Inspection on 02/02/10 for The Priory

This inspection was carried out on 2nd February 2010.

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

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

The Priory 10/02/10

The Priory 20/10/09

The Priory 30/06/09

The Priory 02/12/08

The Priory 21/10/08

The Priory 08/07/08

The Priory 31/07/07

The Priory 02/03/07

The Priory 11/12/06

The Priory 06/10/06

The Priory 08/05/06

The Priory 14/11/05

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Extracts from inspection reports are licensed from CQC, this page was updated on 29/06/2010.

Random inspection report Care homes for older people Name: Address: The Priory Springhill Wellington Telford Shropshire TF1 3NA zero star poor service 22/10/2009 The quality rating for this care home is: The rating was made on: 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 review of the service We call this review a ‘key’ inspection This is a report of a random inspection of this care home A random inspection is a short, focussed review of the service Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report Lead inspector: Dawn Evans Date: 0 2 0 2 2 0 1 0 Information about the care home Name of care home: Address: The Priory Springhill Wellington Telford Shropshire TF1 3NA 01952242535 01952641577 thepriory home@yahoo com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Wellcare Management Ltd The registered provider is responsible for running the service care home 37 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 37 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 37 The registered person may provide the following category of service only: Care Home with Nursing (Code N) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 37 Date of last inspection Brief description of the care home The date of the last key Inspection was 22 October 2009 The Priory is care home for older people and also provides nursing care for individuals with complex nursing needs Care Homes for Older People Page 2 of 14 2 2 1 0 2 0 0 9 Brief description of the care home due to their physical health condition The home is located in residential area and is accessible via public transport and is nearby to local amenities, such as shops and pubs The two storey property is situated within its own grounds, offering single bedrooms on both the ground and first floor The majority of bedrooms are equipped with en suite Bathrooms and toilets are provided on each floor and are nearby to communal areas A lounge, dining room, kitchen and laundry is situated on the ground floor and are accessible to people who live there Equipment and adaptations are in place for people with restricted mobility These include a passenger lift, grab rails and lifting appliances Staffing is provided throughout the day and night People do not have access to previous inspection reports Access to these reports should enable people to find out about the quality of service provided and peoples experiences of living there The fees charged for the service provided at The Priory was not made available to us The reader is advised to contact the service direct for this information Care Homes for Older People Page 3 of 14 What we found: The focus of inspections undertaken by the Care Quality Commission is based upon outcomes for people who use the service The inspection process considers the homes capacity to meet regulatory requirements, national minimum standards and aspects where the service requires further development This was an unannounced random inspection; the home did not know we were going to visit The inspection was undertaken in a day and involved discussions with staff, observations of care practices We looked at care records and also the property The reason for the visit was to find out what measures had be taken to comply with requirements made at the last inspection visit on 20 October 2009, and to see if outcomes for people who live there had improved We case tracked four people who live there This involves establishing individuals experiences of living in the care home by meeting them, observing the care they receive, discussing their care with staff, looking at care files, and focusing on outcomes Tracking peoples care helps we understand the experiences of people who use the service We looked at three care plans; these do not provide consistent information, so staff know how to meet peoples needs For example, discussions with two staff members confirm that various methods are used to assist a person to communicate but this information was not written in their care plan Both staff members acknowledged the absence of this information This person cannot be confident that all staff members will know how to meet their needs Information contained in another care plan tells staff about the equipment required to assist a person with their mobility However, one staff member said they never use this equipment and told us about other equipment they use We showed them this persons care plan and they confirm the information they shared with us was not written in the care plan The absence of vital written information in this care plan does not ensure this person will receive the appropriate assistance and could compromise the care they receive We looked at one care record, which shows the person had moved into the home in December 2009 This was also confirmed by staff spoken to We did not see a care plan in place, the care manager and deputy manager told us this person did not have one Discussions with two staff members showed a lack of understanding of this persons care needs This person was unable to tell us about the care they receive The absence of a care plan does not ensure all staff will know how to meet this persons needs properly and this could place them at risk of harm Care plans are not reviewed on regular basis to reflect peoples current needs One care plan had not been reviewed since October 2009 This means staff do not have access to up to date information to ensure they know how to assist people appropriately Both staff spoken to acknowledged this One staff member said this was because they have not had a manager for a while and there are insufficient nursing staff on duty to review peoples care needs Care Homes for Older People Page 4 of 14 There was no evidence to show people are involved in their care planning and this was also acknowledged by staff spoken to People cannot be confident they will receive a service the way they prefer or to reflect their specific needs We looked at systems and practices in place for the management of peoples prescribed medicines These are not robust to ensure people receive their medicines regularly or safely For example, the medication administration record [MAR] are not always signed to show if prescribed medicines have been administered We asked two staff members, who are responsible for the administration of medicines if one particular medicine had been given out They said they did not know We saw prescribed medicines in storage for one person; these were not shown on the MAR Two staff members spoken to were not able to confirm whether or not this person was receiving these medicines Discussions with staff confirm they were on week two of the medication cycle They told us that one particular medicine had been discontinued by the General Practitioner However, we saw that one dose for week three was missing Staff were unable to give an explanation for this Discussions with one staff member confirm that two people we case tracked are prescribed creams We asked what creams are in use, they said, I dont know I use what ever is in the bedroom This staff member also told us about a persons health condition and said, If they were my dog, I would put Vaseline on them This shows the lack of respect offered to people who live there We shared our concerns with the care manager Inadequate management of peoples prescribed medicines do not ensure they will receive their medicines as directed by their General Practitioner and could compromise their health We have made nine safeguarding referrals to Social Services A safeguarding referral is where there has been an allegation of abuse or where care practices may compromise peoples health or safety We have also issued a Code B Notice; this is where we have reason to believe that an offense has been commented under the Care Standards Act 2000 and where necessary we may take enforcement action A further unannounced random inspection was carried out on 10 February 2010, to see what action had been taken to improve the management of peoples medicines We found that practices were still poor and peoples health are still being placed at risk The care plans we looked at and discussions with staff members confirm that a number of people are on bed rest This should be reviewed and discussed with relevant healthcare professionals to ensure a suitable course of care, so people are not unnecessarily isolated in their bedrooms Care Homes for Older People Page 5 of 14 Discussions with staff members confirms that insufficient staffing levels are provided to ensure appropriate care planning or to support people to engage in their social interest or to enable them to maintain contact with their local community One staff member told us about a trip that took place approximately two years ago Discussions with another staff member confirm some staff will volunteer their time to take people to the local supermarket We observed some people engaging in music and movement activities in the dining room The home provides a service for people who have dementia The staff we spoke to did not have an awareness of appropriate activities or stimulation for people with this health condition The staff we spoke to did not view social activities and stimulation as an integral part of a persons needs This means people cannot be confident they will be provided with the relevant support to enable them to live fulfilled and stimulating lifestyle During our visit it was brought to our attention that a number of nurse call alarms are not working This means people are not able to call for assistance when needed An immediate requirement was issued This is to ensure immediate action is taken so all nurse call alarms are in working order by 09 February 2010 Action has now been taken to improve fire safety standards within the home An enforcement notice was issued by the Fire Safety Department in October 2009 This told them about things they need to do to improve fire safety systems, equipment and practices within a specific timescale This should ensure staff have the appropriate skills and access to necessary equipment so peoples safety is not compromised in the evident of a fire The Fire Safety Officer told us that an extension to the enforcement notice has been agreed to allow the home time to provide essential training for the use of fire safety equipment What the care home does well: What they could do better: To ensure staff have access to clear, informative and up to date care plans, so they know how to meet peoples needs To ensure that all staff who are responsible for the administration of medication receive appropriate training relating to the safe handling of medicines, so people can be confident staff have the skills to assist them with their medicines To ensure the management of prescribed medicines is robust, so people can be confident they will receive the support they need To ensure there are sufficient numbers of staff on duty, so people can be confident their Care Homes for Older People Page 6 of 14 care and social needs will be met To ensure that all staff receive regular on going fire safety awareness training, so people can be confident staff will have the skills to ensure their safety in the event of a fire To ensure all staff receive the appropriate training or guidance to recognise the importance of maintaining peoples dignity 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 2 Care Homes for Older People Page 7 of 14 Are there any outstanding requirements from the last inspection? Yes R No £ 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, Regulations 2001 and the National Minimum Standards No Standard Regulation Requirement Timescale for action 1 7 12 Action must be taken to 07/12/2009 ensure that information relating to Do not resuscitate [DNR] is supported by the relevant authorised documents from a medical consultant or removed This should ensure people are given the relevant nursing intervention if and when needed 2 7 15 Measures must be taken to 23/12/2009 ensure staff have access to clear, informative care plans This should ensure staff know how meet peoples needs properly 3 9 13 The necessary measures should be taken to ensure a written protocol is in place for the use of When Required medicines This should ensure staff know when and how to administer these medicines properly 07/12/2009 4 9 13 The appropriate measures must be taken to ensure medication administration records are completed 07/12/2009 Care Homes for Older People Page 8 of 14 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, Regulations 2001 and the National Minimum Standards No Standard Regulation Requirement Timescale for action accurately This should ensure people receive their medicines safely 5 12 16 The necessary measures should be taken to ensure people are appropriately supported enabling them to pursue their chosen social interests This should ensure all people live a fulfilled and stimulating lifestyle 6 16 22 Action must be taken to 04/01/2010 ensure people have access to a complaint procedure in a format they understand This should ensure people know how to share their concerns 7 19 23 The appropriate action must 30/11/2009 be taken to ensure all clutter in the corridor that pose a tripping hazard and compromise the means of escape in the event of fire are removed This should promote safety standards within the home 8 19 23 Action must be taken to ensure all fire doors are in working order This should allow staff sufficient time to evacuate the premises in the event of Care Homes for Older People Page 9 of 14 30/12/2009 26/01/2010 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, Regulations 2001 and the National Minimum Standards No Standard Regulation Requirement Timescale for action a fire 9 19 23 The necessary measures must be taken to ensure the driveway is repaired and maintained This should reduce the risk of falls and damage to peoples vehicles 10 22 23 The necessary measures 29/01/2010 need to be taken to ensure people are provided with relevant equipment or adaptations that are safe and meet their needs This should support peoples independence and safety 11 27 18 The necessary action must 30/11/2009 be taken to ensure sufficient staffing levels are provided throughout the day and night This should ensure people are appropriately supported and their needs met properly 12 33 26 The necessary action must be taken to ensure monthly quality assurance visits are carried out This should ensure the service provided meets peoples needs 13 37 12 Action must be taken to ensure furnishings disposed of outside the building are removed 18/12/2009 30/12/2009 31/03/2010 Care Homes for Older People Page 10 of 14 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, Regulations 2001 and the National Minimum Standards No Standard Regulation Requirement Timescale for action This should ensure people are not placed at risk of harm 14 38 13 The necessary measures 30/11/2009 must be taken to ensure any windows that may place people at risk are fitted with an appropriate restrictor This should ensure peoples safety 15 38 23 Measures must be taken to ensure the practice of wedging fire doors open stops This should promote fire safety standards within the home 16 38 12 Action must be taken to ensure all wardrobes are secured to the wall or a written risk assessment put in place that show control measures to reduce the risk to people This should ensure people are not placed at risk of injury 17 38 13 The appropriate measures must be taken to ensure all chemicals are securely stored [An immediate requirement was issued on the day of the inspection] This should ensure people are not placed at risk of Care Homes for Older People Page 11 of 14 30/11/2009 18/12/2009 14/11/2009 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, Regulations 2001 and the National Minimum Standards No Standard Regulation Requirement Timescale for action harm 18 38 23 Action must be taken to 26/01/2010 ensure all deficiencies shown in the homes fire risk assessment dated March 2007 are addressed and also comply with the Enforcement Notice issued by the Fire Safety Department This should enhance fire safety systems in the home Care Homes for Older People Page 12 of 14 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, 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 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 Care Homes for Older People Page 13 of 14 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000 Copies of the National Minimum Standards –Care Homes for Older People can be found at www dh gov uk or got 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 Helpline: Telephone: 03000 616161 Email: 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