Inspection on 21/05/09 for Priory Grange Care Home Limited

This inspection was carried out on 21st May 2009.

CQC found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Priory Grange Care Home Limited 14/05/08

Priory Grange Care Home Limited 22/05/07

Priory Grange Care Home Limited 13/06/06

Priory Grange Care Home Limited 20/01/06

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Extracts from inspection reports are licensed from CQC, this page was updated on 07/08/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Priory Grange Care Home Limited Hessle High Road Hull East Yorkshire HU4 7BA     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: George Skinn     Date: 2 1 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Priory Grange Care Home Limited Hessle High Road Hull East Yorkshire HU4 7BA 01482504222 01482573966 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Priory Grange Care Home Limited care home 41 Number of places (if applicable): Under 65 Over 65 41 41 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 0 Priory Grange is owned by Priory Grange Care Home Limited, a family company that have the one home. It is registered to provide personal care and accommodation for up to 41 people of either gender, over the age of 65, some of who may suffer from dementia. Priory Grange is located in the Hessle area of Hull to the west of the city centre. The home is purpose built with a rear garden and some car parking space. It is a short drive from the centre of Hessle where there is a wide range of shops, pubs and churches. The home provides accommodation in single rooms all with en-suite on two floors. There was a passenger lift connecting the floors. Downstairs there was a large conservatory and dining room, there was also a lounge and dining room on the first floor and a smaller lounge. People who live at the home that smoke must go outside. Care Homes for Older People Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means that the people who use this service experience adeqaute quality outcomes. The key inspection has used information from different sources to provide evidence, these sources include: Reviewing information that has been received about the home since the last inspection Comment cards returned from people who live at the home relatives and staff A visit to the home carried out by one inspector Care Homes for Older People Page 5 of 25 A site visit was carried out which lasted 6 hours. We spoke with the people who live at the home, their relatives and staff. we looked at records relating to the people who live at the home, staff and the management activities of the home. During the visit care practices were observed where appropriate, and time was also spent watching the general activity within the home. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future if a requirement is repeated it is likely that enforcement action will be taken. Date of last inspection 14th May 2008. the Deputy manager was availble to assist throughout the day. The current weekly charges range from 359.50 to 390.00GBP and a top up fee of 25GBP. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 25 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed prior to moving into the home. Evidence: We looked at a sample of files which belonged to the people who had been recently admitted to the home and we saw that these contained copies of assessments undertaken by the placing authority and the home. This assessment information is then used to write a care or support plan describing what staff need to do to look after each person. The home does not provide intermediate care, which is a specialist service aimed at maximising peoples independence and return home after a hospital admission. Care Homes for Older People Page 9 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All the people who live at the home have plan of care and this details their needs. people are treated with respect and their dignity is upheld due to staff practise and training. People are not protected by the homes handling of medication and are put at risk due to the poor recording. Evidence: We looked at four (4) care plans, which belonged to the people who live at the home. We saw that personal support is provided in accordance with the care plan and these contained risk assessments around the area of falls, tissue viability, nutrition and diet. We saw that the people who live at the home can access health care professionals like doctors and nurses when needed; some people also have input from specialist nurses like Community Psychiatric Nurses (CPN). Some people have involvement with psychiatrists, specialist social workers, physiotherapist and dietitians. When we spoke with the staff they were clear about how to maintain someones dignity Care Homes for Older People Page 10 of 25 Evidence: and uphold their rights. We saw that the staff were sensitive to peoples needs when undertaking any personal tasks and were sensitive and patient when dealing with those people who have dementia. At no time did we hear any of the staff using any derogatory language or belittling any one in any way. When we looked at the medication we found some discrepancies these included medication that had been signed as given but remained in the packaging and some signatures not present for medication which had been given. The quality of recording was extremely variable and did not provide a good audit trail. Care Homes for Older People Page 11 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can take part in age appropriate activities and are able to excises choice in their daily lives. The home provides people with food which is wholesome and nutritious. Friends and relatives are made welcome. Evidence: When we spoke with the people who live at the home they said they could make choices about activities, food, how to spend their time and when to get up and go to bed. The home encourages contact with relatives and friends. We saw that visitors were made welcome to the home and had good relationships with the staff. We saw that a selection of activities are now arranged for the people who live at the home to take part in if they wish these included reminiscence, one to one discussions, bingo, quizzes, table games dominoes and crosswords. On the afternoon of the site visit an entertainer had been organised to visit the home. people told us that they were looking forward to this. People told us that they had enjoyed a trip out the local theatre to see some old time music hall acts. When we spoke with the people who live at the home about the food they told us it Care Homes for Older People Page 12 of 25 Evidence: was very good and there is always plenty of it. The cook visits all the people who live at the home every day to establish what they would like for lunch and tea as choice is available for both. Lunch on the day of the inspection was nicely presented and looked wholesome and nutritious. Staff helped those people who required assistance when eating in a relaxed unhurried manner. Care Homes for Older People Page 13 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the homes handling of complaints and the homes safe guarding procedures. Evidence: We saw that no complaints have been received by the home since the last inspection. The CQC have received no complaints about the home since the last inspection. We saw that the home continue to have a means of recording any complaint received. The home is currently the subject of a Safe Guarding Adults investigation being undertaken by the Local Authority Safe Guarding Team concerning allegations made about he conduct of the manager. He is currently suspended from duty pending the outcome of the investigation. The owners took the appropriate action and safe guarded the welfare of the people who live at the home. People who live at the home told us they were aware that they had the right to make complaints and told us that they would talk to their key worker or the manager. The home has a policy and procedure for safeguarding adults and the staff interviewed were aware of this, all had received training about Protection Of Vulnerable Adults (POVA). Staff were able to describe what they would do if they suspected any abuse was occurring with in the home. Care Homes for Older People Page 14 of 25 Care Homes for Older People Page 15 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in well maintained clean environment. Evidence: The building is purpose built and all internal areas are accessible by the people who live there. All of the rooms are single and have en-suite facilities. The home provides large bathrooms and toilets so those people who have limited mobility can easily receive help from the staff. The home was genrally clean and tidy. The home have now provided access to the garden and large French doors have been fitted in the rear lounge. There are plans to improve the garden area for easier access for those who may have mobility problems so people can plant flowers and tend the garden. The people who live at the home have a choice of communal areas and both the ground floor and first floor have separate lounges for people to use. We saw that the home continue to have a programme of routine maintenance and renewal of the decor of the building. Some areas of the building have been redecorated and this is an ongoing programme. Care Homes for Older People Page 16 of 25 Care Homes for Older People Page 17 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are not protected by the homes recruitment procedures. People are not cared for by staff who are trained appropriately to meet their needs. Evidence: There is a satisfactory staff rota in place that records the role of each member of staff. The staffing levels are based on the needs of the people who live at the home. There is a cook on duty each day as well as a kitchen assistant and other ancillary staff. This enables care staff to concentrate on assisting people with personal and social care activities. Training records indicated that more than 50 of the staff are trained to NVQ level 2 which includes training on equality and diversity and an awareness of abuse. One of the staff recruitment files we looked at did not contain references from the staffs previous employer; all files had an application form which identified gaps in employment and a completed Criminal Record Bureau (CRB) check was available to look at. Currently the owners are undertaking a audit of all of the staff training and are accessing training provided by the local authority to ensure that staff have all of the mandatory training needed this includes training on health and safety, fire, lifting and Care Homes for Older People Page 18 of 25 Evidence: handling, basic food hygiene, and first aid. Care Homes for Older People Page 19 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People continue to live in a home which run in their best interests, however the management arrangements could leave people vulnerable. Evidence: There is currently no register manager at the home. He has been suspended from duty following allegations about his conduct; this is an ongoing safeguarding investigation being undertaken by the Local Authority Safeguarding team. The home is currently being managed by the deputy manager and the owner has sought the support of an owner of another home in the area. The home continues to be managed in the best interest of the people who live there and the day to day management is being maintained. We saw that equipment and safety checks have been completed. The quality assurance system is on hold for the time being but it is intended that this is implemented again once the management issues have been resolved. Care Homes for Older People Page 20 of 25 Evidence: Prior to the inspection the home was sent an Annual Quality Assurance Assessment AQAA to complete. This was not done this is now a breach of a regulation. When we spoke to the staff they told they had confidence in the current management situation and were receiving plenty of support and regular supervision from the management team. Care Homes for Older People Page 21 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The registered person must ensure that all medication adminitstered is acuratly recrorded an people are not put at risk due to the staffs practise when handling and recording medication. This will ensure that peole are not put at risk of harm. 01/09/2009 2 9 18 The registered person must ensure that the staff have received the proper accredited training prior to handling any medication. This will ensure that people are not put at risk of harm. 01/09/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 31 The registered person should ensure that the home is managed by someone who has the necessary qualifications and experience to ensue the safety and well being of the Page 23 of 25 Care Homes for Older People people who live at the home. Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!