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Preston Private Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 25 December 2020

About the service

Preston Private is a nursing home providing personal and nursing care to 58 people aged 65 and over at the time of the inspection. The service can support up to 109 people across four units. One of the units specialises in providing care to people living with dementia.

People’s experience of using this service and what we found

People and their relatives told us they felt safe living at the home. However, our observations in two parts of the home showed people could not be assured of their safety because there were times when there were not adequate numbers of staff to supervise them safely. The system for deploying staff did not robustly consider people’s presenting risks and needs. There had been an increase in unwitnessed falls resulting in fractures. Risks to were assessed and in some cases, actions had been taken to reduce the risk however, this was not always consistent.

Staff were recruited safely. Medicines were managed and administered safely. Infection prevention protocols were in place and we were assured by measures in place including measures to reduce the risks associated with COVID-19. Safeguarding procedures were in place to protect people from the risk of abuse, and to educate staff on how to recognise and respond to concerns.

We found on this inspection some inconsistencies in applying audits and quality monitoring tools, such as those that determined staffing levels and those that acted on staff feedback. The provider’s systems and processes for ensuring the deployment of adequate numbers of staff were not robust to effectively monitor, respond to people’s needs and reduce known risks. We received mixed feedback from staff regarding management support and the impact of staffing levels in the home. Staff told us,“People are having to wait longer for help and for their medicines some nights, we have shared this with management we are told there is enough staff.”

The registered manager used a variety of methods to assess and monitor the quality of the service. They worked in partnership with a variety of agencies to ensure people's health and social needs were met.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update:

The last rating for this service was good (published 18 December 2019)

Why we inspected

The inspection was prompted in part due to concerns received about people experiencing falls and sustaining serious injuries and staffing levels in the home. A decision was made for us to inspect and examine those risks.

We undertook a focused inspection to review the key questions of safe and well-led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Preston Private Nursing Home on our website at www.cqc.org.uk

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

Enforcement:

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what

Inspection areas

Safe

Requires improvement

Updated 25 December 2020

The service was not always safe.

Details are in our safe findings below.

Effective

Good

Updated 25 December 2020

Caring

Good

Updated 25 December 2020

Responsive

Good

Updated 25 December 2020

Well-led

Requires improvement

Updated 25 December 2020

The service was not always well-led.

Details are in our well-Led findings below.