Inspection on 25/05/05 for The Priory Grange Potters Bar

This inspection was carried out on 25th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

The Priory Grange Potters Bar 30/04/07

The Priory Grange Potters Bar 09/06/06

The Priory Grange Potters Bar 22/09/05

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 HOMES FOR OLDER PEOPLE Priory Grange 190 Barnet Road Potters Bar Hertfordshire EN6 2SE Lead Inspector Marian Byrne Unannounced 25th May 2005 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 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 Grange I52 S62368 Priory Grange V229604 250505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Priory Grange Address 190 Barnet Road, Potters Bar, Hertfordshire, EN6 2SE Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01707 858585 01707 858080 christinawallis@prioryhealcare.com Brookdale Healthcare (Potters Bar) Ltd Christina Wallis Care Home with Nursing 82 82 Category(ies) of PD Physical Disability registration, with number of places Priory Grange I52 S62368 Priory Grange V229604 250505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Variation will revert to 81 service users when either named service users leaves the home or stop sharing the bedroom. 2. The home must inform CSCI of any changes. 3. 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. Date of last inspection 20/12/2004 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 Brookdale Health Care. 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 three-storey 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. Priory Grange I52 S62368 Priory Grange V229604 250505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on 25 May 2005. The inspection was carried out by two inspectors it started at 11.00 hours and finished at 20.00 hours. It was in response to concerns about the Protection of Vulnerable Adults in the home. There had been allegations that warranted Police intervention. These investigations have not been completed by the Police. The Home is cooperating fully with the Police investigations. The ownership of the home had changed since the last inspection it is now owned by Priory Group Limited. The home is managed in units - ground floor, middle floor, top floor and the Hadley unit. The middle floor was not inspected in this inspection. Not all rooms were personalised some were very bare and had not being made homely. Given the size of the size of the home extreme care must be taken to ensure that the home is seen to be homely and that the staff are aware that they are working in other people’s home. This was not always apparent throughout the duration of the inspection. The management of the home needs to be vigilant to ensure that an atmosphere similar to that of a large institution does not present itself in the home. The service users who were able to express an opinion, said they were happy with the care they get. Visitors endorsed this and added that they would like to be more involved with reviewing care plans. The home was clean and odour free. One service user’s clothes were stained. One care plan contained confidential banking information of a service user. This information was not protected. What the service does well: There was very positive feedback from service users and visitors. On the day of the inspection the home had a b-b-q lunch in the grounds of the home to celebrate the birthday of one of the service users, the celebrations included an impressive diabetic cake. The service users present appeared to enjoy themselves. There is an extensive breakfast menu available. Thorough assessments are in place. In the main the inspectors observed good interaction between service users and the staff. The management of the home are keen to address all issues raised and to work with the CSCI to ensure all the standards set out in this report are being met. The Registered Manager is very positive and wants to work with this Commission to improve the standards in the home. Priory Grange I52 S62368 Priory Grange V229604 250505 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? 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 Grange I52 S62368 Priory Grange V229604 250505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Priory Grange I52 S62368 Priory Grange V229604 250505 Stage 4.doc Version 1.30 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 standard(s) These standards were not inspected. EVIDENCE: Priory Grange I52 S62368 Priory Grange V229604 250505 Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10 Care plans contained some good information on care but were not reviewed regularly and therefore were not reflecting the care service users were receiving. Service users and their representative did not have any input into the care plans. In the main service users health and personal care needs were met. Care must be taken with the recording of the administration of medication. The home needs to take more care to ensure that service users are treated with dignity at all times. The home lacked a homely atmosphere. EVIDENCE: Care plans contained some good detail on care but had not being reviewed. This could mean that the information in the care plan is no longer relevant to the service user or their care. One visitor spoken with indicated that she would very much like to be involved in her daughter’s review and stated that she often wonders what her daughter does in the home when she is not there. She said she was always kept informed if any adverse incidents occurred but didn’t get to hear about the good things that may have happened. This left her with an imbalanced view of her daughter’s life. When staff are dealing with service users who have little or no communication ability it is imperative that as much information is known by staff about the individual as possible so that their social needs are being met. The care plans do not contain enough/any Priory Grange I52 S62368 Priory Grange V229604 250505 Stage 4.doc Version 1.30 Page 10 personal information. A requirement was left at the last inspection requiring that medication must be administered as prescribed, if this was not possible then any omissions must be recorded. This requirement has not being met. There were gaps on the mediation administration records (MAR). The reasons for these were not recorded. This means that the medication could have been given and not recorded or that it was offered and refused. This could have a negative impact on the health of service users. Two female service users had hairstyles that could be associated with small girls. These two service users were in middle age and had been held down professional careers. They could not approve or disapprove of their hairstyles. This detracted from their dignity. Another member of staff when asked by a service user if he had a ‘light’ the member of staff said yes and walked away. This showed a lack of respect to and understanding of the service users’ needs. Some service users who were unable to dress themselves were wearing soiled clothing. Staff were observed to put on protective clothing in the corridor before entering a service users’ room. To preserve dignity protective clothing should be put on discreetly in the service users’ room. Some service users had large supplies of ‘nursing supplies’ in their rooms, leaving them little space and an unpleasant outlook. Priory Grange I52 S62368 Priory Grange V229604 250505 Stage 4.doc Version 1.30 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 standard(s) 12,13,14,15 The home does not have enough information on service users to determine if their social, cultural, recreational and religious needs are being met. The home welcomes visitors. The service users are offered a varied diet of good quality food. EVIDENCE: There was a steady stream of visitors in the home throughout the inspection. The inspector observed them being made welcome and being offered refreshments. Visitors spoken with confirmed that they were always made welcome and could visit at any time. One service user regularly has food delivered from local take away restaurants. Service users can have their own telephone lines. Many do and use IT facilities to stay in touch with events local, national and international. One service user attends the local Multiple Scolorsis Society on a daily bases where she has access to alternative therapies. This enhances the quality of her life. On the day of the inspection the home had a b-b-q lunch to celebrate the birthday of a service user. Service users appeared to enjoy themselves and the food where tasted was of good quality, good taste and appearance. There is a menu for breakfast, lunch and evening meal offering choices to service users. The chef stated that he had an adequate budget to provide meals for the service users. He had made a diabetic chocolate cake for the birthday celebrant, this looked and tasted very good. The birthday ‘boy’ declared himself very happy with his celebrations. As Priory Grange I52 S62368 Priory Grange V229604 250505 Stage 4.doc Version 1.30 Page 12 mentioned in the previous section the information kept on service users is not sufficient to determine if they are helped to exercise control over their lives. Priory Grange I52 S62368 Priory Grange V229604 250505 Stage 4.doc Version 1.30 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 standard(s) 16,18 The home does not keep adequate records to show it investigates complaints thoroughly. The home does not adequately protect service users from abuse. EVIDENCE: This inspection was conducted in response to alleged incidents of abuse to service users by staff. The police are currently investigating these incidents. The home is co-operating fully with the police and one member of staff has been suspended and is undergoing disciplinary proceedings. On the day of the inspection one service user told the inspector that she was unhappy with a member of staff and had made a complaint about her. The inspector attempted to follow a paper trail to establish how the complaint had been investigated. There was no evidence that the complaint had been taken seriously or was investigated. One care plan held the details of a service users bank account including the number of his debit cards. This confidential information was available to a range of people who could have used it or misappropriated his funds. Priory Grange I52 S62368 Priory Grange V229604 250505 Stage 4.doc Version 1.30 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 standard(s) 23,24,25,26. These standards were not inspected. EVIDENCE: Priory Grange I52 S62368 Priory Grange V229604 250505 Stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 The recruitments practices are not robust enough to ensure the protection of the service users. EVIDENCE: Priory Grange I52 S62368 Priory Grange V229604 250505 Stage 4.doc Version 1.30 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 The health and safety of service user is compromised through the use of door wedges and not disposing ‘sharps’ (used injections) appropriately. EVIDENCE: There was evidence that fire doors were being kept open by the use of door wedges. Used injections ‘sharps’ were being stored in appropriate boxes but were being left in unlocked rooms. Infection control was being compromised through staff wearing personal care gloves in the corridor. While these standards were not inspected individually the Registered Manager presented herself and some one who was very keen to work with this Commission and other Statutory Bodies to improve the care at the home. Given the size of the home and problems presented the Registered Manager will need to be well supported by her new Employers. Priory Grange I52 S62368 Priory Grange V229604 250505 Stage 4.doc Version 1.30 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score N/A N/A N/A N/A N/A N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 N/A DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION N/A N/A N/A N/A N/A N/A N/A N/A STAFFING Standard No Score 27 N/A 28 N/A 29 N/A 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 1 N/A 2 N/A N/A N/A N/A N/A N/A N/A 2 Priory Grange I52 S62368 Priory Grange V229604 250505 Stage 4.doc Version 1.30 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 7&8 Regulation 15 (2) (b) 12 (2) Timescale for action The Registered Manager must Henceforth ensure that care plans reflect the and needs of service users and that ongoing 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. The Registered manager must Henceforth ensure that the dignity of and ongong service uses is be maintained at all times The Registered manager must Henceforth ensure that the administration and of medication is recorded ongoing appropriately. 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. The Registered manager must ensure all complaints, the investigation of the complaint and the out come are recorded. The Registered manager must Henceforth ensure that service users are and protected from all types of ongoing abuse. Version 1.30 Page 19 Requirement 2. 10 12(4) (a) & (b) 13(2) 3. 9 4. 12 & 14 16(2)(n)& (m) 5. 17 22(3) 6. 18 13(6) Priory Grange I52 S62368 Priory Grange V229604 250505 Stage 4.doc 7. 30 8. 38 17(2) Schedule (4) and 19(1) Schedule 2 13 (3)&(4) The Registered manager must ensur that service users are protected through the use of a robust recruitment system. The Registered Manager must ensure that risks to service users are removed by ensuring sharps are stored in a locked area and that the use of door wedges ceases. Henceforth and ongoing Henceforth and ongoing, 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. Refer to Standard Good Practice Recommendations Priory Grange I52 S62368 Priory Grange V229604 250505 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 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 Priory Grange I52 S62368 Priory Grange V229604 250505 Stage 4.doc Version 1.30 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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