Archived: Priory Mews Care Home

Updated 25 October 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was carried out to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection was carried out by a team of seven on 01 and 02 September 2016. On the first day the inspection team included three inspectors, a specialist nurse and two experts by experience; on the second day, there were three inspectors, an inspection manager and one expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

The manager had completed a Provider Information Return (PIR) at the time of our visit. The PIR is a form that asks the provider to give some key information about the service, what the service does well and what improvements they plan to make. We took this into account when we made the judgements in this report. Before our inspection we looked at records that were sent to us by the manager and the local authority to inform us of significant changes and events. We also reviewed our previous inspection report.

We looked at 13 sets of records which included those related to people’s care and medicines. In 11 of these records, we looked at people’s assessments of needs and care plans and observed to check care and treatment were appropriately and consistently delivered. We reviewed documentation that related to staff management and six staff recruitment files. We looked at records concerning the monitoring, safety and quality of the service, menus and the activities programme. We sampled the services’ policies and procedures.

We spoke with 19 people who lived in the service and 11 of their relatives to gather their feedback. Although several people were able to converse with us, others were unable to, or did not wish to communicate. Therefore we also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with the regional director, the clinical lead, three units managers, two deputy unit managers, nine nurses, nine care workers, three activities coordinators, the chef, the housekeeping manager and one member of the housekeeping staff. We also spoke with a GP who visited the home regularly to provide medical care, a local authority safeguarding assessor and two local authority case managers who oversaw people's care in the service. We obtained feedback about their experience of the service.

Updated 25 October 2016

The inspection took place on 01 and 02 September 2016 and was unannounced. Priory Mews Nursing home is a large nursing home providing nursing and personal care for up to 156 older people, some of whom have palliative and dementia care needs.

The accommodation comprises of five separate houses adjacent to each other. Beaumont and Berkeley provide residential and nursing care; Marchall and Mountenay provide care for people with nursing dementia needs and Cressenor House cares for people with residential dementia requirements. A separate house accommodates the main reception, the kitchen, the senior management team, and the administration team. There were 136 people living in Priory Mews at the time of our visit, 95 of whom lived with dementia.

There was a manager in post who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

Staff knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow or make sure people were protected from harm. Accidents and incidents were recorded and monitored to identify how the risks of recurrence could be reduced.

There was a sufficient number of staff deployed to meet people’s needs. Thorough recruitment procedures were in place which included the checking of references.

Medicines were stored, administered, recorded and disposed of safely and correctly. Staff were trained in the safe administration of medicines and kept relevant records that were accurate.

At our last inspection in July 2014, we found a breach of Regulation 21 Health and Social care Act 2008 (Regulated Activities) Regulations 2010. Accurate and appropriate care records were not consistently maintained. At this inspection we found that improvements had been carried out and that the Regulation was being met.

We had also identified that improvements were needed to ensure that the Mental Capacity Act 2005 requirements were implemented correctly to make sure that people’s rights were protected. At this inspection we found that improvements had been carried out.

The CQC is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Appropriate applications to restrict people’s freedom had been submitted and the least restrictive options had been considered.

Staff sought and obtained people’s consent before they helped them. They knew each person well and understood how to meet their support and communication needs. Staff communicated effectively with people and treated them with kindness and respect.

At our last inspection in July 2014, we found a breach of Regulation 23 Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. Adequate training had not been provided to ensure that the prevention and treatment of pressure and leg ulcers was effective. At this inspection we found that improvements had been carried out and that Regulation was being met. Staff received essential training, additional training relevant to people’s individual needs, and regular one to one supervision sessions.

The staff provided meals that were in sufficient quantity and met people’s needs and choices. People’s feedback was positive about the food. Staff knew about and provided for people’s dietary preferences and restrictions.

People were promptly referred to health care professionals when needed. Personal records included people’s individual plans of care, life history, likes and dislikes and preferred activities. The staff promoted people’s independence and encouraged people to do as much as possible for themselves.

A range of suitable activities and entertainment was provided. People were involved in the planning of activities that responded to their individual needs.

Staff told us they felt valued and supported by the registered manager, the management team and the provider. The registered manager was open and transparent in their approach. They placed emphasis on continuous improvement of the service and promoted links with the community.

There was a robust system of monitoring checks and audits to identify any improvements that needed to be made. The management team acted on the results of these checks to improve the quality of the service and care.