St Thomas' Priory

Updated 14 July 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by 4 inspectors and 1 Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Hawksyard Priory Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Hawksyard Priory Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider did not complete the required Provider Information Return (PIR). This is information providers are required to send us annually with key information about the service, what it does well and improvements they plan to make. Please see the well-led of this report to see further details about this. We sought feedback from partner agencies, such as the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all this information to plan our inspection.

During the inspection

We spoke with 9 people who used the service. We also spoke with 4 relatives of those who used the service. We spoke with 12 staff, including care assistants, senior carers, nurses, domestic staff, estates manager, the deputy manager, and the registered manager.

We looked at 6 people’s care records, including care plans, risk assessments plus some medicine records. We made observations in communal areas to see how staff interacted with people. We also looked at policies, procedures and building safety records. We continued to seek clarification from the deputy manager and registered manager after the site visits.

Updated 14 July 2023

About the service

Hawksyard Priory Nursing Home is a care home providing personal and nursing care to up to 106 people over three different floors. There was access to a church and gardens at the home. The home provides support to younger adults, older people and people with dementia, mental health needs and those with a physical disability. At the time of our inspection there were 29 people using the service.

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

There were numerous issues identified throughout this inspection which had not been identified. Staff were not always recruited safely. The risk of contractors working unaccompanied on site had not been considered. Some improvements had been made to medicines management, but we found further improvements were needed. Risks to people were not always assessed and risks were not always mitigated.

Checks had been made on the safety of the building. However, timely action had not always been taken to rectify issues. Despite this, people felt safe and other safeguarding referrals had been reported. Lessons were not always learned when things went wrong. The building needed refurbishment, but the provider was already working on this. People told us they felt well treated, but we observed instances when they were not always treated with respect. People were not always supported enough to partake in enough activities of their choice. People were not always fully supported with their communication needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this. However, there was not always clear evidence of involvement from people’s relatives in the decisions to administer medicines covertly.

Staff received training and support to be effective in their role, although some improvements were needed. There were enough staff to support people. People felt safe and liked the staff. Infection control measures were in place to keep people safe. People liked the food and had choices, in line with their needs. People were supported to access other health professionals and had their health needs assessed and monitored, when needed. People were supported to remain independent. People felt staff knew them well and care plans contained people’s preferences.

People and relatives told us they felt able to make a complaint if needed and the registered manager was aware of their responsibility in this area. People’s end of life wishes had been considered. Despite some issues, people, relatives, and staff told us the home had improved since the last inspection. There was positive feedback about the registered manager and deputy manager. There were meetings to engage with those involved with the service.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence, and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

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 requires improvement (published 10 January 2023) and there were breaches of regulation. The provider had a date to be compliant by and completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about staff recruitment. A decision was made for us to inspect and examine those risks. This inspection was also carried out to follow up on action we told the provider to take at the last inspection.

We have found evidence that the provider needs to make improvements. Please see the full report for details.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches in relation to staff recruitment, assessing and managing risks to people, supporting people in a respectful and dignified way and the oversight of the quality and safety of the service.

We have issued the provider with warning notices. We will check the provider is taking action to comply with the legal requirements set out in the warning notices.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.