13 September 2021
During an inspection looking at part of the service
Hawksyard Priory Nursing Home is a nursing home providing personal and nursing care to 73 people aged 65 and over and younger adults at the time of the inspection, some of whom were living with dementia. The service can support up to 106 people across three floors.
People’s experience of using this service and what we found
At our previous inspection we found information was not always available for staff to support people who required support with their behaviours. At this inspection we found the provider had not taken enough action to address this. Risk management systems were not in place to reduce the risk of skin damage. People’s right to privacy and dignity was not always respected by staff.
At our previous inspection we found audits did not identify improvements required. At this inspection we found action had not always been taken to ensure the effectiveness of quality audits.
Systems and practices in place did not follow best practice with regards to infection prevention and control to reduce or mitigate the risk of avoidable infections.
Although some staff had not completed safeguarding training, they knew how to safeguard people from the risk of potential abuse. Not all staff had been provided with relevant training to meet people’s needs safely. People had a lack of meal choices.
People did not always receive care in line with their care plans, even though they had been involved in their care planning. Plans were not always reflective of their current needs. People’s care was not always delivered in line with their choice or preference. People had limited activities and stimulation at the home.
During the inspection we did not see evidence of consistent use and recording of Best Interest decision making to show people had been supported in their best interests. Following the inspection, the provider sent us information to show how external professional had been consulted where decisions had been made on people’s behalf.
Improvements were made since our previous inspection to the management of medicines. Medicine stock levels now matched people’s medicine administration records.
People were cared for by staff who had been recruited safely. Systems were in place to record and monitor accidents and incidents and showed action taken to reduce them.
The environment was suitable to meet people’s needs. The provider worked with other health and social care professionals to meet people’s needs. People’s communication needs were assessed. Complaints were listened to and acted on. People’s end of life care wishes was documented in their care plan and included specialist input.
Staff were supported to be open and honest when things went wrong. The provider engaged and involved people using the service, their relatives and staff to make improvements to the home. The provider also worked with external agencies.
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 26 February 2021) where there was a breach of regulation 17. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement or inadequate for the last eight consecutive inspections.
Why we inspected
The inspection was prompted in part due to concerns received about infection control, safeguarding, pressure care and incidents. A decision was made for us to inspect and examine those risks.
We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.
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 enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to good governance, safe care and dignity and respect at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will also meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.