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Inspection on 09/06/06 for The Priory Grange Potters Bar

Also see our care home review for The Priory Grange Potters Bar for more information

This inspection was carried out on 9th June 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service has managed change and service improvements in a very limited period. All the requirements from the last inspection had been met. Staff training is compulsory and timescales have been introduced to ensure staff have completed their taining.

What has improved since the last inspection?

A new manager has been appointed and the turnabout in the care provision in the home has been exceptionally competent. Almost every aspect of service delivery has improved. Service users are no longer restricted to `their` area of the home. These service users are happier and informed the inspectors that they had `been released`. One was in reception meeting and greeting visitors where previously he was very angry and non-communicative. All areas that were locked have been opened. On previous inspections service users were not allowed into their kitchens to make drinks or get a snacks. Service users in one area of the home were baking cakes. The reception area is more welcoming and security at the front of the home has also improved.

CARE HOME ADULTS 18-65 The Priory Grange Potters Bar 190 Barnet Road Potters Bar Hertfordshire EN6 2SE Lead Inspector Marian Byrne Key Unannounced Inspection 9 & 29th June 2006 10:00 th The Priory Grange Potters Bar DS0000062368.V298975.R01.S.doc Version 5.2 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.V298975.R01.S.doc Version 5.2 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.V298975.R01.S.doc Version 5.2 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) Priory Group Limited Christina Wallis Care Home 82 Category(ies) of Physical disability (82) registration, with number of places The Priory Grange Potters Bar DS0000062368.V298975.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered numbers are increased by one to enable two service users to share a bedroom. 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. 20th October 2005 2. 3. 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 Group. 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. The Priory Grange Potters Bar DS0000062368.V298975.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over two days by two inspectors. This was a very positive inspection. Care outcomes in the home had changed positively almost beyond recognition. All service users now have free access to all parts of the home and are free to leave the home should they wish (subject to a risk assessment). It was very positive to see one of the service users from that part of the home which previously had restricted access in reception greeting visitors. The Management and staff of the home are to be congratulated on their hard work in changing this home from one where the home appeared to run to the staffs’ criteria to one where the service users are at the heart of service delivery. There was a very calm but lively atmosphere in the home. All service users appeared to be occupied in a constructive manner. What the service does well: 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. The Priory Grange Potters Bar DS0000062368.V298975.R01.S.doc Version 5.2 Page 6 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.V298975.R01.S.doc Version 5.2 Page 7 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): 2 Service users individual aspirations and needs are assessed. EVIDENCE: Four care plans were inspected and contained evidence to indicate that service users aspirations and needs are met. Service users spoken with also informed the inspectors that every effort is made to ensure needs and wishes are met. Quality in this outcome is good; this judgement has been made using available evidence including a visit to this service. The Priory Grange Potters Bar DS0000062368.V298975.R01.S.doc Version 5.2 Page 8 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 & 9 Care plans are detailed and service users are involved in all aspects of planning their lives. Service users are supported to take risks. EVIDENCE: New care plans have been drawn up, these are user friendly and give good detail on how service users wish to live their lives. Where possible the care plan is drawn up with the service users. The unit that was traditionally ‘locked’ has now been open and service users have free access to all aspects of the home. This is much appreciated by the service users in question, two service user mentioned to the inspectors that they had been ‘released’. One of the service users who was considered most at risk through having freedom to come and go as he pleased was in reception meeting and greeting visitors and staff. He appeared to be very happy and his anger was not apparent. Staff informed the inspectors that they were planning on taking him on holiday this year. Quality in this outcome is good; this judgement has been made using available evidence including a visit to this service. The Priory Grange Potters Bar DS0000062368.V298975.R01.S.doc Version 5.2 Page 9 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): 12,13,15,16,17. Service users are supported in appropriate activities, service users have access to the local amenities, appropriate relationships are supported, service users are treated with respect. The food was extremely good. EVIDENCE: Written evidence and conversations with service users indicated that service users were treated with respect and dignity. Staff were observed to interact very positively with service users. Staff endeavour to meet needs in relation to interests and activities both in the home and in the local community. /service users use the local pubs and clubs. The inspectors had lunch in the home in the dining room with the service users all were observed to enjoy their meal there was very little wasted food and the food served to the inspectors was exceptionally good. Quality in this outcome is good; this judgement has been made using available evidence including a visit to this service. The Priory Grange Potters Bar DS0000062368.V298975.R01.S.doc Version 5.2 Page 10 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): 18,19 & 20 Service users are supported in an appropriate manner. Care is taken to ensure service users emotional and physical health needs are met. Medication was administered and stored appropriately. EVIDENCE: Care plans where inspected that service users have their physical and emotional health met. They are included in the drawing up of their care plans and are consulted on how they want their care administered. Service users spoken with assured the inspectors that they were consulted on all aspects of their care. The medication was administered and stored appropriately. Quality in this outcome is good; this judgement has been made using available evidence including a visit to this service. The Priory Grange Potters Bar DS0000062368.V298975.R01.S.doc Version 5.2 Page 11 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): 22 & 23 Service users are listened to and their views are acted on. Service users are protected from abuse, neglect and self harm. EVIDENCE: Service users now feel that they are listened to and evidence showed that they are protected from abuse. The home follows Hertfordshire Social Services’ Department guideline on the protection of vulnerable adults. Staff spoken with were aware of the whistle blowing policy. The home has followed the Adult Protection policy in the past. Quality in this outcome is good; this judgement has been made using available evidence including a visit to this service. The Priory Grange Potters Bar DS0000062368.V298975.R01.S.doc Version 5.2 Page 12 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 & 30 The home was clean and hygienic, it is comfortable, homely and safe. EVIDENCE: The home is large and every effort is made to ensure it is as homely as possible. New furniture has been provided since the last inspection and service users who previously were not happy with their rooms informed the inspectors that their rooms are now good. The home was clean and hygienic throughout. Quality in this outcome is good; this judgement has been made using available evidence including a visit to this service. The Priory Grange Potters Bar DS0000062368.V298975.R01.S.doc Version 5.2 Page 13 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): 32, 34 & 35 Staff are qualified and competent they are well supported and supervised. The home has robust recruitment policies and practices. EVIDENCE: Records inspected indicate that all the appropriate safeguards are in place when recruiting staff. These include two references and a Criminal Records Bureau check. Training is made available to all staff and they are given time scales to complete training. Training provided is appropriate to the staffing group to enable they to deliver the best possible care to service users. The home has undergone a programme of change in a very limited timeframe the result of this is that the staff are now more focused and the service now has the service users best interests at its core. Quality in this outcome is good; this judgement has been made using available evidence including a visit to this service. The Priory Grange Potters Bar DS0000062368.V298975.R01.S.doc Version 5.2 Page 14 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): 37,38,39,42. The home is very well run with the best interests of service users underpinning all aspects of the home. The new Manager shows leadership and strong management. The health and safety of service users is paramount. EVIDENCE: A new manager has been appointed since the last inspection. She has yet to be registered. She has brought about an immense change in the home in a very short time. Service users are now assisted and supported in all aspects of their lives including risk taking in the pursuit of meeting their wishes, desires and needs. It is now clearly run in best interests of the service users. The home now has a happy relaxed atmosphere where both service users and staff can flourish. The staff and service users spoke very highly of the new manager and those spoken with were very supportive of the work she has done and the changes she has achieved. Quality in this outcome is good; this judgement has been made using available evidence including a visit to this service. The Priory Grange Potters Bar DS0000062368.V298975.R01.S.doc Version 5.2 Page 15 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 Standard No Score 1 x 2 X 3 3 4 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 3 X X 3 x The Priory Grange Potters Bar DS0000062368.V298975.R01.S.doc Version 5.2 Page 16 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. Standard Regulation Requirement Timescale for action 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.V298975.R01.S.doc Version 5.2 Page 17 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. 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