Inspection on 07/11/08 for The Priory Home

This inspection was carried out on 7th November 2008.

CSCI found this care home to be providing an Good service.

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.

Other inspections for this house

The Priory Home 29/05/08

The Priory Home 04/12/07

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Priory Home 26-28 Priory Avenue Hastings East Sussex TN34 1UG     The quality rating for this care home is:   two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alexis Reilly     Date: 0 7 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: The Priory Home 26-28 Priory Avenue Hastings East Sussex TN34 1UG 01424436792 Telephone number: Fax number: Email address: Provider web address: bmsaumtally@hotmail.co.uk Name of registered provider(s): Name of registered manager (if applicable) Mr Bhaye Saumtally Type of registration: Number of places registered: The Priory Residential Ltd care home 17 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: Service users must be aged between eighteen (18) and sixty-five (65) years on admission. Service users will have a past or present mental illness. The maximum number of service users to be accommodated is seventeen (17). Date of last inspection Brief description of the care home The Priory is registered to provide accommodation for up to 17 people suffering from mental health issues and admits people with medium to high dependency needs. The premise was originally two detached properties, is situated in Hastings, and has only single rooms, (all with wash hand basin) these are located on the ground, first and second floors. The building has undergoing refurbishment work. Residents have the use of a large lounge on the ground floor, a smoking area and three dining areas. There is a large rear garden with lawn areas for residents to enjoy. The home is in a residential part of Hastings within easy walking distance of the town centre. Short stay Care Homes for Adults (18-65 years) Page 4 of 27 17 Over 65 0 Brief description of the care home car parking is available in the street outside. The Priory is not registered or suitable for those with mobility problems. Fees charged by the service range from £355 - £500 per week. Inspection reports and other information such as Statement of Purpose are made available by the service on request. In June 2006 the home became a company following a successful registration process. This resulted in change of service number and change of name from the Priory residential home to the Priory home. The manager who is also the owner of the home remains unchanged. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The inspection began at 9.30am and finished at 1.30pm. The inspector saw the residents briefly in the morning and spent time with all three residents who were part of the case tracking; however one of these was distracted due to the presenting symptoms of their illness. The inspector case tracked three residents, examining the new person centred care plans and the associated documents such as risk assessments and the activities plan for these individuals. Other documents examined were copies of notifications, accidents and appointments, evidence of external reviews, the record of complaints and the complaints procedure. Staff recruitment files and staff induction training sheets were also examined. A brief environmental tour was carried out of the work which had been done since the last inspection in May 2008. The inspector spent time with the Registered Manager and gained views about the service from Care Homes for Adults (18-65 years) Page 6 of 27 professionals in the community, their comments are included in the report. Information was also taken from the AQAA which was comprehensively filled in and returned by the due date. What the care home does well: What has improved since the last inspection? What they could do better: 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 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has had no new admissions recently. However the Registered Manager has formulated a comprehensive assessment document which would be used to ascertain a persons suitability for the service. Evidence was supporting to suggest that the Registered Manager has in the past always obtained assessment documents such as mental health assessments from the community mental health team and also CPA documentation. Evidence: As part of the inspection the inspector case tracked three residents in the home and spent time with them. As part of the case tracking the inspector examined the new person centred care plans and the associated documents such as risk assessments and the activities plan for these individuals, also evidenced were the external reviews from the community mental health team to ascertain if the needs identified in the assessment are used as a basis for a comprehensive care plan. The Priory Residential home has had no new admissions, however in discussion with the Registered Manager they were able to evidence that they have a comprehensive assessment document in Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: place which would be used to assess someone referred to the service. Also available to view was collated information with regard to other service users in the home, and their referring documents. This highlighted that the Registered Manager obtains background information and up to date CPA and mental health assessments prior to offering a place in the service. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have care plans in place which are person centred and are clear documents to work from. Residents have being involved in the development of their care plan. Risk assessments are detailed and clear. Residents are able to make their own choices and decisions, and are treated as individuals, however this is balanced within the basis of their risk assessments and the restrictions which have been agreed on their care plans. Contact with advocacy services is promoted. Evidence: As part of the inspection the inspector case tracked three residents in the home and spent time with them. As part of the case tracking the inspector examined the new person centred care plans and the associated documents such as risk assessments and the activities plan for these individuals, also evidenced were the external reviews from the community mental health team this helped the inspector to ascertain if the needs identified in the assessment are used by the Registered Manager as the basis for a comprehensive care plan. Other documents examined were copies of notifications, and Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: accidents and appointments. The inspector spent time with the Registered Manager and gained views about the services from professionals in the community, and also comments from service users these are included in the report. Care plans are now person centred in an easy to access booklet style format and contain clear, relevant information. Risk assessments are comprehensive and detailed, with guidance included specifically for dealing with individuals behaviour. All care plans in the service had been reviewed by the community mental health team, and by a community GP. Restrictions are evident in some of the care plans. However these had been agreed with the individual and had also been agreed by the CMHT following individual reviews. The service user, a representative from the CMHT and the GP had all signed and agreed each care plan. Contact with advocacy services is promoted and posters are displayed on the notice board of the home. The inspector had a discussion with the Registered Manager in relation to one particular service user and a historical event, it was agreed that the risk assessment would be updated to reflect this information, and a policy introduced into the home in relation to this incident. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents do benefit from regular and planned activities. Residents benefit from freedoms and flexible routines, and generally enjoy the food. Residents are consulted and listened to regarding the choice of daily activity. However continued work needs to be done on encouraging residents to become involved in the activities on offer both within the home and the community. Evidence: As part of the inspection the inspector case tracked three residents in the home and spent time with them. As part of the case tracking the inspector examined the new person centred care plans and the associated documents such as risk assessments and the activities plan for these individuals, also evidenced were the external reviews from the community mental health team. Other documents examined were copies of notifications, and accidents and appointments, evidence of external reviews, the record Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: of complaints and the complaints procedure. The inspector spent time with the Registered Manager and gained views about the services from professionals in the community, and also comments from service users these are included in the report. The service runs an activity each day in the home these include cookery, health care, such as hair dressing, manicures and make up sessions, also held are discussion groups, relaxation classes and exercise classes. The exercise classes get the greatest attendance as they are run by the Registered Manager and the residents enjoy this. The Registered Manager now has a book and keeps a record of resident who have attend and those who have chosen not to attend. This document shows that some residents will continually choose to do their own person lead activity or go and visit friends instead of joining in with the activities on offer in the home. In discussion with professional in the community with regard to the engagement of residents in the activities comments were extremely difficult to motivate, they are not really interested in doing structured stuff and have their own daily patterns and activities, the Registered Manager is trying but is limited in what he can do . Personal relationships and family relationships are encouraged if these are helpful and appropriate. Menus in the home are varied. One complaint had been received with regard to a dish being served in the home, and the resident was offered an alternative. Comments received from residents were really like the new bathrooms,I dont really do the things on offer in the home, I do my own thing. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a comprehensive plan of care and input from the community mental health team. The Registered Manager has a good relationship with the general practice and residents health care needs are reviewed and referrals made if appropriate. The procedure for administering medication was found to be in good order. Evidence: As part of the inspection the inspector case tracked three residents in the home and spent time with them. As part of the case tracking the inspector examined the new person centred care plans and the associated documents such as risk assessments and the activities plan for these individuals, also evidenced were the external reviews from the community mental health team. Other documents examined were copies of notifications, and accidents and appointments, evidence of external reviews, the record of complaints and the complaints procedure. The inspector examined a sample of MAR sheets and can confirm there is now a sample list of staff signatures to reference with the MAR sheets. On the day of the inspection the inspector observed one resident making their own doctors appointment and informing the Registered Manager of the Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: date of this. Medication records were found to be in good order, and these sheets had a photograph of each resident on them. The Registered Manager has a productive relationship with the CMHT and this has resulted in all residents having a full review of their care needs in the service. No resident currently self medicates. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service now records complaints and deals with these effectively. The Registered Manager now notifies the CSCI and social services of all significant incidents in the home, the policy and guidelines on restraint are detailed and informative. Residents are protected by the homes recruitment procedures. Evidence: As part of the inspection the inspector examined copies of notifications, and accidents and the record of complaints and the complaints procedure. The inspector spent time with the Registered Manager and gained views about the services from professionals in the community, from relatives of residents and also comments from service users. These are included in the report. The Registered Manager has notified the CSCI of any significant incidents which have occurred in the home, and has produced evidence to show these had also been forwarded to the relevant member of the CMHT. Complaints in the home are now recorded and on the day of the inspection were in relation to a complaint about the food. This was dealt with by the registered manager and the complaint resolved. The service has a policy on restraint and individual guidelines are available in residents risk assessments to guide staff in ways of dealing with incidents of aggression in the home, also recorded are signs for staff to be aware of in relation to the deterioration of a residents mental health. Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: The recruitment documents of staff employed in the home since the last inspection were examined and found to be in good order. Care Homes for Adults (18-65 years) Page 19 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have benefited from improvements to the homes environment, and live in a bright and clean home with an accessible garden. The Registered Manager has ensured environmental risk assessments are in place and all window restrictors used are in working order. Evidence: As part of the inspection the inspector carried out a brief environmental tour of the areas of the home which had been improved since the last inspection. Since the last inspection the upstairs toilet has been decorated and new flooring has been installed, this is the case also for the shower room upstairs. Bathrooms have had new toilets, flooring and have been retiled. Three new leather sofas have been brought for the lounge and a new kitchen has been installed. The home has a bright and recently decorated dining area, a pleasant lounge, and is a well maintained home. Residents bedrooms are well decorated some with wooden flooring providing a comfortable pleasantly decorated home in which to live. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff interact well with residents and have a understanding of the needs through, training and knowledge passed to them by the Registered Manager. Staff are working with the new care plan documentation and provide a person centred approach to the delivery of care. Evidence: As part of the inspection the inspector examined the recruitment files of staff recruited to the service since the last inspection these were found to be in good order. Also completed skills for care induction booklets were viewed for the staff in the service, and the list of training. Since the last inspection the home has recruited a staff member with NVQ level 3, and a member of staff deployed in cleaning duties has been recruited to work on a part time basis. Staff have received training in first aid, health and safety, food hygiene and moving and handling. Existing staff have already achieved NVQ level 2 in care. Staff are also trained in areas relevant to the needs of residents such as mental health related subjects including dealing with depression, obsessive compulsive disorders, schizophrenia and psychotropic medication. Members of staff were seen on the day of the inspection interacting positively with residents in an encouraging manner. Care Homes for Adults (18-65 years) Page 21 of 27 Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a long serving Registered Manager they trust and who is very experienced and qualified. The Registered Manager has worked hard in the last six months to address the short falls of the service provided and now works in partnership with the CSCI and the CMHT. He has taken the opportunity to evaluates the service and has a plan in place to move the service forward. Evidence: As part of the inspection the inspector case tracked three residents in the home and spent time with them. As part of the case tracking the inspector examined the new person centred care plans and the associated documents such as risk assessments and the activities plan for these individuals, also evidenced were the external reviews from the community mental health team. Other documents examined were copies of notifications, and accidents and appointments, the record of complaints and the complaints procedure. The staff recruitment files of new staff within the service were examined and the completed induction training. The inspector spent time with the Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: Registered Manager and gained views about the services from professionals in the community, and also comments from service users these are included in the report. The Registered Manager who is also the owner has managed the home for twenty-five years and is clearly valued by residents. The manager is well qualified including having a management qualification in public and social studies. They are a Registered Mental Nurse, State Enrolled Nurse, and have completed the AQAA course and the Mental Capacity Act 2005 training as well as the Deprivation of Liberty training. In discussion with residents it is obvious he is well liked and respected within the home. The Registered Manager has worked hard over the last 6 months to improved things in the service and move the service forward. Restrictions and risk assessments have been agreed and updated. The recruitment procedures within the home were assessed during the inspection and found to be in good order. Quality assurance systems are in the home and the Registered Manager now uses these as a management tool to improve the service. Residents are given questionnaires to complete about their life in the home and these are also sent to families and friends of the resident. All service users have had a full review of their care needs and discussions with regard to any restrictions have been agreed and signed by the service user and the relevant professionals. Complaints are taken seriously in the home. Service user surveys were not seen on the day of the inspection. The service has a range of general policies and procedures in place such as, values of privacy, dignity, choice, fulfilment, rights and independence. The manager has been advised to update a policy in relation to a particular service user in the home. A draft of this was written during the inspection by the Registered Manager. The home now maintains a visitors record book. The Registered Manager now notifies the CSCI and relevant others of incidents of notice within the home and deals with complaints and issues with regard to adult protection appropriately. Comments received from external professionals were forward movement understands the whole process better, and comments received from the Registered Manager were I have found the whole process helpful. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R 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, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 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, Care Homes 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 1 2 9 12 That in relation to one service user their risk assessment is updated to reflect historical information. The Registered Manager continues to encourage and engage residents in activities in the home and in the community. The Registered Manager develop a policy in relation to a historical incident involving one service user in the home. 3 40 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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