We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014. We were also visiting to inspect the action taken by the provider to address enforcement action by the Care Quality Commission (CQC).
We have completed four comprehensive inspections and two focused inspections since a comprehensive inspection in December 2014. In a focused inspection in May 2015, we followed up on a previous warning notice relating to governance of the service; this had not been fully met. In a comprehensive inspection in May 2016, we found there had been improvements, although further work was needed to sustain and embed the changes. A further focussed inspection took place in August 2016, which was in relation to concerns raised about the quality of people's care and to check whether the service was compliant with enforcement action. On both of these inspections, the service had not improved enough to address the enforcement action.
We visited the home on 1 and 8 December 2016. The visit was unannounced and was carried out by one inspector on the first day and by one inspector and a pharmacist inspector on the second day. The service provides accommodation without nursing care and is registered for 21 people to live at the home. When we visited there were 12 people living at the home and one person staying there temporarily.
Prior to the inspection we reviewed a range of information to ensure we were addressing potential areas of concern and to identify good practice. This included the Provider Information Record (PIR), which asks the provider to give some key information about the service, including what the service does well and improvements they plan to make. We also reviewed previous inspection reports and other information held by CQC, such as notifications. A notification is information about important events which the service is required to tell us about by law.
During the visit we met 13 people living at the home; five people shared their views on living at The Priory Residential Care Home. We spoke with one visitor to the home, seven staff and the registered manager who is also the provider. We contacted the district nursing team, visiting health and social care professionals, GPs and the local commissioning and contracting team, plus the local authority quality improvement team. Five health professionals and two social care professionals responded to our request for information. We also gained permission from visiting health and social care professionals to use information from their recent reports following visits to the home.
We observed care and support in communal areas and also looked at 12 people's bedrooms and two bathrooms. We reviewed a range of records about people's care and how the home was managed. These included the care plans for three people, the training and induction records for three staff employed at the home, the recruitment files for three staff working at the home, training records for staff and 13 medication records. We also discussed the quality assurance audits systems with the registered manager and the deputy managers.