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Preston Private Requires improvement

All reports

Inspection report

Date of Inspection: 30 June 2014
Date of Publication: 9 August 2014
Inspection Report published 09 August 2014 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Not met this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 30 June 2014, observed how people were being cared for and talked with people who use the service. We talked with carers and / or family members, talked with staff, talked with commissioners of services and were accompanied by a specialist advisor.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We were supported on this inspection by an expert-by-experience. This is a person who has personal experience of using or caring for someone who uses this type of care service.

Our judgement

People did not always experience care, treatment and support that met their needs and protected their rights.

Reasons for our judgement

We spoke with a range of people about the home. They included the registered manager, the operations director, 7 staff members, 17 people who lived at the home and 13 visiting family members. We also asked for the views of external agencies in order to gain a balanced overview of what people experienced living at Preston Private.

Majority of the people we spoke with during our visit were happy with the service and care they received. People told us they had a good relationship with the staff, who they described as “caring, supportive, patient and considerate.” One person told us “The staff here are excellent. Overall I’m very happy here.” Another person told us, “The staff do a darn good job.”

A family member we spoke with, told us, “I can’t praise the staff highly enough. They are absolutely brilliant. They know Mum to a tee.” Another family member singled out a member of staff for special praise as they had helped their relative settle in to the home after their recent admission. The family member explained the staff member had shown real compassion. This was in understanding the difficult situation from which their relative had been admitted to the home.

However there was mixed feedback from family members. One family member we spoke with had concerns about their relatives clothing being soiled after meals. Another family said they had found their relative in urine soaked clothing in the past. On the day of the visit we saw the person was clean and well dressed with no obvious signs of discomfort. We did speak with the registered manager and operations director at the end of visit about the mixed comments we had received, to ensure actions were taken to deliver consistency in the care people received.

During our visit we were informed by family members there had been two incidents where people had rolled from their beds after bed wedges had been removed. They told us the bed wedges acted as protection to stop the person from falling out of bed. During our observations we saw in some of the bedrooms the bed height was lowered. A soft protective mat had been placed on the floor next to the bed. We also noted one person’s bed had protective rails.

The registered manager informed us the removal of bed wedges and the introduction of a lower bed height and protective mat had been recently been introduced. This was seen as best practice by the provider. They told us as a result of these two incidents, risk assessments had been carried out. Also bedrails had been placed on people’s beds where there continued to be a risk of injury. The home had acted appropriately in responding to incidents. However they had not considered the impact on people’s safety from the introduction of a new practice within the home. Individual risk assessments had not been carried out for each person before the bed wedges were removed.

During our inspection we used a method called Short Observational Framework for Inspection (SOFI) in each of the four units. This involved observing staff interactions with the people in their care. SOFI helps us assess and understand whether people who use services are receiving good quality care which meets their individual needs.

We noted some very good practice where staff were attentive and dealt with requests without delay. We observed one person appeared upset. A staff member went and sat with them smiling, speaking to them in a reassuring and calming manner. This interaction calmed the person and they responded by smiling back. We saw another person was agitated and their behaviour became challenging to other people in the lounge area. A member of staff demonstrated patience and understanding of the person’s condition to diffuse the situation safely in a caring and compassionate way.

However our observations of staff interaction were mixed. During time spent in one unit for a half hour period before lunchtime, we saw there were three people sat at a table in the lounge/dining area of the unit. The three