Priors House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

This is the first inspection for this service under this newly registered provider. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 75 (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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The provider promoted an open and transparent culture where staff were encouraged to acknowledge their mistakes, reflect on what had gone wrong and take action to improve their practice. One staff member told us, “If we have made a mistake, they have a very nice way of letting you know how your error happened and what you need to do to prevent it. I would say it is exceptionally helpful." Another staff member said, “There is very much a learning culture here. It’s never about blame, it’s always about what can we do differently or better. If you make a mistake, you are supported and helped to learn from it.”

Accidents and incidents were recorded and reported by staff and reviewed by managers to ensure actions had been taken to keep people safe. Learning identified from accidents, incidents or complaints was shared consistently through staff handovers, team meetings, individual staff supervision and reflective practice.

The provider worked with people and healthcare partners to design, establish and maintain safe systems of care, in which safety was well managed and monitored. They made sure there was continuity of care, including when people moved between different services.

A full medical history was gained for each person before they were admitted to the home. This ensured people’s clinical and health needs were known and continuity of care between healthcare professionals maintained.

Effective information sharing ensured safe systems of working were in place and established prior to a person transitioning to Priors House. One staff member explained, “Partnership working is very effective here. Before a resident comes to us, we gather all the information we can. That helps us know if we can care for the resident and what their needs are. Working closely with the social workers, hospital staff, doctors, whoever, helps the move into the home be a smooth one.”

The provider followed the “red bag scheme” which is a pathway of care for people in care homes who require hospital treatment. The bag contains essential items for a hospital visit including information about the person’s medicines and allergies and any support they need with eating, drinking and moving around safely. This ensured people’s needs could continue to be met during a transition between services.

Where people with communication or sensory needs attended hospital, a member of staff escorted the person to ensure effective communication. This meant the hospital healthcare professional had the information they needed to support their clinical decision making and any recommendations were clearly recorded.

There were processes to ensure people’s external healthcare appointments were known and planned for. This included information about whether people needed support to attend the appointment or transport to be arranged.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People told us they felt comfortable and secure living at Priors House. Comments included: “Oh yes, perfectly safe. I can leave my door open, and I don’t have to hide anything away and I am looked after very well”, “I do feel safe and I love living here. I don’t ever think that I am not safe, there is always someone around” and “I feel perfectly safe here, you can talk to anyone at all.” One relative told us they were 100% confident their family member was safe at Priors House and added, “I can sleep at night.” Another relative said, “It’s massive to be able to feel that I can trust somebody to look after [Name] and if there are any issues, they’ll be straight on the phone to me.”

Staff had received training in safeguarding and understood their responsibility to report any concerns to senior staff and/or the management team. One staff member told us, “Safeguarding is ensuring everyone is being treated fairly and making sure there are no signs of abuse, especially as we are working with vulnerable people. I would definitely take it up with the senior above me, like the manager or the nurse." Another staff member commented, “Safeguarding training makes you think about the different types of abuse, some may not be obvious, so you need to be alert. You have to think if a resident’s behaviour has changed and what could cause that. It could be they are feeling unwell, but it could also be that something has happened. Don’t make assumptions, check things out.”

Staff told us they would escalate concerns if they felt the right action had not been taken to address poor practice or abusive behaviours and keep people safe. One staff member said, “I know [Registered manager] would take the concern seriously, but I also know if something didn’t appear to be being done, I could raise it with CQC. The priority is the residents must be safe.”

Safeguarding concerns were referred appropriately to the local authority safeguarding team and notifications submitted to us, CQC. Where people expressed wishes and behaviours that had potential to place them at risk, managers and staff worked with social workers and the safeguarding team to ensure strategies were implemented to keep people safe without imposing unnecessary restrictions.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care home, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. When people were identified as potentially being deprived of their liberty, applications were made to the authorising body as required. Processes were in place to ensure Deprivation of Liberty Safeguards (DoLS) were managed in accordance with legislative requirements.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Care records informed staff about risks to people’s health and wellbeing and the action they needed to take to mitigate identified risks. For example, in relation to moving and transferring people safely, catheter care and wound management.

However, we found care plans when people received their medicines and nutrition through a tube directly into their stomach required more detail to reflect the support required to minimise associated risks. Despite the lack of detail in these care plans, our observations and conversations with staff demonstrated they were working in accordance with best practice in these areas.

Risk management tools and care records had been regularly reviewed and updated where needed.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The provider had effective systems and processes to ensure the building and equipment were regularly inspected, serviced, and maintained to a high standard. There was maintenance support available 7 days a week so any environmental issues could be addressed promptly.

Staff had completed fire safety training and demonstrated a good understanding of their roles and responsibilities in the event of a fire or other emergency. Comments included: “We have very regular fire drills. We all recognise their importance. It gives us the chance to keep practicing so in the event of a real fire, which I hope never happens, we will know exactly what we need to do” and “All the residents have evacuation plans kept in the reception, and they have coloured dots by their bedroom doors. The dots are there to tell you how many staff they need to evacuate the home.”

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The provider used a dependency tool to assess people’s needs and identify required staffing levels within the home. The dependency tool was supplemented by feedback from people and staff, analysis of accidents, incidents and complaints and quality assurance checks. The registered manager explained, “It is not just about a dependency, that only gives us a starting point and an overview of who we have in the building. There are lots of other things like in resident meetings we talk to people to make sure we are meeting their needs." People and their relatives confirmed staffing levels were acceptable and sufficient.

Staff told us staffing levels enabled them to provide people’s care safely and without rushing. One staff member told us, “I don't feel it is short staffed when I am on shift. There is just the right amount of staff to manage and do the job well." Our observations during the inspection were that staff were visible and worked well together to provide safe care that met people’s individual needs.

Staff received a mixture of face to face and virtual training to ensure they had the right skills to meet the needs of people living at Priors House. One staff member commented, “Training I had when I started and since, it’s online and face to face, has been very, very good. It boosts my confidence when doing new things and reinforces when its annual updates.”

The provider followed recruitment procedures to ensure all required checks were completed before staff started work at the service. Enhanced Disclosure and Barring Service (DBS) checks were carried out. DBS checks provide information about convictions and cautions held on the police national computer. The information helps employers make safer recruitment decisions.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Staff had completed infection prevention and control (IPC) training and applied this learning effectively in practice. They worked in accordance with the provider's IPC policies and procedures, helping to minimise the risk of infection and promote people's safety. IPC champions supported good practice across the service by providing guidance, raising awareness, and helping to maintain standards.

The home was clean, welcoming, and well maintained, with no visible infection prevention and control concerns identified during the inspection. This demonstrated effective systems were in place to maintain a safe environment and help protect people from avoidable harm.

The provider demonstrated appropriate reporting and liaison with IPC partners during any infection outbreaks.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

People and their relatives were positive about the management of medicines at Priors House. Comments included: “Pills, I take so many now, but I trust them” and “I am particularly impressed with how the medications are given out to me.”

People received their medicines as prescribed. Staff responsible for medicines management had completed training and their competency to administer medicines safely was assessed.

Where people received their medicines via a patch applied directly to their skin, best practice guidelines were followed and application sites recorded on body maps.

When prescribed medicines such as topical creams or food supplements were kept in people’s rooms, we found improvements were required to ensure they were stored safely and at the right temperatures. The registered manager immediately addressed this during our inspection visit.