We carried out a review of the data available to us about Priory Supporting Care Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Priory Supporting Care Limited, you can give feedback on this service.
Priory Supporting Care Limited is a residential care home providing personal care to 22 people aged 65 and over, at the time of the inspection. The service can support up to 25 people.
People’s experience of using this service and what we found
The service had arrangements in place to protect people from the unsafe management of medicines. Where people needed assistance to take their medicines, staff helped them accordingly. People were safeguarded from abuse or harm and staff understood how to keep them safe and report any concerns they had. Risk assessments had been carried out to identify any risks to people, when providing care and support. There were enough staff employed to meet the needs of the people using the service. The provider had effective recruitment procedures to make safe recruitment decisions when employing new staff. Accidents and incidents were recorded in detail and these were investigated by the registered manager to prevent or minimise them from happening again. Staff had received training in infection prevention and control. They understood the roles and responsibilities in this area to ensure people they supported, were safe.
The registered manager operated an open and inclusive culture where people, relatives, staff and other professionals were encouraged to help improve the service provided to people. Staff had access to a range of policies and procedures, and this helped them to carry out their role. People were treated equally regardless of their abilities, background, lifestyle, values, beliefs and their cultures. There were systems in place to monitor the service and address any areas of improvement where needed. The management team had good links and worked closely with other health and social care professionals to ensure people received the care and support they needed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
At the last inspection the service was rated requires improvement (published 21 January 2021) and there were breaches of regulation 12 (Safe care and treatment), and regulation 17 (Good governance). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
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.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Priory Supporting Care Limited on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Priory Supporting Care Limited is a residential care home providing personal and nursing care to 17 people at the time of the inspection. Most people living at the service were older people some of whom had dementia. The service can support up to 25 people.
People’s experience of using this service and what we found
The service had enough staff to meet people's needs. The registered manager was clear about the need to keep the staffing level under review so that there were suitably qualified and experienced staff to meet people's needs.
The staff recruitment processes were robust. This meant that staff were checked before starting work at the service and were also supported in their roles.
The service had a safe medicines management system. People received their medicines as prescribed by their doctors.
Personal and environmental risk assessments were completed and action taken to ensure people were safe. Regular health and safety checks had been undertaken to ensure people lived in a safe home.
Infection control procedures had been enhanced due to the risk of COVID19 and we observed the service was clean and there was a cleaning a cleaning schedule. Systems were in place to ensure visits were made safely. Personal protective equipment (PPE) was readily available and people and staff were tested regularly.
Quality assurances auditing processes were used to monitor and ensure the service was safe. The service sought feedback from people and relatives to improve the quality of the service.
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 11 December 2019).
Why we inspected
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
The inspection was prompted in part due to concerns received about staffing, medicines management and risk assessments. A decision was made for us to inspect and examine those risks and how the service was managed.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe, Effective, and well-led sections of this full report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.
Priory Supporting Care Limited is a residential care home providing personal care to 25 people aged 65 and over at the time of the inspection. The service can support up to 23 people.
People’s experience of using this service and what we found
People did not always have access to their medicines due to stock balances not being available. Systems in place to monitor the quality of the service were not always effective and had not identified shortcomings we found during the inspection.
People told us they felt safe. Systems were in place to protect people from abuse. However, we found on two occasions the service had not notified local safeguarding teams in a timely manner. We have made a recommendation about this.
People told us they were happy with the care and support provided. When asked about the service one person said, “I am very lucky, a very nice home. The surroundings and staff are nice.”
Risk assessments were completed to identify and manage risks to keep people safe. Staff were trained to support people to take their medicines and measures were in place to protect people from the spread of infection.
There were enough staff to meet people’s needs and people did not have to wait long when they requested care or support. Pre-employment checks were carried out to ensure staff were suitable to support people. There were procedures for responding to accidents and incidents.
The service carried out assessments of people’s needs prior to admission to the service to ensure they could meet their needs. 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.
People were supported to eat and drink enough to meet their needs. Staff had completed required training to perform their roles effectively and felt supported in their role. The service worked with other agencies to promote people’s health, safety and well-being.
People were included in decisions about their care, including their wishes and preferences at the end of their life. People received care and support from staff who were caring and compassionate. One person told us, “The staff are caring and I feel comfortable and well cared for.”
Staff treated people in a respectful manner maintaining their dignity and encouraging independence. One staff member told us, “People [using the service] are not children. You respect the way they need their care delivered.” Systems were in place to protect people’s right to confidentiality. The service was respectful of people’s equality diversity.
Care plans were person centred and included the individual needs of people. Care plans were reviewed monthly to reflect people’s changing needs. Complaints procedures were in place and people told us they knew how to make a complaint. One person said, “If there were concerns, I would feel safe raising them, if there was anything to complain about.”
People and staff told us they found the registered manager approachable and supportive. Staff were positive about the culture of the service.
Rating at last inspection
The last rating for this service was good (published 31 May 2017).
Why we inspected
This was a planned inspection based on the previous rating. The inspection was prompted in part due to concerns received about medicines administration records. A decision was made for us to inspect and examine those risks.
We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report. You can see what action we have asked the provider to take at the end of this full report. The provider has taken action to mitigate the risks.
Enforcement
We have identified breaches in relation to medicines management and leadership of the service at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Priory Supporting Care provides personal care to a maximum of 24 people some of whom may be living with dementia. The service is on three floors and accessible via lift and staircase. There is a large well maintained garden and a conservatory. On the day of our visit there were 22 people using the service.
There was a registered manager. 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.
People consistently told us they were happy living at the service. They thought they were safe, treated with dignity and respect and involved in planning their care.
The manager was innovative and passionate about dementia care. They had set up various forums to share best practice in dementia care and had been involved in developing a dementia care "Do's and Don'ts" summary document to aid staff when supporting people living with dementia. They had gained Gold standards framework accreditation for end of life care delivery. They were also a member of NAPA and had been a finalist in 2016 Health investors awards evidencing their commitment to providing person centred care.
The service had made progress in ensuring that care plans were person cantered and took account of people’s physical, social and emotional needs. Life stories were in people’s rooms in order to enable staff to effectively engage with people using the service. Activities were centred on the needs of people and included a dementia friendly environment where people could engage freely in activities such as poet therapy, interacting with the wall murals and doll therapy.
People told us they were able to express their concerns without any fear of reprisal. Complaints were managed effectively and the policy was clear and accessible to people and their relatives.
Staff were supported by means of regular supervision, annual appraisal, regular staff meetings, training and a supportive management team.
Staff were aware of the Mental Capacity Act 2005 (MCA) and how it applied in practice. They could explain the procedures in place to ensure decisions were made in people's best interests.
People were supported to have maximum choice and control of their lives. Staff supported in the least restrictive way possible; the policies and systems in the service supported this practice.
People were supported to maintain a healthy lifestyle. They were offered food that met their individual preferences. For people on puree diet the chef had found innovative methods to ensure the food was appetising thereby increasing the chances of people finishing their food.
People, their relatives and staff thought there was an open culture where their concerns were listened to and acted upon.
There were effective quality assurance systems in place to ensure care delivered was continuously improved. People and their relatives and staff had an opportunity to be involved in influencing how care was delivered and improved.
The inspection was unannounced and took place on 13 April 2015. There were no breaches of any legal requirements at our last follow up inspection on 11 November 2013.
Priory Supporting Care Limited Residential Home provides 24 hour care, accommodation and personal care for 24 older people, some of whom have been diagnosed with dementia. The service supports people with all aspects of personal care and day-to-day living activities.
The service had a registered manager. ‘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.’
People were protected from abuse and harm as the service had systems to enable staff to recognise and report abuse. Medicines were administered, handled, stored and disposed of appropriately.
Staffing levels were determined by the dependency of people and there were procedures to cover for sickness and absences. There were robust recruitment processes to ensure that only staff members who had undergone disclosure and barring checks and had provided suitable references were employed.
There were procedures to manage risks to individuals and the environment so that people were protected. These included risk assessments, business continuity plan and procedures in place to deal with foreseeable emergencies.
People were supported to eat and drink sufficient amounts. Where required people had access to healthcare professionals in order to improve their health.
There were procedures to ensure that consent was sought before care was delivered. Where people lacked capacity best interests decisions were sought. The staff and the manager were aware of the process to follow in order to lawfully deprive people of their liberty where necessary.
Staff received annual training and appraisal as well as regular supervision and monthly team meeting. Staff members were supported during the induction period and were encouraged to develop in their roles by taking on roles such dignity and dementia champions.
We observed that staff were caring and compassionate and responded quickly when people called. People’s privacy and dignity was respected.
Care plans reflected people’s individual preferences and were reviewed monthly or when people’s care needs changed.
People had access to various activities daily and their preferences were noted and considered. Relatives were involved in activities and told us they could visit at any time they chose.
We found that people relatives and staff were aware of the complaints procedure and would not hesitate to raise any concerns. Complaints were responded to in a timely manner and according to people’s satisfaction.
There was an “open, no blame” culture. Staff told us they had opportunities to feedback or discuss any issues with the manager and the deputy. The home’s values included encouraging “individuals to lead a purposeful life and enjoy independence, choice and total respect”. Staff were aware of these values. We saw evidence that the service was working towards accreditation for end of life care and for valuing staff development.
People spoke positively about the changes that had taken place and with the care they received. A relative we spoke with said 'my wife is happy here, they do a lot for her and its lovely here. They make sure she eats. The improvements to the home seem continuous and I visit more or unless every day.' Another person said 'a lot of changes have been taking place. We have had new chairs to make it nicer. I'm not just saying it but it's really nice here, we have nothing to grumble about. I'm really quite happy.' A member of staff told us 'it needed updating and it's 100 times better for the residents. The new manager has bought in a lot of new changes.'
We found that people who used the service had access to premises that were suitably designed and adequately maintained. There were maintenance checks in place to ensure the proper operation of the building. This meant that people were protected against the risks associated with unsafe premises.
People who used the service told us that they felt safe at the home and were well looked after. One person we spoke with said, 'I feel safe here and the staff are good to me.'
There was enough qualified, skilled and experienced staff to meet people's needs. People we spoke with said that, "staff are all very friendly and pleasant." A relative we spoke with said, "I am very happy with the care staff and they are all very welcoming."
We found that people had their comments and complaints listened to and acted on, without the fear that they would be discriminated against for making a complaint. People we spoke with told us that they always felt comfortable in raising concerns and knew they would be resolved. A relative said, "I would complain if I wasn't happy and I'm sure they would sort it out."
Although a refurbishment programme was in place. We found that the provider had not always taken steps to provide care in an environment that was adequately maintained.
The inspection team was led by a CQC inspector joined by an Expert by Experience; people who have experience of using services and who can provide that perspective and a practising professional.
We used the Short Observational Framework for inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We observed that people who used the service were supported to eat and people enjoyed meal times.
People who use the service spoke positively about The Priory Residential Home. When asked what they thought about the care provided at the home, one person said, 'I couldn't ask for anything more, its home from home here.' Another person said, 'I haven't had any problems here.' People who use the service made positive comments regarding the meals provided at the home. One person said, 'The food is very nice.' We found that people were protected from the risks of inadequate nutrition and dehydration.
People who use the service told us that they felt safe and well looked after. They had no concerns about staff attitudes and told us that staff were 'caring." Although we received positive feedback regarding staff, there was not enough staff to meet people's needs. Staff told us that they found it difficult to cope at times with current staffing levels.
Care plan documentation of people using the service lacked consistent and accurate information. People were not involved in their care planning and in the review process, which meant they did not have appropriate information provided to them about their care.