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Inspection carried out on 18 April 2017

During a routine inspection

The inspection took place on 18 April 2017 and it was unannounced.

Priors House is a purpose built nursing home which provides care over two floors to people including people who are living with dementia and people who have a physical or mental disability. Priors House is registered to provide care for 80 people. At the time of our inspection visit there were 70 people living at the home. On the ground floor, residential and dementia care was provided. People living on the first floor received residential and nursing care.

Priors House was last inspected in May 2016 and was rated as ‘requires improvement’. We returned to check if required improvements had been made to the responsiveness of staff to meet people’s needs and to the governance and management of the home. At this inspection, we found improvements had been made.

There was a registered manager at the home. 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.

People and relatives gave positive comments about the care and support they received. People received care that enabled them to live their lives as they wanted and people were supported to remain as independent as possible. People were encouraged to make their own decisions where possible and care was given in line with their expressed wishes. People were supported to maintain relationships and keep in touch with those people who were important to them.

Care plans were detailed and contained accurate and up to date relevant information for staff to help them provide the individual care people required. People and relatives were involved in making care decisions and reviewing their care to ensure it continued to meet their needs.

Where people were assessed of being at risk, care records included information for staff so risks to people’s health and welfare were minimised. Staff had a good knowledge of people’s needs and abilities which meant they provided safe and effective care. Staff received essential training to meet people’s individual needs, and effectively used their skills, knowledge and experience to support people and develop trusting relationships.

People’s care and support was provided by a trained and caring staff team and there were enough available staff to be responsive to meet their needs. People told us they felt safe living at Priors House and relatives were confident their family members received safe care and treatment. Staff knew how to keep people safe from the risk of abuse. Staff understood what actions they needed to take if they had any concerns for people's wellbeing or safety.

The registered manager and care staff understood their responsibilities in relation to the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). Where people lacked capacity, staff’s knowledge and people’s records ensured people received consistent support when they were involved in making complex decisions, such as decisions around their personal safety or where they wanted to live. People said staff gained people’s consent before they provided care and supported people to retain as much independence as possible.

People were supported to pursue various hobbies and leisure activities and people had a variety of activities to interest them. The registered manager wanted to further develop the activities programme to ensure people’s stimulus was maintained.

People had meals and drinks that met their individual requirements. People received support from staff when they required it, and anyone at risk of malnutrition or dehydration, were monitored.

People knew how to raise concerns or complaints if they needed to. Information in the home advised them how to raise complaints and expected timesc

Inspection carried out on 23 May 2016

During a routine inspection

This inspection took place on 23 May 2016 and was unannounced.

Priors House is a nursing home which provides care to older people, people living with dementia and young people with physical disabilities. Priors House is registered to provide nursing care for up to 80 people. At the time of our inspection vist there were 66 people living at the home. The home provides care and support across two floors, divided into four suites. The ground floor provides residential care (Jephson suite) and care to people living with dementia (Telford suite). The first floor provides residential care (Victoria suite) and nursing care (Beaufort suite).

There was a registered manager in post. The previous registered manager left the service in January 2016 and the new registered manager had been appointed in March 2016. 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.

The service has not previously been inspected so it was it’s first inspection since being registered.

Staff knew how to keep people safe from the risk of abuse. People told us they felt safe living at Priors House and relatives agreed their family members felt safe and protected from abuse or poor practice.

The provider assessed risks to people’s health and welfare and wrote care plans that minimised the identified risks. However, some care records and risk assessments required additional information to make sure staff provided consistent support that met people’s needs.

There were enough staff on duty to meet people’s health needs. The provider relied on agency staff to support existing staff and people sometimes felt on occasions they did not have continuity of care from an established staff team.

People’s medicines were managed, stored and administered safely in line with GP and pharmacist prescription instructions.

People were cared for by kind and compassionate staff, who knew their individual preferences for care and their likes and dislikes. Staff understood people’s needs and abilities and they received updated information at shift handovers to ensure the care they provided, supported people’s needs. Staff received training that was essential to support people’s needs. Staff felt they had the right skills and knowledge to support people safely and effectively.

Nursing and care staff supported and promoted people’s choice and understood their responsibilities to comply with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Records showed consideration had been made if a persons’ liberty may be deprived, as the provider had made applications to the local authority. However, there were inconsistent records for some people who lacked capacity and where they needed encouragement with those decisions to ensure decisions were taken in their best interests.

People were offered meals that were suitable for their individual dietary needs and personal preferences. People were supported to eat and drink according to their needs, which minimised risks of malnutrition. Staff ensured people obtained advice and support from other health professionals to maintain their health.

Care was planned to meet people’s individual needs and abilities and care plans were reviewed although some information required updating to ensure staff had the necessary information to support people as their needs changed. People were supported to pursue their interests and hobbies and live their lives how they wished, and staff supported people to remain as independent as possible.

The quality monitoring system included reviews of people’s care plans and checks on medicines management, but some of those reviews did not identify the issues we found. Accidents, incidents and fal