Inspection on 07/02/06 for Priory Mews Nursing Home

This inspection was carried out on 7th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Priory Mews Nursing Home 16/04/07

Priory Mews Nursing Home 24/10/06

Priory Mews Nursing Home 04/10/05

Priory Mews Nursing Home 12/10/04

Priory Mews Nursing Home 25/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Priory Mews Nursing Home Watling Street Dartford Kent DA2 6EG Lead Inspector Alison Spreadbridge Unannounced Inspection 23rd February 2006 09:30 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Priory Mews Nursing Home DS0000026199.V274945.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Priory Mews Nursing Home DS0000026199.V274945.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Priory Mews Nursing Home Address Watling Street Dartford Kent DA2 6EG Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01322 292514 01322 281372 BUPA Care Homes Limited Mrs Clare Swan Care Home 150 Category(ies) of Dementia - over 65 years of age (60), Old age, registration, with number not falling within any other category (90), of places Physical disability (5) Priory Mews Nursing Home DS0000026199.V274945.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Patients detained under the Sections of the Mental Health Act may not be admitted to the home Of the 150 beds, 30 beds in one house are registered for Dementia Nursing Care Of the 150 beds, 30 beds in one house are registered for dementia care Total number of bedspace must not exceed 150 Date of last inspection 4th October 2005 Brief Description of the Service: Priory Mews accommodates one hundred and fifty older people ninety of whom are provided with nursing care, thirty with nursing and dementia care and a further thirty with personal and dementia care. BUPA Care Homes Limited owns the home. Priory mews is purpose built and was first registered in November 1993. The home comprises of five single storey houses, Cressner, Marchall, Beaumont, Montenay and Woodford. Accommodation in each house consists of thirty single bedrooms, a large communal day room / conservatory, an integrated dining area and kitchenette. A small quiet room is also available. All bedrooms have a television, telephone and staff call point. Each house is surrounded by a small garden. There is also a main building containing offices, the kitchen and laundry. Priory Mews is located near to the town centre of Dartford, close to the Bluewater shopping complex, and can be easily reached by public transport. Dartford is connected to mainline train and motorway networks. The home has ample car parking facilities. Priory Mews Nursing Home DS0000026199.V274945.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Alison Spreadbridge and Helen Martin, Regulation Inspectors carried out this unannounced inspection. The inspection took place between 09:30 am and 6 pm on the 23 February 2006. The inspection included speaking with the home’s manager, service users and staff. A tour of the buildings was made and some documentation was seen. During the inspection the manager said she was leaving the home to take up a new appointment and the new home’s manager would start work on the 1st March 2006. There was to be a short handover period before she left. What the service does well: What has improved since the last inspection? The service users’ care plans and risk assessments are beginning to be regularly reviewed and updated. The external door to Marchall House has been repaired. Bed rails and fenders are in use with more on order. The recording of complaints is beginning to take place. The sluice rooms were clean and tidy The laundry facilities are working well and an additional tumble dryer has been installed. Staff in sufficient numbers were on duty to ensure service users assessed needs could be met. Menus have been reviewed and the number of repartitions have been reduced offering service users a better choice. Priory Mews Nursing Home DS0000026199.V274945.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Priory Mews Nursing Home DS0000026199.V274945.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Priory Mews Nursing Home DS0000026199.V274945.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5, 6 The service users are provided with all the information they need prior to moving into the home. EVIDENCE: Prospective service users are provided with the information they need prior to moving into the home. Each service user has a contract, which explains their rights. All prospective service users have an assessment prior to moving into the home. Careful thought is given to which house would best suit a new service user. The manager made it very clear that they do not accept any emergency admissions into the houses; all admissions are planned entries. Service users and their representatives are encouraged to visit the home and stay for a while and meet the service users already living in the home. The home’s sisters have a good rapport with the families of their service users. Priory Mews Nursing Home DS0000026199.V274945.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 The work being undertaken around the service users’ care plans and risk assessments will ensure their assessed needs are met. EVIDENCE: Each service user has their own personal care plan, which includes their assessment undertaken prior to moving into the home. The care plans have been reviewed since the last inspection and some work around risk assessments has also begun. The care plans and risk assessments still require more work as they do not currently meet all of the assessed needs of service users and do not ensure the safety of service users is fully maintained. All service users have access to health care professionals. G.P’s and the optician visit the home on a regular basis. Service users are protected by the policies and the storage arrangements for medication held in the home. Staff are qualified and receive training in the administration of medication. It was however noted during the inspection, that in one of the homes a member of staff administering medication did not do so in a very professional way. Service users’ medication was potted and left on Priory Mews Nursing Home DS0000026199.V274945.R01.S.doc Version 5.1 Page 10 the table. The staff member did not wait to ensure the medication was taken. One service user was seen to have great difficulty in taking their medication, having to tip the contents of the pot on the table and having difficulty stopping them from rolling off of the table. This matter was brought to the attention of the home’s sister during the inspection. Staff was seen to treat service users with dignity and respect. Their privacy was being maintained. The laundry system has improved since the last inspection with some additional equipment. The laundry is now fully staffed. It was noted during the inspection that not all of the service users’ clothes are clearly marked enabling staff to return them to the rightful owner. Priory Mews Nursing Home DS0000026199.V274945.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 The service users are able to make personal choices around their activities and daily lifestyle. EVIDENCE: The service users’ care plans and risk assessments are being reviewed. However, the records still do not show that a holistic approach to care is being provided. An audit of activities including the recording of service users participation in activities cannot be fully supported as the current methods of recording does not correlate with service users’ care plans and is not consistent across the activities team. On the day of the inspection a number of service users were going into Dartford for shopping and a pub lunch. The activities co-ordinators from each of the houses had arranged the visit. They had chosen local people to go and look at the planed changes for the town centre. From the look of the service users on their return it was clear that it had been a very good outing. The organisers said they try to arrange an outing once a month in the better weather. The activity co-ordinators each have their own way of approaching activities in the different houses. A monthly programme of activities is decided in Priory Mews Nursing Home DS0000026199.V274945.R01.S.doc Version 5.1 Page 12 consultation with the service users and the activities staff. One of the homes is having a cultural evening and they are building a model of the Taj Mahal as the centrepiece for the evening. Staff will be contributing to the evening by cooking some of their favourite dishes and bringing some Indian music for the occasion. Each house has a small activities area where they can undertake art and craft work. Residents are able to attend activities in the different houses and meet with other service users. They are also able to attend church services. Some of the service users said they really enjoyed the activities and would like them to be extended to include dancing. A new four-week menu has been introduced, offering the services users more choice with less repartitions. Staff in the individual houses is expected to probe the hot food when it arrives from the kitchen. The temperatures are then to record on a sheet. This is not being done on a regular basis. In one house the record sheet showed that the temperature of the hot food had not been recorded since December, and in another the probe was broken. Food is sent over from the kitchens for the service users’ evening snacks. The sisters order these each morning. Priory Mews Nursing Home DS0000026199.V274945.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18 Residents and their representatives are encouraged to take concerns to the homes staff however, the home is unable to fully evidence that service users’ concerns are listened to and acted upon. EVIDENCE: The homes have a complaints system with which they only seem to have recorded a few serious concerns raised by the service users of their representatives. The daily concerns in the home are not being recorded, and while staff says that any concerns raised are acted upon there is little evidence to support this. The complaints book for Montenay House, which was missing at the last inspection, has been replaced and was available for inspection. The home’s policies and complaints procedure are in place and the complaints procedure forms part of the information provided to service users prior to moving into one of the houses. Priory Mews Nursing Home DS0000026199.V274945.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26 The service users live in a very pleasant environment, although they would benefit from additional facilities and access to all bathrooms. EVIDENCE: The home has an ongoing refurbishment programme. It is planned that one of the houses will soon be undergoing refurbishment to enable the homes registration to change to 30 older people with dementia. For the changes to take place some staff and service users have been moved to other house on the site. This was achieved following a full consultation process with the service users and their representatives. The damaged exterior door in Marchall house identified at the last inspection has been repaired. An additional tumble dryer has been purchased and the laundry is running well with no backlog of washing in any of the houses. All sluices were found to be clean and tidy. Priory Mews Nursing Home DS0000026199.V274945.R01.S.doc Version 5.1 Page 15 Extra bedrails and protective bumpers have been provided for those service users that require them and more have been ordered. There is still a very strong smell of urine in one of the houses, which the matron said they were trying to eradicate using some new products. The grounds were looking welcoming, clean and tidy despite the wintry weather. Some of the service users told the inspectors about the gardening competition and hoped they would do it again. Service users are provided with four bathrooms in each house as none of the rooms have ensuite facilities. In Cressenor and Marchall only three are in use as the other bathroom is used as a general storage area. Priory Mews Nursing Home DS0000026199.V274945.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29,30 The home ensures that the service users are cared for by skilled well trained staff. EVIDENCE: The manager said the home was now fully staffed and had only used agency staff on a small number of occasions. All service users and relatives spoken to were very complementary about the staff. They said they were always helpful and the care was good. The proposed change of use of one of the homes has meant that staff have been required to move to other houses as their numbers increase and the number in the home for refurbishment drops to fourteen. These changes have been in consultation with service users their families and the homes staff. On speaking with staff they were a little anxious about the proposed changes to their working routine but they are being well supported by senior staff and the house sister’s who are supporting them. The sister of the house, which is to have a variation to its registration, is being provided with training to help her prepare for the new service users some of who already live in other houses on the site. BUPA takes staff training very seriously. All staff including ancillary and administrative staff working on the site undertakes a basic level of training in Priory Mews Nursing Home DS0000026199.V274945.R01.S.doc Version 5.1 Page 17 dementia care. 76 of staff has undertaken NVQ qualifications. Some of the housekeeping staff has just completing their NVQ level one. Team meetings are being held in the individual houses on a monthly basis with staff receiving supervision three monthly and annual appraisals are now taking place. The home has a sound recruitment procedure in place. References are sought and CRB checks are undertaken prior to a new member of staff taking up their post. Priory Mews Nursing Home DS0000026199.V274945.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36, 37, 38 The welfare of service users has been safeguarded, and the record keeping has improved. A new manager is about to come into post. EVIDENCE: The current manager will be leaving next week with the new manager taking up her duties straight away. A short handover period has been arranged. There are changes taking place to one of the houses, which will necessitate a variation to the homes registration. It is to be a home for service users with a diagnosis of EMI once the refurbishment has taken place. This has necessitated some service users moving to other homes on the site. This has been done sensitively with full consultation with the service users and their families. The timescale for the changes to the house is March / April. It is anticipated that the house will be fully occupied by September, as there is currently a waiting list for places. Priory Mews Nursing Home DS0000026199.V274945.R01.S.doc Version 5.1 Page 19 Relatives meetings are being held to ensure they are aware of the changes as they occur. The other houses hold their relatives meeting about every six months. These are usually held on a Sunday afternoon to enable more families to be present. Relatives are encouraged to raise their individual concerns with the staff or homes sister, any formal complaints are forwarded to the matron for investigation. It is proposed that the home develops its own newsletter to help keep families involved in the activities in the home. Some of the service users’ families leave money with staff in the home for the payment of personal services such as hairdressing and chiropody. The staff do not provide the families with a receipt and it was suggested during the inspection that this practice be looked at. Not all records in the houses are being kept in sufficient detail to ensure they meet the requirements for regulatory inspections. These were discussed with the manager and sisters during the visit. A newsletter for the home is planned and other information is included in the BUPA magazine called Today. Staff are encourage to send articles into the editor for inclusion as away of showing good practice, and activities and ideas being tried in other BUPA homes. Priory Mews Nursing Home DS0000026199.V274945.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 3 18 3 3 3 2 2 3 3 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 3 2 3 2 2 Priory Mews Nursing Home DS0000026199.V274945.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement The service users’ care plans are recorded in greater detail and cover the holistic care provided including service users wishes and preferences regarding death and dying. The registered person shall ensure that unnecessary risks to service users are identified and as far as possible eliminated The registered person shall ensure that a record of all complaints made by service users and their representatives or by staff are fully recorded and investigated. The registered person shall ensure that service users have access to all bathrooms. They must not be used for the storage of mobile hoists and other items preventing service users from accessing facilities. The registered person shall ensure that having regard to the size of the home and the number of service users keep the home free from offensive odours. Timescale for action 30/06/06 2 OP7 13 30/06/06 3 OP16 17 (2) 30/06/06 4 OP22 23 (2) (1) 30/06/06 5 OP26 16( 2) (K) 30/06/06 Priory Mews Nursing Home DS0000026199.V274945.R01.S.doc Version 5.1 Page 22 These issues have been raised in the last four reports dated 25 May and 12th October 2004, 4th October 2005 and in this report. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP11 OP34 Good Practice Recommendations It is strongly recommended that information in respect to the wishes and preferences in respect to death and dying is recorded on service users care plans. It is strongly recommended that the procedure whereby monies are paid by relatives and received by staff for services such as chiropody and hairdressing etc be reviewed. Priory Mews Nursing Home DS0000026199.V274945.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Priory Mews Nursing Home DS0000026199.V274945.R01.S.doc Version 5.1 Page 24 - 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. 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