Priory Care Residential Home is a care home that accommodates up to 35 older people, some of whom may be living with dementia. On the day of the inspection there were 29 people living at the home. The home is situated in the village of Cottingham, in East Yorkshire. Bedrooms are located on the ground and first floors and there is a passenger lift to reach the first floor. Accommodation on the first floor is designed to meet the needs of people who are living with dementia.

At the last inspection in July 2016 we were concerned that care and treatment was not person-centred. We issued a requirement in respect of Regulation 9 (1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we saw that people’s care plans had been updated and that people received care that was based on their individual needs. The provider was no longer in breach of this regulation.

At the last inspection in July 2016 we were concerned that staff did not act in accordance with the Mental Capacity Act 2005 (MCA) in respect of consent and making informed decisions. We issued a requirement in respect of Regulation 11 (1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we saw that people’s records had been updated to reflect their capacity to make decisions and consent to aspects of their care. The provider was no longer in breach of this regulation.

At the last inspection in July 2016 we were concerned that medicines were not being managed appropriately and that the emergency call bell had not been properly maintained. We issued a requirement in respect of Regulation 12 (1) (2) (d) (e) (g) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we saw that the management of medicines was safe and that a new emergency call bell system had been installed. The provider was no longer in breach of this regulation.

At the last inspection in July 2016 we were concerned that there was a lack of maintenance certificates and risk assessments in place and that a high standard of hygiene was not being maintained. We issued a requirement in respect of Regulation 15 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we saw that equipment was well maintained and that the premises were maintained in a clean and hygienic condition. The provider was no longer in breach of this regulation.

At the last inspection in July 2016 we were concerned that the provider had failed to maintain an accurate, complete and contemporaneous record in respect of each person who lived at the home. We issued a requirement in respect of Regulation 17 (1) (2) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we saw that people’s records were complete and accurate. The provider was no longer in breach of this regulation.

At the last inspection in July 2016 we were concerned that CQC had not been notified about DoLS applications that had been authorised as required by regulation. This was a breach of Regulation 18 of the Registration Regulations 2009. At this inspection we saw that notifications about DoLS and other issues had been submitted to CQC, meaning the provider was no longer in breach of this regulation.

At this inspection we found there was a manager in post and they had been in post since the home was first registered. People who lived at the home, relatives and staff reported that the service was well managed.

Staff had been recruited following robust policies and procedures and people told us they felt safe living at the home. Sufficient numbers of staff were employed to make sure people received the support they needed.

People told us they were happy with the choice of meals provided at the home. People’s nutritional needs had been assessed, people’s special diets were catered for and food and fluid intake was being monitored when this wa

This inspection took place on 11July 2016 and was unannounced. The service was registered with a new provider in September 2015 and this was the first visit since its registration. The registered provider recently purchased this service and were aware of a number of shortcomings, which are reflected in this report. We found there was on-going work to up-grade the service and improve the quality of care.

Priory Care Residential Home is registered to provide accommodation and personal care to up to 25 people. The service supports older people, some of whom may be living with dementia and people with a physical or sensory impairment. The service is located in Cottingham, in the East Riding of Yorkshire and close to the city of Hull. At the time of this inspection there were 20 people using the service.

The registered provider is required to have a registered manager and the manager in post was registered with the Care Quality Commission (CQC) in September 2015. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There was a lack of maintenance certificates and risk assessments in place, which meant the registered provider could not assure us that the premises and equipment used by the service was properly maintained. There was on-going building work within the service, but some areas of the premises were not clean, well maintained and did not maintain standards of hygiene appropriate for the purpose for which they were being used. There was a major refurbishment of the service taking place. The majority of the people and relatives we spoke with said they were confident that things in the service were improving. Staff were optimistic about the future of the home and felt the registered manager would drive forward the necessary improvements needed to ensure the service met people's needs.

The recording, administration and return of medicines was not being managed appropriately in the service. People said they received their medicines on time and when they needed them, but we found that staff practices for medicine management were not robust.

People’s nutritional needs had been assessed and they told us they were satisfied with the meals provided by the home. However, the dining experience of people living with dementia could be improved as there were no picture menus and the lack of visual prompts meant they found it more difficult to make a choice about what they wished to eat each day. We have made a recommendation in the report about this.

The care and treatment of people using the service did not always meet their needs. People told us that they were often bored and lacked stimulating and interesting social opportunities to keep them engaged and occupied.

People spoken with said staff were caring and they were happy with the care they received. We saw appropriate moving and handling techniques used to assist people with their mobility and people were satisfied that their privacy and dignity was maintained at all times. However, we found that there was little documentation about the support of people receiving end of life care. We have made a recommendation in the report about this.

The registered provider failed to notify the CQC about Deprivation of Liberty Safeguard applications which had been authorised by the supervisory body. They had also failed to ensure that where a person lacked mental capacity to make an informed decision, or give consent, that staff acted in accordance with the requirements of the Mental Capacity Act 2005 and the associated code of practice.

There were processes in place to help make sure the people who used the service were protected from the risk of abuse and the staff demonstrated a good understanding o