Archived: The Priory Nursing and Residential Home

There were 30 people living in the home on the day we visited. We met and spoke with 17 people who lived at the home, seven relatives, including three people who were visiting, and six members of staff. We also spoke with a social care professional who visits the home regularly.

All the people who were able to talk with us told us they were happy living at the home. After our inspection we contacted four relatives of the people who were not able to share their views with us. They agreed they were satisfied with the care their family member received.

People were happy to describe how they felt involved to make sure they had their say about how they wanted to live their lives at the home. People commented this was because communication in the home had greatly improved and the home care team were friendly, open and welcoming.

People told us they appreciated the regular meetings held for residents and relatives at the home, and the information the home management regularly posted out to them so they were kept up to date with changes and plans at The Priory Nursing and Residential Home.

We met some people with a variety of nursing needs that meant they were highly dependent on the staff team to care and support them. People were appreciative of the care they received and agreed the staff looked after them well.

On the day of our visit we saw people being supported sensitively and discreetly. People living in the home told us that they had a good working relationship with the staff team and that the home staff were responsive to their changing needs.

People were pleased with the range of activities available. They were complimentary about the home providing staff to support them with their pastimes at weekends as well as during the week. People were unanimous that the regular visits from a border collie we met during our inspection were very welcome. We saw contact with the affectionate well-trained dog brought a lot of smiles and pleasure to people.

Everyone we spoke with said they were happy with the quality of food provided. One relative who has dined at the home commented that the food was very good. Another person commented that the catering team always made sure the pureed food was always nicely presented to look appetising to tempt their family member to eat.

Relatives we spoke with agreed they felt people were safe and well looked after. People were protected because staff were confident to recognise and report abuse. Staff we spoke with confirmed they received training to keep vulnerable people safe on a regular basis.

Staff told us they had received the right training which meant they knew how to use equipment safely whilst caring for people. Staff stated they were confident that people's needs were understood and managed appropriately as they had received regular training opportunities and support to do their job.

There have been further changes to the home management during the past six months because the registered provider for the home went into administration. This has resulted in the home receiving ongoing support from a management consultant on a regular basis. We saw quality assurance systems have continued to monitor and review the quality of the service provided regularly.

The majority of health and safety systems were in place to make sure that people who live and work in the home were safe. At the time of our inspection visit we were able to see how the home had used their infection control systems to manage a viral infection the majority of people living and working at the home had experienced. We identified these would benefit further improvement to fully protect people to keep them well.

We saw that recordkeeping had continued to improve since our last inspection visit and systems were in place to make sure paperwork accurately reflected the care and support people received.

People who we spoke with were positive about their care and told us some nice changes had taken place. For example, they have introduced a supper menu and milk shakes throughout the day. This has had a positive effect and those that need to, are starting to gain weight. Visitors also informed us that meals were much better. A relative told us they personally thanked the cook after tasting their family member's meal.

People looked happier and were pleased that staffing hours have increased throughout the day which means carers have more time to carry out their needs. The majority of the people we had contact with told us that many aspects of care and support offered at the home were improving.

Two people told us that there have been occasions when staff have not responded as quickly as they would have liked when they have called for assistance, although the majority of people told us it was not as big an issue anymore. They told us,

'The call bells don't ring as much now.'

People who have been unhappy for several months about standards at The Priory Nursing and Residential Home also expressed their satisfaction. They commented, 'The home is on a dramatic incline'

We saw that people were treated kindly, but occasionally they did not receive some of the care they required when it was asked for.

All five of the care staff we spoke to were in agreement that they now had enough time to look after people the way they expected to be cared for.

One staff member said, 'It has helped so much. We have more time with the residents'.

Everyone was unanimous to tell us that the laundry service has continued to improve, although two people told us they still took their relatives laundry home.

All people we spoke to agreed the home manager is now more visible and available for them to approach if they need to.

Overall we found that several improvements have been made since our December visit to The Priory Nursing and Residential Home, although they have been slower than we expected. Some issues we reported to be improved at previous visits have not yet been fully addressed.

Nevertheless, we shared these concerns with the management team at the end of our visit and they have immediately responded, and carried out additional activities, which have had a positive effect. Following on from our visit on 4 March 2011, we have had contact with a variety of people who use the service, including those who were previously been unhappy for some time. They have been enthusiastic to volunteer details about how the home is getting better on a day to day basis. People continue to contact us to express their satisfaction at the ongoing changes in progress to improve the lifestyle of people at the Priory.

Comments we received told us people had mixed opinions about the care people experienced whilst living at the Priory recently.

Some people told us they were satisfied with the overall care their relative received.

One person commented,

The care and support is sensitively managed.'

Another person we contacted told us they were going to contact the home to thank hem for the care their family member had received.

However, other individuals were not so pleased. People expressed concerns that staffing levels were an issue and that people do not get the care they need as often as is required. Delays in waiting for help to use the toilet were a common concern people shared with us. Others expressed comments that it was not easy to find staff for help when people needed it.

One person told us that although the care was generally ok they, 'kept an eye on things' as some attention to detail was lacking. Examples of their relative not wearing glasses when they visited and another commented that their relative was not always wearing their teeth.

The laundry service appeared to be a main issue of concern at the home. Four people we spoke to told us that this service had deteriorated recently.

We received comments of clothing being damaged or missing.

Two people told us that individuals were regularly dressed in someone else's clothing. As a result some relatives have resorted to doing the washing for their relatives themselves. We were told care workers now assist with ancillary tasks such as laundry due to recent staff reorganisation.

Although the home management assured us there were enough careworkers available, other people expressed mixed opinions about this issue.

Staff said they did not have time to finish all tasks, and this causes extra work to others who are also very busy.

The majority of them told us they were rushed and one staff member said that staff work additional time without payment.

Our discussions with people confirmed our observations that there are a lack of skilled and competent management systems in the home. This has resulted in a failure to identify issues, which has not had a favourable effect on the day to day care for people at The Priory. We saw that people were treated kindly and that there were good interactions between careworkers and the people in the home, but they did not receive all of the care they required when it was needed. Our findings suggest this was due to the care workers not receiving adequate guidance by the nurse in charge about their roles and responsibilities for their working day.

Staff were all in agreement that the new care paperwork is easier to use and understand, and this has been an improvement they appreciated. However, we found that when there have been incidents involving the safety and welfare of people living at the home, important information has been left out of these communication records.

This suggests that nursing and care staff have not been kept fully informed about changes to people's care needs. This has had the potential to put people at risk.

We were able to confirm that records are not being kept up to date, delays in training, and lack of oversight of important care issues are not being managed and accounted for properly has challenged the impact of the quality of care given at this home. Some of our findings are similar to those we reported after our last visit in July 2010.