Priory Lodge

Updated 21 December 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection team consisted of 1 inspector on 9 and 11 October 2023 and 2 inspectors on 16 October 2023.

Service and service type

Priory Lodge is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Priory Lodge is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

The inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We used all this information to plan our inspection.

During the inspection

We spoke with 3 people who used the service. Some people did not want to give us feedback. We spoke with the provider, the registered manager and 6 staff members, including the cook and housekeeper. We looked at records relating to 6 people using the service, the recruitment 4 staff and training of all staff, management of the service and systems for checking the quality and safety of the service.

Updated 21 December 2023

About the service

Priory Lodge is a residential care home providing accommodation and personal care to people who require support with their mental health. The service provides support to up to 18 people. At the time of our inspection there were 15 people using the service, 4 people were not in receipt of personal care.

People’s experience of the service and what we found:

Management did not have adequate oversight of the service and the provider lacked robust and effective governance systems to monitor the quality and safety of the service and improve care delivery. Incidents were not being reported correctly or investigated properly, and lessons were not learned.

The provider had missed some areas within the environment that posed a potential risk to people’s safety, and fire safety and infection control arrangements needed strengthening.

Staff were kind and considerate towards the people they cared for. However, care and support delivered were more intuitive than knowledge based. Staff had a basic understanding and awareness of people’s mental health needs. Care records contained insufficient guidance for staff to reduce risk, provide safe care and to promote and support people’s wellbeing. Improvement was needed in staff training and development to enable them to deliver care and support that is responsive, person centred and in line with relevant guidance and best practice.

Improvement was needed to demonstrate the service was working within the legal framework for making particular decisions for people who lacked capacity to do so.

We received positive feedback from the staff team about the management of the service. However, systems and processes needed to be reviewed to ensure that the registered manager could demonstrate that people’s individual needs were being met and staff were effectively supported to deliver safe care.

People we spoke with were happy living at the service. The atmosphere within the home was friendly and welcoming.

The registered manager was working closely with the local safeguarding and quality improvement team to reflect on the current practice within the home to ensure that lessons were learned, and to make improvements where needed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 24 December 2019). The service has been rated requires improvement for the last four inspections. The provider failed to complete and submit an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider had not made improvement and was in breach of regulations. The rating for the service has changed to inadequate.

Why we inspected

The inspection was prompted in part due to concerns received about management oversight and responsibilities, staff training, skill and competence and people’s care and support. A decision was made for us to inspect and examine those risks.

We undertook a comprehensive inspection to review all key questions.

Enforcement

We have identified breaches in relation to management and oversight, risk management and safety and staff training and support.

Please see the action we have told the provider to take at the end of this report.

Follow Up

We will meet with the provider and request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.