Priors House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first inspection for this service under this newly registered provider. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Managers carried out individual and detailed assessments of people to ensure their needs could be met before they moved to Priors House. Assessments ensured staff had the appropriate training to meet each person’s needs and that people were appropriately placed to achieve the best possible outcomes. One relative in providing feedback described the assessment as, “Caring and efficient.” Another relative said, “We discussed what care and support [Name] needed and went through everything and they were very thorough.”

Care plans were developed from the assessments and reflected each person’s needs and wishes. Care records were regularly reviewed to ensure they remained effective and continued to reflect what people needed and wanted.

The provider always planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation. They worked to develop evidence-based good practice and standards.

The provider used NICE (National Institute for Health and Care Excellence) guidelines to ensure their policies and processes were accurate and reflected current evidence-based practice. When policies were updated, these were shared with staff to ensure they worked in accordance with up-to-date guidance and quality standards.

Staff training was refreshed at regular intervals to maintain their knowledge and skills. Specialist training, such as catheter care, wound management, syringe driver management, Percutaneous Endoscopic Gastrostomy (PEG), compression dressing and stoma care was carried out by the provider’s clinical trainer.

Where people had complex medical conditions, training was arranged with specialists in that area. For example, training from the Huntingdon's Disease society was sought for all staff following the admission of a person with that condition into the home. The training ensured staff had a better understanding of the disease and any potential complications or signs of deterioration.

Staff worked with health and social care professionals to ensure they delivered care safely. Care records incorporated professional guidance for staff to follow to ensure people’s care was delivered as directed and in line with evidence-based practice. One visiting health professional told us, “When I feed back any recommendations they write it down and implement it. Recently I recommended using a walking frame opposed to a stand aid and they are doing that.”

People’s nutritional and hydration needs were assessed using a recognised risk assessment tool to identify any concerns around malnutrition. Where a need was identified, people were referred to external health professionals for guidance and support to ensure their hydration and nutritional needs were met. Detailed information was available in the kitchen to show people’s specific dietary requirements and preferences. Staff followed people’s nutritional care plans to ensure guidance was followed and food was modified as required.

People were encouraged to eat and drink well. There were hydration and snack stations in different areas of the home that were kept well stocked and accessible to people without staff support.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff consistently described good teamwork because of effective communication between staff. Comments included: “Teamwork is excellent. I don’t normally work on this suite (unit), so I have been asking staff about different things. They will work with me and support me. Our focus is the residents. Residents come first and we can only achieve the best for them by working as a team” and "I think it (communication) is very positive and always very clear. The staff are really good at communicating and delegating tasks. Everything is well delegated between us, and it is always very clear what we need to do in a very helpful way.”

Care staff were able to access information to understand people's needs through the electronic care planning system. Any changes in people's needs were shared with staff during the handovers between shifts and daily meetings.One staff member told us, “We are constantly updated about our residents in handovers, at meetings and verbally. Whilst you get to know all the residents, the care plans are on the computer, and you can go to them if you’re not quite sure about something and want to double check.”

When healthcare professionals had been contacted to discuss a person’s care, processes were in place to share any advice or guidance within the staff team. Following a visit by a health professional a member of staff told us, “I will now put it on [the electronic system] and in the handover book. It will go on the shift handover sheet and our communication book so any staff coming on shift after me will know what to do and be aware if they have got any concerns."

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff generally supported people to live healthier lives and where possible, reduce their future needs for care and support.

One relative explained the care their family member received supported them to remain well and prevent deterioration. They told us, “[Name] has a history of pressure sores, but they have not had one in Priors House, because staff are really on it. It’s taken a weight off my shoulders because they do what they are supposed to be doing.”

However, whilst people had oral health care plans, we found information recorded by staff in daily records conflicted with our observations and the care plans themselves. The registered manager acknowledged our feedback and assured us they would address this with the staff team.

People were encouraged to participate in regular exercise and spend time outside to improve their mobility and strength and maintain their physical wellbeing.

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

Relatives expressed confidence in how staff monitored people to ensure they received medical support when they needed it, promoting positive outcomes. One relative told us, “We (family) consider [Name] is safe, she has some challenging health conditions, but they are all dealt with very well and the liaison between the home and the family is very good too.” Another relative said, “They notice if something is not right, they pick up on things like that immediately.” A person confirmed, “Medically all the staff here are ‘on’ it, so I have no worries. The liaison with GPs is good here too.”

The GP and frailty practitioner carried out weekly ‘ward rounds’ at the home. Direct access to the frailty team meant deterioration or concerns could be promptly escalated, facilitating referral to appropriate services and preventing unnecessary hospital admissions. A visiting health professional told us staff completed any monitoring as requested which supported their clinical decision making. They said, “They are very good at that. When I do the ward round, they give me the SATs, blood pressure and temperature. If we have concerns about hydration, they will do a fluid chart for the person. It is done so that the following week they will tell me what the patient's fluid intake has been and having that information is invaluable."

There were examples of the positive impact staff support had on improving outcomes for people. One relative told us their family member had recently had a significant health event and through the support of staff, had started to regain their strength and mobility. They explained, “What was fantastic, is they have done a great job with [Name’s] nutrition and fluids. They were right on it and are always monitoring the food and fluids."

Another person had a health condition that had previously required numerous hospital admissions for intravenous antibiotics. Through collaborative working with the hospital, the person now received their intravenous antibiotics at Priors House, reducing the need for stressful visits to hospital.

One relative described the positive outcome for their relative after a period of respite at the home. They told us, “It gave [Name] the support she needed, some sociability and some confidence. By the time she went back home, she was walking about and had some care at home.” Another relative said, “I just think it’s a fantastic home and we have never had any issues. I’m sure it’s down to her care that she’s still carrying on and having the fight and determination to carry on.”

Where needed staff completed records to evidence the monitoring of for example, fluid intake and repositioning people to prevent skin damage. This enabled staff to identify if people’s needs were being effectively met or changes were required in their planned care to improve outcomes.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People were supported to make decisions about their care and treatment wherever possible. During the inspection, we observed staff seeking people's consent before providing support and respecting the choices people made. One staff member explained, “When you start to help a resident, you ask them if they are ready. If they say no, you go back later. Some of our residents have dementia and don’t always want help at the time and we respect that.” When we asked another staff member what they would do if a person declined support they responded, "I would want to know the reason why and if they don’t want care, you respect their choice, their rights and their dignity and tell them I will come back when they want the care."

Mental capacity assessments were completed when required and demonstrated relatives’ involvement in best interest decision making.