a transitional facility. During people’s time in the service they will be supported where possible to able be to access a combination of educational, social development, life skills, work experience and therapeutic care. The aim is to further develop their life skills to gain independence and integration into their community. There were 11 people living in the service at the time of our inspection.

Priory Rookery Hove had been designed, developed and registered before ‘Registering the Right Support’ and other best practice guidance was published. Had the provider applied to register Priory Rookery Hove today, the application would be unlikely to be granted. The model and scale of care provided is not in keeping with the cultural and professional changes to how services for people with a learning disability and/or Autism should be operated to meet their needs. Improvements are needed to ensure the service develops in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service had 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. There was a clear management structure with identified leadership roles. The registered manager was supported by a deputy manager, and two senior care staff. However, the registered manager was not present for the inspection, and we were told they are due to leave the service. A new manager has been recruited and had started working in the service the previous week. They were present for the inspection.

At our last inspection on 24 January 2017 we rated the service Good overall but Requires Improvement in Effective. Where new staff were completing Care Certificate modules, they did not appear to have deadlines for completing these to ensure they were completed in a timely manner. At this inspection we found this had been addressed. Not all care staff had completed training to provide specific care and support needs for people using the service in relation to managing challenging behaviours. Some staff felt they hadn’t received enough support and guidance in the management of such incidents. At this inspection we found not all these issues had been fully addressed and further areas were in need of improvement. The overall rating of Good for the service had not been maintained.

Prior to this at our inspection on 15 December 2015 the service was rated overall as Requires Improvement, and at our inspection on 16 April 2015 the service was rated overall as Inadequate. The provider had not ensured through the management of the service the maintenance of the required standards and continuous improvement to ensure the service had maintained the overall rating of Good.

At this inspection we rec

Inspection areas

Safe

Requires improvement

Updated 4 April 2019

The service was not consistently safe.

People were protected from the risk of abuse as staff understood the signs of abuse and how to report concerns. However, staff spoke of lack of support and training to work with people who have challenging behaviours.

Some repairs and renovations had not been actioned in a timely way which had impacted on people's quality of life.

Medicines were managed safely.

Robust recruitment procedures had been followed. People were supported by sufficient numbers of staff to meet their needs.

Effective

Requires improvement

Updated 4 April 2019

The service was not consistently effective.

Staff had a good understanding of peoples care and support needs. Staff told us although they had undertaken the necessary training they did not feel this had always provided them with the necessary skills and knowledge to meet people’s individual care and support needs.

Staff were aware of their responsibilities from the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS.) Care staff had a good understanding of consent.

People were supported to make decisions about what they wanted to eat and drink and to stay healthy. They had access to health care professionals when they needed them.

Caring

Good

Updated 4 April 2019

The service was caring.

Staff involved and treated people with compassion, kindness, dignity and respect.

People were treated as individuals. People were asked regularly about their individual preferences and checks were carried out to make sure they were receiving the care and support they needed.

Responsive

Requires improvement

Updated 4 April 2019

The service was not consistently responsive.

The system in place to manage complaints and comments had not always ensured a timely response to concerns raised.

Care plans had been reviewed. Staff had information that enabled them to provide support in line with people’s wishes, including the best way to communicate with people.

People could participate in activities which reflected their interests.

Well-led

Requires improvement

Updated 4 April 2019

The service was not consistently well-led.

Staff told us the management and leadership of the service had not always been visible and supportive.

We identified a number of areas on this inspection that told us the provider’s policies and procedure had not always fully been maintained.

Quality assurance audits had been completed to review the care and support provided.