Inspection on 22/09/05 for The Priory Grange Potters Bar

This inspection was carried out on 22nd September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 16 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Priory Grange Potters Bar 30/04/07

The Priory Grange Potters Bar 09/06/06

The Priory Grange Potters Bar 25/05/05

The Priory Grange Potters Bar 20/12/04

Similar services:

Claremont House

Sun Court Nursing Home

Bramley Avenue (73)

15 Bramble Close

Dolphin Court

Fen Road

Wakes Hall

165 Putnoe Lane

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

CARE HOME ADULTS 18-65 The Priory Grange Potters Bar 190 Barnet Road Potters Bar Hertfordshire EN6 2SE Lead Inspector Marian Byrne Unannounced Inspection 10:00 22 September & 20 October 2005 th th The Priory Grange Potters Bar DS0000062368.V264473.R01.S.doc Version 5.0 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 The Priory Grange Potters Bar DS0000062368.V264473.R01.S.doc Version 5.0 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 Adults 18-65. 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. The Priory Grange Potters Bar DS0000062368.V264473.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Priory Grange Potters Bar Address 190 Barnet Road Potters Bar Hertfordshire EN6 2SE 01707 858585 01707 850607 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) Brookdale Healthcare (Potters Bar) Limited Christina Wallis Care Home 82 Category(ies) of Physical disability (82) registration, with number of places The Priory Grange Potters Bar DS0000062368.V264473.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The variation will revert to 81 service users when either named service user leaves the home, or stop sharing the bedroom. The home must inform the CSCI of any changes. There are currently 6 service users over the age of 65 who were admitted when the home was registered for Older People. This number must be reduced when a service user moves on with no further admission of service users under the OP category. 25th May 2005 Date of last inspection Brief Description of the Service: Priory Grange is a care home providing nursing care for 82 people with a physical disability. It is owned and managed by The Priory. The home is located in Potters Bar, set back from the main Potters Bar to Barnet Road and is close to the High Street shops, pubs and other amenities. The home was opened in 1995 and consists of a threestorey building with a newer purpose build extension (Hadley Unit). All the homes bedrooms are single accommodation with en-suite facilities. There are passenger lifts in both Units. The grounds are easily accessible. The Priory Grange Potters Bar DS0000062368.V264473.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was not a positive inspection. This inspection was carried out over two days (20 hours in total) by four inspectors on each occasion. On the first date the inspectors, inspected the entire home and on the second date the inspectors concentrated on the part of the home known as the ‘Hadley Unit’. The home is registered to offer residential care with nursing to adults with a physical disability. The home is divided into four areas and provides care to 82 service users. The service users in an area of the home known as ‘Hadley Unit’ were deprived of their liberty by staff locking all the exit doors and only staff having electronic keys to gain access and exit. Within the unit service users are further barred from access to the kitchen units. The home’s Statement of Purpose does not make reference to this ‘locked’ facility and it further states the ethos and core values of the home are ‘breaking down barriers and promoting independence, we value open mindedness, flexibility and a non-judgmental approach to service users and staff, we aim to support and empower service users to make informed decisions and to take calculated risk’ (see the home’s Statement of Purpose of the home for full details). This was not in evidence in that part of the home. When the care plans of the service users in that area of the home were inspected there was no reason recorded for this action nor could any of the staff questioned could give an explanation for this course of action. The kitchens within this area had a notice saying ‘no unauthorised entry’. One service user told an inspector that he was very angry about being locked in without his permission. There was no indication in the unit that this was the service user’s home. The area had an intuitional air about it. Staff referred to the area as a ward. No staff present at the second day of the inspection had mental health, restraint or challenging behaviour training. However it was noted that a care plan inspected indicated that restraint should be used in certain circumstances. The care plans were bulky and heavy and the inspectors found them difficult to work with, they contained a great deal of historical information that may no longer be relevant. When asked the staff were unable to say what they contained. One service user’s room was devoid of any furniture, clothes, personal items or any form of soft furnishings. The inspector checked the care plan to see if there was any indication as to why this service user had to live in such Spartan conditions and contrary to the Care standards Act 2000. There was not such information. Such was the condition of his room the inspector took photographs. The service user himself had what appeared to be untreated sores on his feet again there was no information available as to why his feet went untreated. Other rooms had broken furniture in them. One service user who is unable to move or get out of bed had his television placed in a position where he could not see it. Elsewhere in the home one service user gave a complaint to the inspector that she got typed, and this indicated that she was unhappy with her level of care. The Priory Grange Potters Bar DS0000062368.V264473.R01.S.doc Version 5.0 Page 6 The inspector gave this information to the Registered Manager to investigate. There was a positive response from some service users in parts of the home and inspectors received good feedback on their care. The service users’ care plans reflected their care needs. A recently admitted service user had no preadmission assessment, despite the fact that staff from the Priory had provided his care at another home until a bed was free for him. Another service user had his privacy and dignity compromised due to him having his personal care delivered on his bed without curtains or blinds. A public pathway ran outside his window. He informed the inspector that he was very unhappy about this. The Priory group of companies took over the management of this home in April 2005. They have an understanding of the problems and have undertaken a plan of action to meet the requirements. What the service does well: What has improved since the last inspection? What they could do better: The home must improve the care of the service users. The home lacks cohesion and clear management. There appears to be different work practices within the home. As already stated this home is registered for service users with a physical disability (nursing) the Registered Manager must review the care practices within the home where service users are deprived of their freedoms. Care plans must be reviewed. The environment must reflect the fact that this is the service user’s home. Service users should have their independence enhanced and they must be consulted on their care and their life within the home. The management of the home must be reviewed and it must The Priory Grange Potters Bar DS0000062368.V264473.R01.S.doc Version 5.0 Page 7 be demonstrated that there is an understanding of the Care Standards Act 2000 and the home’s responsibility within this. 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. The Priory Grange Potters Bar DS0000062368.V264473.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Priory Grange Potters Bar DS0000062368.V264473.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected. EVIDENCE: The Priory Grange Potters Bar DS0000062368.V264473.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9. The home does not meet the needs or offer choices to all its service users. EVIDENCE: There was no evidence of personal goals in the care plans inspected. None of the care plans inspected contained any evidence of service uses involvement. The kitchens in one area of the home were locked to prevent unauthorised entry. Evidence of service users being supported to take risks as part of an independent lifestyle were limited and in some cases non-existent. The Priory Grange Potters Bar DS0000062368.V264473.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,16. Some of the service users had their lifestyle curtailed by having their liberty taken from them through the use of locked doors. EVIDENCE: Care plans inspected did not contain any details of activities one activity was listed as a trip to Tesco which had taken place in August 2005. Watching television and listening to music was also listed. Service users in one area of the home were deprived of their liberty through the use of locked doors. The Priory Grange Potters Bar DS0000062368.V264473.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18. Service users do not receive personal support in a way they maintains their dignity and privacy. EVIDENCE: Dignity and privacy must be preserved one service user told the inspectors of his dissatisfaction of his personal care being delivered on his bed in full view of passers by as his curtains and blinds were broken. The broken blinds were clearly visible to the inspectors. Other areas of the home had no curtains. The Priory Grange Potters Bar DS0000062368.V264473.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected. EVIDENCE: The Priory Grange Potters Bar DS0000062368.V264473.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,26. Service users do not live in a homely, comfortable way. EVIDENCE: One service user’s room was devoid of any furniture, clothes, personal items or any form of soft furnishings. The inspector checked the care plan to see if there was any indication as to why this service user had to live in such unacceptable conditions and contrary to the Care standards Act 2000. There was not such information. Such was the condition of his room the inspector took photographs. The inspectors found broken furniture, wardrobes without doors, one service user’s window did not have blinds or curtains that work other windows in the home did not have curtains. Staff referred to the area as a ward. The ‘Hadley’ area of the home had an institutional atmosphere. The carpet in the smoking room downstairs was stained and badly burned, as was the small table in the same room. The Priory Grange Potters Bar DS0000062368.V264473.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected. EVIDENCE: While these standards were not inspected it was noted that the staff on duty were very busy. The Priory Grange Potters Bar DS0000062368.V264473.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected. EVIDENCE: While these standards were not inspected it was clear from the inspection that the home lacked clear management, leadership and cohesion. The Priory Grange Potters Bar DS0000062368.V264473.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 1 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 1 X 1 X X X X LIFESTYLES Standard No Score 11 1 12 1 13 1 14 1 15 1 16 1 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Priory Grange Potters Bar Score 1 X X x Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000062368.V264473.R01.S.doc Version 5.0 Page 18 YES Are there any outstanding requirements from the last inspection? 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 YA7 Regulation 15(2)(b) 12(2) Requirement Timescale for action 25/05/05 2 YA14YA12 15 3 YA10 12(4) 4 YA20 13 The Registered Managaer must ensure that care plans reflect the needs of service users and that they are reviewed regularly or when there is a change in circumstances. The service user or their representative must be involved in this process where possible. This requirement was left at the last inspection and was not met at this inspection. The Registered manager must 31/07/05 ensure care plans contain enough detail to maximum choice and to establish whether a service users social, cultural and needs are being met. This requirement was left at the last inspection and was not met at this inspection. The Registered Manager must 25/05/05 ensure the dignity and privicy of service users is preserved at all times. This requirement was left at the last inspection and was not met at this inspection. The Registered manager must 25/05/05 ensure that the administration DS0000062368.V264473.R01.S.doc Version 5.0 The Priory Grange Potters Bar Page 19 5 YA17 22 6 YA18 12, 13 7 YA30 19 8 YA26YA24 23(2)(a)& (d) 9 YA8 12(3) 10 YA11 12 11 YA12 12(1) 12 YA13 12 of medication is recorded appropriately.This requirement was not inspected. The Registered manager must ensure all complaints, the investigation of the complaint and the out come are recorded.This requirement was not inspected. The Registered manager must ensure that service users are protected from all types of abuse. That control of their own lives is not comprimised in any way without full assessments by qualified health care staff. This must be fully documented in care plans with the input of service users or their representatives. The Registered manager must ensure that service users are protected through the use of a robust recruitment system.This requirement was not inspected. The environement in the home must be clean and domestic in style. Bedrooms must be decorated and contain items of furniture as set out in the Care Standard Act 2000. The Registered Manager must ensure that all service users are consulted on the running of the home. The Registered Manager must ensure that all service users have access to facilites to enable self development. The Registered Manager must endure that all service users take part in age, peer and culturally appropriate activities. The Registered Manager must ensure that all service users where possible are part of the local community. DS0000062368.V264473.R01.S.doc 25/05/05 30/11/05 25/05/05 20/10/05 20/10/05 20/10/05 20/10/05 20/10/05 The Priory Grange Potters Bar Version 5.0 Page 20 13 YA14 12 14 YA1616 12 The Registered Manger must ensure that all service users have access to appropriate leisure activities. The Registered Manager must ensure that service users rights are respected and that the daily routines of the home promote independence, individual choice and freedom of movement. 20/10/05 20/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Priory Grange Potters Bar DS0000062368.V264473.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 The Priory Grange Potters Bar DS0000062368.V264473.R01.S.doc Version 5.0 Page 22 - 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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