This inspection took place on 16 January 2018 and was unannounced. We announced our return to the home on 17 January 2018.The Priory Care Home is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Priory Care Home is registered to provide accommodation for up to 30 people, including older people and people living with dementia. On the day of our inspection 28 people were living at the home. People have access to communal areas within the home and access to the home's gardens.
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. A registered manager was in post and supported the inspection process over the two days of the inspection.
At our last inspection on 01 December 2015, we gave the service an overall rating of Good. At this inspection, we have rated the key questions Safety, Caring and Well-led as Requires Improvement which has meant the overall rating has changed to Requires Improvement.
The provider had not fulfilled their regulatory responsibilities in submitting notifications about people’s deaths to us. This meant they were in breach of Regulation 16 of registration Regulations.
There were aspects of the provider’s and registered manager’s quality checking arrangements which were not consistently effective in identifying practices which required improving to show continual development of the service.
We found staff did not always promote or maintain people's dignity. People’s personal information was not consistently stored and or when staff were working on care documents they were left in communal areas so unauthorised people could potentially access these thus not maintaining people’s confidentiality.
People benefitted from being supported by kind and caring staff who assisted people to be as independent as possible and involved in their care.
People's individual risk assessments were reviewed and updated to take account of changes in their needs. Staff knew how to recognise and report any concerns to keep people safe from harm. People’s medicines we made available as prescribed and were supported to take these by staff who had the knowledge to do this in a safe manner. The registered manager had identified shortfalls in safe medicine storage for people's prescribed creams and had taken action to remedy the situation.
People were supported by staff who knew how to reduce the risk of infections and people were complimentary about how clean the home environment was and from any unpleasant odours. The registered manager took immediate action to remove a shower chair and ensured slings were for personal to each person to further assist in the prevention of cross infections.
There was evidence of organisational learning from significant incidents and events. Formal complaints were rare and any informal concerns were handled effectively with learning taken to continually improve care.
Staff worked well together in a mutually supportive way and communicated effectively. Training and one to one support systems were in place to provide staff with the knowledge and skills they required to meet people's needs effectively. There were sufficient staff to meet people's care and support needs without rushing.
People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice
People were provided with food and drink of good quality which they enjoyed and met their individual needs and preferences. Staff worked closely with local social and healthcare services to ensure people had access to any specialist support they required. The environment and facilities in the home were being refurbished and redecorated to reflect people’s requirements. People liked their own rooms and they furnished these with personal items so it felt homely.
People were provided responsive care and support which met their individual needs. There was a planned programme of things for people to do for fun and interest. Staff spent time with people on a spontaneous basis chatting about their families and lives. Staff knew people really well and had built up trusting relationships. Staff provided end of life care in a sensitive and personalised way.
The registered manager was well known to, and respected by, everyone connected to the home. They were supported by the provider who ran the home as a family concern which people appreciated.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.
Further information is in the detailed findings below.