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 falls were investigated by the provider and actions taken to minimise the risks of a re-occurrence. Improvements were required in monitoring people whose health conditions posed risks to them and the management and deployment of staff, to ensure safe levels of care were maintained to a standard that supported people’s welfare.