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Priory Mews Care Home Requires improvement

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 8 March 2019

Priory Mews Care Home is a ‘care home’. People in care homes receive accommodation and nursing and personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service can accommodate up to 156 people. At the time of the inspection there were 136 people living at Priory Mews Care Home. The service comprises of five separate units adjacent to each other. Beaumont and Berkeley provide residential and nursing care for 30 and 14 people respectively; Marchall and Mountenay provide care for people with nursing dementia needs for 22 and 29 people respectively; and Cressenor House cares for 41 people with residential dementia requirements. A separate house accommodates the main reception, the kitchen, the senior management team, and the administration team.

The inspection was unannounced and took place on 10 and 11 January 2019.

The service was run by a registered manager and they were present on both days of the inspection visit. 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.

At the last inspection on 6 and 7 November 2017, the overall rating of the service was ‘Requires Improvement’. We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Risks to people were not always minimised nor significant events safely responded to. Checks on the quality of the service were not sufficient to make necessary improvements. People were not always given their medicines as directed by their doctor. People were not always supported appropriately at mealtimes or treated with dignity. We required the provider to take action to make improvements. The provider sent us an action plan detailing how they planned to address the breaches of Regulations and said that this would be completed by 30 April 2018.

We also made four recommendations. These were about making sure there were enough staff available; the control of infections, adaptations to the environment and the range of activities available.

At this inspection, we found that that potential risks were assessed and managed to help keep people safe. Accidents and incidents were monitored, and lessons learned for the benefit of people. People were consistently treated with dignity and got the help they needed at mealtimes. There had been improvements to record keeping. However, shortfalls in the management of medicines remained as it could not be assured that everyone received their medicines as prescribed by their doctor. There were a number of discrepancies in medicines records including the use of ‘only when needed’ medicines prescribed for people with agitation.

This is the second time that the service has been rated as Requires Improvement.

The provider had addressed all good practice recommendations. Staffing levels were assessed and monitored to make sure there were enough staff deployed in each unit. Infection control practices minimised the spread of any infection. This included making sure each person who used a hoist had their own sling to prevent cross contamination. Changes had been made to the environment through a use of visual aids and decoration to help people living with dementia make sense of their surroundings. The activity team had been expanded so there were activity leads in each unit to undertake group and one to one activities with people to help improve their well-being.

Systems to monitor the quality of care had been strengthened but had not identified the shortfalls in the management of medicines.

A consistent staff practice had developed throughout the service whereby everyone was tre

Inspection areas

Safe

Requires improvement

Updated 8 March 2019

The service was not always safe.

The management of medicines did not always ensure that people received their medicines as prescribed by their doctor.

The service learned lessons and made improvements when significant events occurred.

Potential risks to people's health and welfare were assessed and staff followed this guidance to keep people safe.

Checks made sure only suitable staff were employed.

The service was clean and staff practices ensured effective control of infections.

Effective

Good

Updated 8 March 2019

The service had improved so that it was effective.

People's nutrition was monitored they received the support they needed at mealtimes.

Improvements had been made to the environment which took into consideration the needs of people living with dementia.

Staff felt well supported and had the skills and knowledge they required for their role.

People gave consent to care and support. Staff supported people in line with the principles of the Mental Capacity Act 2005 and the requirements of the Deprivation of Liberty Safeguards.

Caring

Good

Updated 8 March 2019

The service had improved so that it was caring.

Staff had built positive and caring relationships with people and this approach was consistent throughout the service.

People were treated respectfully or and supported in a way that was caring and upheld their dignity.

Responsive

Good

Updated 8 March 2019

The service had improved so that it was responsive.

People's needs were assessed and support plans gave guidance to staff about how to provide their care.

People were offered a range of individual and group activities to help enhance their well-being.

People were supported at the end of their life to have a comfortable, dignified and pain-free death.

People and their relatives knew how to raise concerns and

complaints.

Well-led

Requires improvement

Updated 8 March 2019

The service was not consistently well-led.

Although quality assurance systems had improved and strengthened, shortfalls in the management of medicines remained.

Record were easily accessible and their content had improved so that they reflected people's care and treatment.

The views of people and relatives were sought and acted on.

People benefitted from a staff team who were well supported and clear about their roles and responsibilities.