Archived: Priory Rookery Hove

Updated 7 August 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

This was a focused inspection to check whether the provider had met the requirements of the last inspection in relation to Regulation 12 (Safe care and treatment), Regulation 13 (Safeguarding) and Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Inspection team

The inspection was carried out by two inspectors. A third inspector made telephone calls to staff after the inspection.

Service and service type

Priory Rookery Hove is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because we needed to check our visit was carried out in a way which complied with the provider’s policies and procedures about infection control and the use of PPE during the Coronavirus pandemic.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. We used the information the provider sent us in the provider information return (PIR) on 17 April 2020. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with two people who used the service about their experience of the support provided at the home. One person who used the service left us written feedback as they knew they would be out when we visited the home. We spoke with the registered manager, deputy manager and four staff. We spoke with the operational supervisor during feedback at the end of the visit. The operational supervisor supervises the management of the service on behalf of the provider. We reviewed four people’s care records, including their support plans, risk assessments and risk management plans. We read minutes of residents’ meetings and staff meetings. We checked arrangements for medicines management and the quality monitoring checks carried out at the home.

After the inspection

We made telephone calls to three staff who were not on duty at the time of our inspection to hear their feedback about the service. We reviewed additional information sent to us by the registered manager, including training records and the service action plan.

Updated 7 August 2020

About the service

Priory Rookery Hove is a residential care home for up to 13 younger adults with learning disabilities, autism, or mental health conditions. Six people were living at the home at the time of our inspection. Priory Rookery Hove is a transitional unit. The aim of the service is to develop people's life skills and give them opportunities to move on to more independent living.

Priory Rookery Hove was designed, developed and registered before 'Registering the Right Support' best practice guidance was published. If the provider applied to register Priory Rookery Hove today it is unlikely the application would be granted. The model and scale of care provided is not in keeping with the cultural and professional ideas of how services for people with a learning disability and/or autism should be run to meet their needs. Improvements are needed to ensure the service develops in line with the values that underpin the Registering the Right Support and other best practice guidance. The building design fitted into the residential area and the other large domestic homes of a similar size. There were no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were discouraged from wearing anything that suggested they were care staff when coming and going with people.

People’s experience of using this service and what we found

People told us they felt safe at the home and with the staff who supported them. They said staff had time to spend with them to plan and review their support.

There was evidence of learning when things went wrong. When accidents or incidents occurred, these were reviewed to identify measures that could be put in place to prevent a similar incident happening again. If risks to people were identified, a risk management plan had been put in place. These included guidance for staff about how to support people in a way which minimised risks.

The use of Positive Behaviour Support (PBS) was more effective than it had been at our last inspection. (PBS is a person-centred approach to supporting people with a learning disability or autism.) Potential triggers for behaviours were identified and recorded. Strategies to avoid escalation had been developed, which were known by staff.

People told us staff had supported them to protect themselves from the risk of COVID-19 infection. Additional infection control measures had been implemented to protect people and staff during the COVID-19 pandemic. These measures included the use of appropriate PPE, more frequent cleaning of the home and ensuring staff were up-to-date with guidance about infection control.

People’s care records had improved since our last inspection. Old material had been archived and people’s support plans reviewed with their involvement. This meant people’s support plans were more relevant to their needs. For example, some people’s support plans focused on developing the skills needed to move on to more independent living.

Staff told us they received good support from the registered manager and deputy manager. They said the registered manager had improved many aspects of the service since taking up post in March 2020. Staff described the registered manager as approachable and supportive and said he had instilled a sense of clarity about what the service aimed to achieve for people.

Opportunities for people to have their say about the home and the support they received had increased. People told us they were involved in planning their care with support from an allocated keyworker. Residents’ meetings took place regularly at which people were encouraged to give their views about the service and the support they received. People told us staff listened to and acted upon what they had to say.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Although we found evidence of improvements at this inspection and improvements in the ratings for the key questions we reviewed, we were unable to change the overall rating as we did not review all of the previously ‘inadequate’ domains.

Why we inspected

Priory Rookery Hove was last inspected in November 2019 and was rated ‘Inadequate’ overall and placed in special measures. The provider completed an action plan after the last inspection to show what they would do and by when to improve Safe care and treatment, Safeguarding and Good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Priory Rookery Hove on our website at www.cqc.org.uk.

Follow up

We will continue to monitor the service action plan to understand what the provider will do to improve standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.