CQC report explained · a residential care home
What the CQC found at Priestnall Court
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found clear risk assessments, safe medicines management, robust recruitment checks and staffing levels that met people's assessed needs. Some environmental work was completed during the inspection, including action on radiator covers, hot water and kitchen improvements.
- Effective?
- Good
- Staff received supervision, appraisals, induction and training. People were supported with consent and decision-making, healthcare appointments, nutrition and special diets.
- Caring?
- Good
- Inspectors saw kind and positive interactions. Staff respected people's privacy, dignity and choices, and people and visitors said they felt comfortable and welcomed.
- Responsive?
- Good
- Care plans contained detailed information about people's needs, preferences and interests and were reviewed regularly. The home provided a range of activities and responded to concerns and complaints.
- Well-led?
- Requires improvement
- Management systems and audits had improved, but inspectors said the provider needed to show continued sustainability in managing health and safety. The provider had brought in a health and safety consultant and booked further training.
What inspectors found, January 2018
Rated Good overall; inspectors found safe, kind and responsive care, but the home was rated Requires Improvement for well-led management.
Inspectors visited over three days on 7, 8 and 17 November 2017. The first visit was unannounced. They spoke with people living at the home, visitors, staff, the provider and the manager. They also observed care and checked care records, medicines, staff files, safety checks and quality audits.
The home was rated Good for safe, effective, caring and responsive care. Inspectors found that people received medicines safely, staff were suitably trained, consent was sought, care was kind and respectful, and activities and support were tailored to people's needs.
The home was rated Requires Improvement for well-led management. Auditing systems had improved, but inspectors said the provider needed to show that improvements to health and safety management could be maintained over time.
The overall rating improved from Requires Improvement at the previous inspection in January 2017. The earlier breaches and warning notice had been addressed, although the provider still needed to strengthen its oversight of health and safety.
Safe medicines
Inspectors checked medicines, controlled drugs and storage temperatures and found no discrepancies in the sample reviewed. Staff had appropriate training and competency checks were being used.
“People received their medicines safely and as prescribed by their doctor.” from the report
Kind and respectful care
Staff built good relationships with people and respected their privacy, dignity and personal choices. People and visitors described the staff as kind and caring.
“We observed positive interactions between staff and people who used the service.” from the report
Food and healthcare
People had access to healthcare professionals and support with appointments. Inspectors found appetising food, suitable portions and support for special diets.
“The portion sizes were good and the food looked and smelt appetising.” from the report
Improved systems
The provider had acted on the previous inspection findings. Recruitment, staff training, consent, safety checks and notifications to CQC had all improved.
“At this inspection we found improvements to the service and found the warning notice to have been met.” from the report
Health and safety oversight
needs fixingThe well-led rating remained Requires Improvement because the provider needed to demonstrate that its improved health and safety governance would continue to work effectively. Further expert support and training were still being developed.
“This is due to the need for the provider to show continued sustainability in the management of the service with the governance of Health and safety.” from the report
Some work was still in progress
minorAt the inspection, the electrical installation certificate was being updated and some work remained outstanding. The provider later sent CQC an updated certificate.
“The electrical installation certificate was in the process of being updated by the visiting contractor with some outstanding works being carried out.” from the report
- 01What checks are now used to make sure health and safety audits remain complete and up to date?
- 02What changes were made after the health and safety consultant's visit, and what evidence shows those changes have been maintained?
- 03Has the planned health and safety training been completed, and what difference has it made?
- 04How are staffing levels reviewed when people's needs change or staff are absent?
- 05How are care plans and risk assessments reviewed when a person's health, mobility or nutrition needs change?
This was a three-day inspection of the overall service and all five key questions, including checks on improvements made since the January 2017 inspection. This explanation was written from the published report of 5 January 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, September 2017
Rated Requires Improvement overall; inspectors found kind care but serious weaknesses in medicines, safety checks and management.
Inspectors visited over three days in January and February 2017. The first visit was unannounced. They spoke with people living in the home, relatives, staff and health professionals. They looked around the building and checked care records, medicines, staff files, training records and management records.
The home was caring, clean and homely. People were treated kindly and respectfully. Inspectors also found that activities, food and access to healthcare were generally good. However, some medicines were not managed safely. Safety checks, staff training, recruitment checks and care records were not reliable enough.
The home had not made enough improvement since the previous inspection in November 2015. It remained in breach of several regulations. The overall rating was Requires Improvement. Safe, Effective and Responsive were also Requires Improvement, while Caring was Good and Well-led was Inadequate.
Kind and respectful care
People were described as happy, comfortable and well cared for. Staff respected privacy and dignity and responded promptly when people needed help.
“We saw that staff were kind, patient and respectful in their interactions with people.” from the report
Personalised activities
The home offered activities linked to people's interests and kept records of participation. Examples included exercises, games, painting and community entertainment.
“We saw that people were assisted to engage in a variety of meaningful activities of their choosing.” from the report
Access to healthcare
People were supported to see health professionals and attend hospital and doctor appointments. Visiting healthcare professionals said recommendations were followed.
“The service also supported people to attend hospital and doctor appointments.” from the report
Clean and homely surroundings
Inspectors found the home clean and well maintained, with pleasant communal areas and personal protective equipment available.
“The home was clean and well maintained and we saw staff had access to personal protective equipment (PPE) to help reduce the risk of cross infection.” from the report
Medicines were not always safe
seriousCream instructions were not clear, medicine counts did not always match, and one person received only half of a prescribed antibiotic course. Medicine storage temperature records were also missing or appeared to have been altered.
“This meant there was a risk people had not received their medications as prescribed by their doctor and could put them at risk of harm.” from the report
Important safety checks were missing
seriousThere was no evidence of some electrical checks, and fire alarm, emergency lighting and escape route checks had not been recorded since November 2016. Food temperature controls were also not adequately recorded.
“This meant that there was a risk people were not being cared for in a safe environment.” from the report
Staff training and support were inadequate
needs fixingStaff had received only one supervision session since the previous inspection and no annual appraisals. Training records showed gaps in areas including fire safety, food hygiene, infection control and safeguarding.
“This meant that staff were not receiving appropriate support and guidance to enable them to fulfil role effectively.” from the report
Care plans were incomplete
needs fixingSome care plans did not explain clearly how to meet people's assessed needs. Medical advice and treatment needs were not always reflected in the care records.
“This meant that accurate, complete and contemporaneous plans of care were not being kept.” from the report
Management checks were too weak
seriousThere were no effective audits of several areas, including care records, staff files, training, accidents, infection control and cleanliness. Required notifications about deaths, an abuse allegation and DoLS authorisations had not been made to CQC.
“The quality assurances systems in place were not sufficiently robust to identify the issues and concerns we found during our inspection.” from the report
- 01What action has been taken to make sure prescribed creams, antibiotics and other medicines are given exactly as prescribed?
- 02How are medicine fridge temperatures and medicine counts now checked and independently reviewed?
- 03Have all staff completed the missing training, induction, regular supervision and annual appraisal?
- 04What formal checks now confirm that fire safety, electrical equipment, emergency lighting and escape routes are safe?
- 05How are care plans and required CQC notifications now audited to make sure they are complete and submitted on time?
This was a three-day inspection covering all five CQC questions and checking improvements since the November 2015 inspection, using a sample of four people's care records and four staff files. This explanation was written from the published report of 8 September 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Priestnall Court
3 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- January 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- March 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 13 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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At least 100 live-in carers within about an hour of Stockport
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 88 can care for a couple. 10 years' experience on average.
“Primrose is a very kind and compassionate healthcare professional”
“She is an exemplary carer, she is knowledgable empathetic and very respectful in the home.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.