Inspection on 03/10/08 for The Priory Residential Care Home [Ottery St Mary]

This inspection was carried out on 3rd October 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

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Priory Residential Care Home [Ottery St Mary] 10 Paternoster Row Ottery St Mary Devon EX11 1DP     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: Louise Delacroix     Date: 0 4 1 0 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 Older People 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 Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 Older People Page 3 of 25 Information about the care home Name of care home: Address: The Priory Residential Care Home [Ottery St Mary] 10 Paternoster Row Ottery St Mary Devon EX11 1DP 01404812939 Telephone number: Fax number: Email address: Provider web address: priory_10@btconnect.com Name of registered provider(s): Name of registered manager (if applicable) Mrs Margaret Halls-Falconer Type of registration: Number of places registered: Whisselwell Care Ltd care home 21 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is 21. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old Age, not falling within any other category (Code OP) Dementia (Code DE) Physical Disability (Code PD) Date of last inspection Brief description of the care home The Priory Care Home provides personal care for up to 21 older people, some of whom may have dementia, mental health needs and/or a physical disability. The property is a period building in the centre of Ottery St Mary, opposite the local parish church and close to the local shops. There is a shaft lift with access from the ground floor to the Care Homes for Older People Page 4 of 25 Over 65 0 21 0 21 0 21 Brief description of the care home first and second floors. In one corridor on the first floor there are a few steps. There are two lounges and a seperate dining room. There is a small inner courtyard and a small patio area at the back of the building, plus limited parking. Fees are currently between £350 and £600 per week. CSCI inspection reports are available from the home. Care Homes for Older People Page 5 of 25 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 Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This is the first inspection for this service under the new owners. The inspection was unannounced and took place over two days. There were 19 people living at the home. Prior to the inspection, the service sent us an Annual Quality Assurance Assessment (AQAA), which provides details about the service. We also sent out surveys to people living and working at the home, as well as to health professionals visiting the home. During the inspection, we spent time observing care practice and meeting with staff, and people who live at the home. We looked around the building and looked at records relating to training, management of the home and care provided, including medication records. Care Homes for Older People Page 6 of 25 Care Homes for Older People Page 7 of 25 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 Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. People can be confident that the homes assessment will ensure that their care needs can be met. People are provided with information to help them make a decision about moving to the service. Evidence: The homes AQAA states that people are given a service user guide when they move into the home, and provided with a contract, which people confirmed in their surveys. People living at the home told us that they had received enough information to help them make a decision about the home. For example, was it the right place for them and could it meet their care and social needs. People living at the home told us that generally their families looked around on their behalf prior to them moving in. Sometimes this was because they did not live near the Care Homes for Older People Page 10 of 25 Evidence: home or were too unwell. One person told us how they were given a tour of the home before their relative moved in. We looked at care files and saw that generally assessments take place before people move in, which helps ensure that their care needs can be met. The home does not provide intermediate care. Care Homes for Older People Page 11 of 25 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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. People living at the home have their privacy and dignity respected, and are well cared for by staff who are supported by good care and medication systems. Evidence: As part of the inspection, we looked at the quality of the care files for people living at the home. We looked at three care plans in detail and spot checked several others, and saw that the style is person centred, which means that care plans promote an individual approach to each person living at the home. We also saw that they contained information of what triggers peoples behaviour and how staff should respond. For example, changes of approach by staff to people whose behaviour challenges the service. During our discussions with staff, they demonstrated their knowledge of the care plans, and we observed this knowledge being translated into practice. Other improvements in the care plans, include monthly reviews, which are holistic in Care Homes for Older People Page 12 of 25 Evidence: the overview they provide. Care plans are completed in a professional style and incorporate changes, where necessary. The organisation of the care files is clear and risk assessments are in place. One care file highlighted concerns by staff about a moving and handling issue, which a health professional also told us about. We saw that the home has purchased some equipment in response to the concerns, and we discussed with one of the owners how staff would receive training in this area of care. Staff told us in their surveys that they are usually given up to date information about the needs of people they support or care for. Staff confirmed that they had a handover between each shift, one staff member told us that they always have a hand-over to share information, which kept them well informed. Another person said the manager passes on information to an assistant manager, weekend manager and senior staff. If they give information it is entered in to care plans immediately. Details are verbally given to staff on duty. This works very well. In their surveys, three people living at the home told us they always received the care and support they needed, and three said usually. People that we met during our inspection praised the care they received from staff, and some gave us specific examples of how their individual needs are met. One person called the staff guardian angels. Care files for people living at the home show how the home works with health professionals. Two health professionals gave us feedback about the quality of the care provided by the care home, and said that the home usually seeks advice and acts upon it to improve and manage individuals health care needs. One professional complimented the positive attitude of care staff to learn and update their practice and knowledge. We saw examples of the homes commitment to maintaining peoples nutrition e.g. by monitoring their food intake and recording in a consistent manner, in conjunction with monitoring peoples weight. This inspection showed that medication is well managed, secure with accurate records. Our conversations with people living at the home and our observations during the day confirmed that peoples privacy and dignity is respected. Records show that peoples preferred term of address is recorded, and we heard people being called by their choice of name. Staff were seen knocking on doors, and were respectful in the way they spoke about people to us and how they spoke to people directly. Staff showed respect for peoples personal relationships. Care Homes for Older People Page 13 of 25 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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. People benefit from a developing activities programme, good links with the local community and from well managed meals. Evidence: We spent time in communal areas of the home and observed that people looked relaxed in their surroundings. Some people were watching television, reading newspapers or dozing. A range of music was played in one of the areas, and people commented positively on the choices. People were seen walking freely around the home, and several people chose to sit in the courtyard area during our inspection. We met with other people who prefer to spend time in their rooms, and they told us this was respected by staff. The home has recently appointed an activities co-ordinator, which has helped ensure that people have a range of activities to choose from during the week, which they are told about via a newsletter. We also saw staff informing people about planned events. These have included flower arranging, gardening, quizzes and trips out to the seaside, a visit to a shop to choose tropical fish and a garden centre. We were told by staff that Care Homes for Older People Page 14 of 25 Evidence: some people have also benefited from smaller groups to enable them to have more individual attention, which people living at the home also told us about. We saw examples of how the home is in touch with the local community through contact with local groups and optional attendance of the local church. People visiting the home told us that they were always welcomed by staff, and people living at the home told us they could see their visitors in private. We saw people making choices throughout the day, including where they ate their meal, and where they spent their time. Some people told us they preferred their own company and that staff respected this but made sure they were always welcome if they chose to participate in communal life. People confirmed that they could make their own daily routines, and care plans supported peoples choices. One person told us that they were reluctant to participate in some areas of personal care but that a compromise had been reached with staff as they recognised that support in this area of care was necessary. Meals are managed in an efficient but relaxed manner so that people eating their meals were not kept waiting but seemed at ease and were not rushed. One table had a particularly friendly atmosphere and it was clear that people were enjoying each others company. People had a choice of meal, with one person having chicken and other people choosing salmon. People living at the home praised the quality of the food on the day of the inspection, and five people said in their surveys that they usually liked the food and one person said they always liked the food. Staff were clear about peoples preferences, and also were committed to ensuring that people with diabetes did not miss out on the range of puddings. We saw people requesting seconds, for example at breakfast time, which staff responded to in a positive way. Records and our discussion with staff showed that peoples routines are catered for i.e.people who are up during the night are provided with snacks. People were provided with support in a discreet manner, and people are supported to take part in communal meals with additional support, if necessary. However, people also confirmed they could eat in their rooms. Care Homes for Older People Page 15 of 25 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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. People living at the home benefit from the complaints and safeguarding procedures within the home. Evidence: People that we spoke to during the inspection were clear about who they would go to within the organisation of the home if they had a concern or complaint. This was also the case for people who responded to our surveys. Staff were confident about their role in passing on concerns. We received a complaint from a health professional regarding staffing levels on one day in August 2008. The manager has offered an acceptable explanation, and has since consulted with health professionals to revise their visiting times. Staff are clear about their responsibilities to protect vulnerable people and their role in reporting concerns. Records and discussion with staff, highlighted how this had been translated into practice resulting in appropriate action being taken and referring a concern to an outside agency. This concern is not related to the conduct of staff. Care Homes for Older People Page 16 of 25 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, 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. 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. People are provided with a homely, clean and comfortable place to live, which is well maintained. Evidence: There has been significant investment in the home by the new owners, which has resulted in a homely appearance in the communal areas with good quality furnishings and decoration. For example, the dining room is attractively and suitably furnished with new linen and crockery, which people told us they had been involved in choosing. The courtyard area of the home has also been painted and planted with flowers making it a more welcoming place to sit. Staff also praised the quality of the new kitchen. Discussion with staff, people living at the home and the homes AQAA indicate that there is rolling programme of maintenance, which makes the home a comfortable place to live. On the day of the inspection, the home was clean and odour free. The laundry was well organised with clear instructions to ensure that staff maintained good infection control practices. Staff were able to explain these procedures on the day of the inspection. Infection control equipment is available throughout the home and the colour coding of equipment helps prevent the spread of infection. Care Homes for Older People Page 17 of 25 Care Homes for Older People Page 18 of 25 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. People are supported by trained staff and are generally well supported by staffing levels. Evidence: As part of the inspection, we check that the staffing levels at the home can meet the emotional, social and physical health needs of the people living at the home. Feedback from surveys and discussion with people living, working and visiting the home indicates that some people have concerns about staffing levels, particularly at weekends. We discussed the rotas with the manager and with the owners, and how work was divided between staff members, particularly at weekends and in the afternoons. The owners told us that they visit the home at different times of day and different days during the week to gain an insight into the working pressures on staff and the effect on people living at the home. In the feedback that we gathered about the service, people told us that despite the staff being busy, they did always feel listened to by staff and said that they were kind to them. Relatives praised the work of the care staff describing them as approachable, welcoming and friendly. Members from the care team confirmed that they worked well Care Homes for Older People Page 19 of 25 Evidence: together and worked as a team to ensure the well-being of the people living at the home, which was demonstrated during the inspection. The homes AQQA states that over fifty percent of the care home staff have an NVQ 2 in care, which is good practice. We looked at three recruitment files, and discussed in detail with the manager how people were recruited and the checks that took place to confirm their suitability. We saw examples of written references and that gaps in employment had been followed up, and correspondence confirming that safety checks were in place. We received a mixed response from staff regarding training and the quality of their induction and how it supported them in their work. The homes AQAA states that DVDs form a regular part of the homes in-house training, and four out of five staff told us that they did not feel these met their needs and they did not feel they kept them up to date with new ways of working. We looked at training records for staff and saw evidence of booked training courses to supplement in-house training. Care Homes for Older People Page 20 of 25 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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. People benefit from living in a well run home. Evidence: The manager of the home is experienced and maintaining her professional qualifications. She told us that she feels well supported by the new owners and that there is good communication with them. Under the new owners, quality assurance is developing and staff and people living at the home confirmed that the owners visit at different times to observe practice and consult with people regarding changes to the home. Some people have support with managing day to day money issues. We checked the management of peoples personal allowances, and saw that records were accurate and well managed. Care Homes for Older People Page 21 of 25 Evidence: The health and safety of people living at the home is maintained by good care practices and well maintained records. This observation is based on records, discussions with staff and people living at the home, a tour of the building and training. Care Homes for Older People Page 22 of 25 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 Older People Page 23 of 25 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 27 The division of tasks for staff should be reviewed by the management team to ensure that peoples care needs are met. Care Homes for Older People Page 24 of 25 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 © (2009) 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. Care Homes for Older People Page 25 of 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!