Care Home: Priory Court Nursing Home

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What the care home does well The people live in comfortable, well maintained and clean accommodation. People are able to make their rooms more homely with their own personal belongings if they wish. Each person is encouraged and supported to be independent and take part in meaningful activities. They are also offered choices about what they wish to do and to make decisions about how they spend their lives. Staff communicate well with them and respect their choices and decisions. People living in the home are cared for and supported by a caring, educated and committed team of staff. There is a programme of education and training provided for the staff, which ensures that staff know how to care and support the people who live at the home. Visitors are made welcome and kept well informed. There were systems in place to check on the overall quality of the care and accommodation provided to ensure good standards are maintained and improved. What has improved since the last inspection? Staff training has improved to enable the staff to communicate, understand and manage the needs of the people better. Training has included privacy and dignity and there are staff who are dignity champions and monitor that this is taking place in the home by the staff in their day to day contact with the people living in the home. A programme of decoration has resulted in 20 bedrooms, the ground and first floors and ground floor dining room being redecorated. In addtion a further 7 new profile beds (increasing the number in the home to 22 for each of the people receiving nursing care) which enable the people to be cared for when in bed easier and for it to be safer for staff to care for them have been purchased. In addtion, 3 new alternating pressure relieving mattresse have been purchased. The home has also improved the variety of food provided, choice, presentation, table service and staff training and was awarded 5 stars "excellent" by South Kesteven District Council in recognition of the catering service provided. What the care home could do better: There were no requirements as a result of this inspection. We discussed with the manager about ensuring that our new name, address and phone number was in their complaints procedure, the statement of purpose and service user`s guide. This was acted upon immediately. We also discussed with the manager ensuring that all care plans should contain information about recent legislation that is designed to protect people`s rights and choices. This is so the manager can show that they have looked at the effects this legislation has on the lives of all the people receiving care and support from the home rails and plan their care accordingly. The manager agreed to act on this. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Priory Court Nursing Home Priory Road Stamford Lincs PE9 2EU     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: Tobias Payne     Date: 1 6 0 7 2 0 0 9 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. that people have said are important to them: They reflect the things 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 28 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Priory Court Nursing Home Priory Road Stamford Lincs PE9 2EU 01780766130 01780766148 priorycourt@schealthcare.co.uk www.schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Southern Cross Healthcare Services Ltd care home 62 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users in Priory Court Nursing Home with nursing needs does not exceed 22 and the maximum number of service users with personal care only, does not exceed 40. To be able to admit into Priory Court Nursing Home the named person of category LD named in variation no. V36840 dated 28 November 2006 To be able to admit into Priory Court Nursing Home the named person of category PD, SI and LD named in variation application number V35269 dated 22nd September 2006. Date of last inspection 0 3 Over 65 62 0 Care Homes for Older People Page 4 of 28 Brief description of the care home Priory Court Care Home is purpose built and provides nursing and personal care for 62 persons including older persons aged 65 years and over and up to 3 physically disabled persons under the age of 65 years. The home is one of a number of homes owned by Southern Cross Healthcare Services Ltd. It is within half a mile of the centre of the town of Stamford and within easy reach of a wide range of services and facilities. Car parking is available in the grounds of the home. There are also garden and patio areas. All bedrooms apart from 2 are single and all 60 rooms have en-suite facilities. Accommodation on the first floor is served by two shaft lifts. There are a variety of lounges throughout the home and dining rooms on both the ground and first floors. Fees on the day of our inspection visit on the 16/7/2009 ranged from £642 to £832 each week. Extras were hairdressing, which ranged from £7.50 to £30, chiropody £13.50p, personal newspapers and toiletries. Information including the statement of purpose which contained a copy of our last inspection report and the service users guide can be found at the entrance to the home which also had other useful information. These can be made available in CD format, in Braille, audio and large print on request. Care Homes for Older People Page 5 of 28 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: The Last key inspection took place on the 20th August 2007. This key inspection was unannounced and started at 7.30 am. It was undertaken using a review of all the information available to us about Priory Court Nursing Home. It took place over 8 hours. We were assisted throughout our inspection by the manager who was also given feedback at the end of our inspection visit. We looked at a sample of care records, policies and procedures and walked around the home to see the quality of accommodation and visited some of the bedrooms with the permission of the people living in the home. We spoke with 15 people living in the home, 5 visitors, 2 community nurses who were visiting the home, 7 staff and the manager. An (AQAA) Annual quality assurance assessment was completed by the manager and sent to us before our inspection. This is a self- assessment document completed by the manager of the care home. It sets out evidence from the provider to demonstrate that they are Care Homes for Older People Page 6 of 28 meeting the Care Home Regulations. It was very detailed and completed on time. Before this inspection we sent out 15 questionnaires to the people living in the home and 10 to staff to obtain their views about the home. We received 6 from the people living in the home and 5 from the staff. Their were responses in the main were positive and are reflected in this report. Where the use of we or us has been used throughout this report it refers to the Care Quality Commission. 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 Care Homes for Older People Page 8 of 28 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 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 10 of 28 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 coming in to the home receive information in a variety of formats to meet their needs and support to help them make an informed choice of where to live. They are assessed before they come to the home which ensures that individual needs can be met within the home. Evidence: There was a detailed and up to date statement of purpose and service users guide in the entrance to the home. We noticed that our new name, address and phone number needed to be added to these documents and the complaints procedure and this was acted upon during our vsit. The manager told us that where a referral was made she would visit each person and make a thorough assessment of their needs involving the person and any other person involved in their care and support. Once this was done written confirmation was sent to them that based on the assessment the home could meet their needs. We looked at records for a person who had recently been admitted to the home. We could see that a detailed pre admission assessment had taken place Care Homes for Older People Page 11 of 28 Evidence: and that the person had received a letter confirming the service could meet their needs. The service does not offer intermediate care. Care Homes for Older People Page 12 of 28 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. Each person had a detailed care plan giving details about their care and support to ensure that their needs are met. Medication was safely given by staff who knew what they were doing. Evidence: All the people had care plans, which described their health, support and welfare needs. Care records included a service user profile with photograph, service user admission and medication, dietary preferences, physical and social assessment coverning each aspect of care with comments about specifc needs, pre-admission assessment and client profiile. From this there was a personal care plan which was handwritten and gave details of each persons needs. The care plan identified the strengths, needs, planned care and aim of care. They included risk assesements, a nationally recognised nutritional assessment tool, weight record and daily report. The reports were dated with a signature. There were also records of eating, drinking and weight. Care plans had clear care directions. There was sufficient information to enable staff to know how to care and support each person. The manager made a 2 monthly audit to monitor how care records were being recorded. We noticed however Care Homes for Older People Page 13 of 28 Evidence: that not every person had a mental capacity assessment completed. The manager acknowledged this and agreed to ensure this was arranged for each person.. We looked at records for 2 people one of whom had complex needs. One person was cared for in bed and had a fluid balance chart and turning chart which showed the person was receiving regular fluids and their position altered to relieve pressure even though they were on an alternating pressure mattress. We saw other people confined to bed with overbed tables, bed protection rails and drinks and books within their reach. Throughout our visit we saw staff respecting the peoples wishes and choices in the way they made contact with the people living in the home and their response. We also spoke with staff who showed good knowledge about the particular needs of the people living in the home. Where required, people living in the home were referred to GPs, Community Nurse, Community Psychiatric Nurse, Tissue Viability Nurse, Continence Nurse, Physiotherapist, Opticians, Dentist, Chiropodist and other specialists. There were Link Nurses who specialise in various aspects of care including tissue viability, continence, palliative care and continence and meet up with other nurses and staff from NHS Lincolnshire to promote good practise. The manager told us the home continues to work towards achieving the Gold Standard Framework for terminal care and after care which will be assessed by the Macmillan Nursing Service and operates the Liverpool Care Pathway at the end stage of life. Each person had their own key worker responsible for their care and support. Registered nurses and senior care assistants gave out medication. There was a policy and procedure and each person was assessed before they were considered safe to administer medication. Records we saw were clear and well maintained with a good audit trail. The manager told us that the people were encouraged by the staff team to self medicate but all the people needed a degree of assistance in order to ensure they took their medication safely. The manager made a monthly audit to monitor how medication records had been maintained. This showed adequate records were being kept. In addtion they received a pharmacy inspection on the 24/6/2009 and the report showed no concerns. People we spoke with were satisfied with the way staff cared for them and had confidence in the staff. We saw throughout our inspection staff attended to the people in a warm, friendly and kind manner, knocking on doors before entering their bedrooms and asking whether they needed any help. The people told us the staff Care Homes for Older People Page 14 of 28 Evidence: have endless patience, they are so kind and the staff are so polite and understand my needs. Care Homes for Older People Page 15 of 28 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 are able and supported to make their own choices about how they want to live their lives, and what they want to do. Social activities are varied and provide stimulation and interest for people living in the home. People enjoy varied and nutritious meals. Visitors are made to feel welcome and supported. Evidence: We saw information about each persons interests and life history in their care records and the manager told us the service employed 2 activity organizers. There was an activities programme displayed at the entrance and throughout the home with a copy in each persons room for the week commencing the 13/7/2009. This showed activities Monday to Friday. These included collecting flowers from the garden for pressing, painting, baking, visit by the mobile library service, armchair excercises and craftwork. For those people who had a learning disability arrangements had been made for them to go to a local youth club and in the case of one person specific one to one support during the day. Also provided were hairdressing (the home has its own hairdressing room and the hairdresser was in the home during our visit), outside entertainment and 2 church services each month (other religious needs could be arranged to suit the person) and occasional trips out. The home also had a mini-bus with tail lift. During our inspection visit we saw chair excercises taking place with one Care Homes for Older People Page 16 of 28 Evidence: of the activities organisers and a member of staff with 11 people. There was music and laughter. There were well-tended garden areas with accessible patio areas which had been made wider and easier for wheelchairs. The garden had raised beds, a pergolla and a Bar BQ. Visitors were welcomed into the home at all times. All the 5 visitors we spoke with were very complimentary about the staff and home. Comments included, I can visit whenever I wish, I am very satisfied, I find staff are always respectful and I can discuss any concerns I have with the staff, I am always kept informed and any changes or prgress and It has been my very first visit to the home and I have been very impressed with the friendly and relaxed atmosphere and how clean the home is. A comment card included the activity programme is wonderful with dedicated and enthusiastic organisers, the pets give great joy and make it easier to make it more like home. The people living in the home were offered 3 main meals a day plus snacks. Menus were on a four week rota . There was a set menu with a choice and an alternative could be arranged to suit the needs of the person. The catering service was awarded 5 stars excellent following the last inspection by South Kesteven District Council on the 17/7/2008. The chef monitored food temperatures. We saw breakfast trays being taken on a trolley to each persons room. The meals were plated and gave a choice of a cooked breakfast cereal or toast. Staff knocked on the doors and we heard good morning here is your breakfast. you have egg on toast, tea and toast as well as are you ready for your breakfast or shall I come back later on and how are you feeling today. When coffee was being served midmorning we saw a member of staff asking those people who wished to stay in their rooms what they wanted for lunch and this information was passed to the staff in the kitchen who were preparing lunch. Lunch was served in the the dining rooms on the ground and first floors or in their bedrooms on a tray. Meals were taken from the kitchen in heated trolleys and served from them. The menus which were also displayed on notice boards showed us that there was a varied menu. The dining tables had clean table cloths and table mats. We saw staff were assisting those people who needed assistance in a dignified, unhurried and sensitive manner. All the people we spoke with were complimentary about the food. Comments included, I am diabetic and the chef goes out of his way to find something to suit my needs and I always enjoy the meals and find them hot and well presented. The manager told us that the company had introduced a nutritional analysis system to ensure that food nutritionally was correct. Care Homes for Older People Page 17 of 28 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 know how to make a complaint and feel that staff will listen to their views. The care team know how to respond to a complaint and how to act in order to protect people from abuse. They are protected from abuse by correct and safe recruitment procedures. Evidence: Each person received a copy of the complaints procedure in the service users guide and this was also in the statement of purpose and on the wall at the entrance to the home. We noticed it did not contain our new name, address or phone number and the manager did this during our visit. We examined the complaints register and could see from information from the manager in the AQAA that over the last year 10 complaints had been received by the home. Records showed that all complaints were fully investigated using their own procedures with a clear audit trail. As a result 7 had been upheld. We had received one complaint which we asked the manager to investigate and respond to the complainant and ourselves. This was done within the timescale. We had been made aware of one safeguarding adults issue in November 2008 which was investigated by Lincolnshire County Councils safeguarding adults team. We were told that the manager had fully co-operated with the investigation. The home also had a copy of Lincolnshires Adult Protection policy. All staff were correctly recruited including a check by the Criminal Records Bureau (CRB). During their induction we were told that staff received information about abuse. We asked 4 Care Homes for Older People Page 18 of 28 Evidence: staff what abuse was and they showed knowledge about their role and what they would do if abuse was suspected. Staff told us they received regular refresher training to ensure their knowledge was up to date. None of the people we spoke with, visitors or staff had any complaints about the home and felt they could discuss any concerns with staff or the manager. We saw that staff were polite and respectful when talking to or undertaking care duties with the people. Care Homes for Older People Page 19 of 28 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 live in clean, comfortable, safe and well maintained accommodation. The infection control policy is followed and a safe environment is maintained. Evidence: The home was well maintained, clean, tidy, safe, well decorated and odour free throughout. All the people we spoke with spoke highly of the accommodation and how much they liked their bedrooms. The people told us they were encouraged to bring into the home small items of furniture, television, pictures and personal items and several rooms had a fridges in them. The manager told us that areas throughout the home had been redecorated with other improvements. During our visit we walked around the home and found all areas of the home were clean, tidy and odour free. We saw throughout our visit domestic staff cleaning all areas of the home thoroughly. People we spoke with told us they were satisfied with the decoration and cleanliness of the home. They also spoke of how they liked their bedrooms. They told us my clothes are looked after very well and returned very promptly, the home is always clean and laid out to suit my needs. In my view it is a home from home. A visitor told us I chose this home because it was clean and odour free throughout. There were grab rails and raised toilet seats and bathrooms and toilets were Care Homes for Older People Page 20 of 28 Evidence: wheelchair accessible and had thermostatic valves fitted to basins and baths to prevent the people from scalding. There were a variety of pressure relieving mattresses, special profiling beds and a variety of mobile hoists with a variety of slings and other moving and handling equipment. There were clear signs throughout the home which showed where toilets, bathrooms and other rooms were. Staff told us they had received training and knew how to use equipment properly. Separate staff were employed for domestic and laundry services. Gloves and aprons were provided and the home had clear infection control policies and alcohol hand wash dispensers were throughout the home and at the entrance to the home. There was a laundry with sluice cycles on both of the commercial washing machines. There are two commercial tumble dryers. We discussed with the manager our observation that one of commercial tumble dryers had been out of action since 11/6/2009 and the steam iron had been out of action over a year and clothes had to be hand ironed using a domestic iron. There was a commercial roller for bedding. The manager told us that she had requested replacements from the company. People were sat in the lounges of the home or in their bedrooms. The lounges each had televisions, radios and there was a quiet library off from the entrance with crafts and books. Those in bed had over bed tables enabling them to have access to drinks, tissues, fruit, newspapers or books or the television control. Care Homes for Older People Page 21 of 28 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. There is a safely recruited, well-trained, supported staff team available who have the skills to meet the varying needs of the people living in the home. Evidence: People we spoke with did not express any worries about the level or availability of staff. During our inspection visit we saw staff attended to the needs of the people promptly and in a calm and friendly manner. Throughout our visit people we spoke with felt the home was adequately staffed with staff who were experienced and competent to care for the people living in the home. All the comments were very positive. The manager told us that she was able to monitor how long it took staff to attend to the needs of the people and address any shortfalls as they arose. The home employs registered nurses, care assistants, domestic, laundry, catering staff, adminstration and a maintenance person. The people we spoke with told us the staff are very nice, infact I would go as far to say that they are perfect and they are there if I need them and I know I can call on them if I need any help. We looked at the files for 2 new members of staff. Records we saw were clear, detailed and showed that staff were safely recruited in accordance with the regulations. This included a check by the Criminal Records Bureau (CRB). When new staff started work at the home they told us they received a supported nationally Care Homes for Older People Page 22 of 28 Evidence: recognised induction programme during which time they learnt about the policies and procedures of the home and how to provide the necessary care and support to the people living in the home. The duty rota showed across the 24-hour period that there were registered nurses working in the home. There was a wide range of training provided. It remains a training placement for nursing students from Anglia Ruskin University as well as being accredited by Sunderland University to provide an overseas nursing proramme. In addtion the manager told us that staff are encouraged and supported to obtain training in care to National Vocational Qualification standards. There is a training room. We saw records and staff confirmed that mandatory training covers induction, fire prevention, safeguarding adults, moving and handling, food hygiene, health and safety and infection control. Other training over the year had included nutrition, medication, pressure area care, customer care, care planning, understanding and managing challenging behaviour and dementia awareness. In addition there were 53 of the care staff who had obtained or who were studying for a care qualification (National Vocational Qualification). We spoke with 7 members of staff who told us, I have learnt so much since I have been here and since I have come here I have gained further qualifications and experience which has given me confidence and increased my knowledge about how to care for these people,when I first came here this was my first care job and I was nervous but I received a warm and friendly welcome and a supported induction during which I worked with an experienced member of staff, I have learnt a lot and have now completed an NVQ and I enjoy working here and it gives me pleasure improving the lives of the people as it after all their home. A comment card included the training is good and we are always up to date. Care Homes for Older People Page 23 of 28 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. There is a good overall management structure and record systems show that the peoples health, welfare, safety and choices are promoted. The management ensures that the people living in the home have the opportunity to voice their views and opinions. They use feedback from questionnaires from a number of sources and quality assurance systems to make improvements. Evidence: The manager had been in post for many years and is a registered nurse with care and management experience. She also had a management qualification. She was also an assessor. People living in the home, visitors and staff told us they had confidence in the manager. She was supported by a deputy manager who was also a very experienced registerd nurse. Staff received supervision regularly and spoke of the support received from the manager and deputy manager. Comments included, I find staff very helpful, I cannot fault Priory Court and it provides top range care and care to both myself and my wife. the staff are to be commended and maintenance is excellent, the home is generally responsive to resolving problems, laundry and Care Homes for Older People Page 24 of 28 Evidence: hairdressing are excellent, internal maintenance is usually good and staff generally try hard and are caring. The manager made herself available to meet with relatives at a monthly relatives group, had regular meetings with the people and had regular staff meetings. The company had comprehensive established quality assurance procedures. These consisted of a comprehensive internal audit every month by the manager. These audits looked at maintenance, induction, safeguarding referals, agency use, occupancy, bedrails mattress, weights of the people. The last audit showed a score rating of 94 . In addtion there was a care plan audit every month and a medication audit. As a result an action plan would be produced by the manager to identify any areas which required improvements. The manager had just received a new key outcome audit tool which was going to introduced in the future looking at outcomes. The company also sends out surveys every month to a sample of people living in the home, staff, and other professionals to obtain their views about the home. The operations manager also made unannounced monthly monitoring visits to the home and produced reports for each visit. There were policies and procedures available for staff to use when providing care, which were clear and detailed and a number had been reviewed. There were also up to date clinical procedures. There was a detailed equal opportunities policy, which referred to discrimination, disability and victimisation. Staff had received training on equality and diversity, communicating with people who have communication problems and the Mental Capacity Act 2005. There were no communication issues or concerns about equality and diversity during our visit. There were comprehensive health and safety policies, which also included detailed and up to date risk assessments and a fire risk assessment. There were regular tests of the fire system as well as regular fire drills and monthly monitoring of hot water temperatures. There were also infection control policies and staff made use of alcohol hand rub bottles throughout the home to further prevent infection. Records we looked at showed that equipment was regularly checked and serviced and there were systems to monitor any maintenance issues. We found records throughout our visit were available, well maintained and up to date. Care Homes for Older People Page 25 of 28 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 26 of 28 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 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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. 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