Friary House

“While people mostly received safe care, some areas still needed further improvements. Medicines had improved since our last assessment, but more information was needed for ‘as and when’ medicines, such as laxatives. Care plans and guidance was not always clear with information on when and what medicine should be administered. The premises were safe and clean and an ongoing improvement plan indicated there would be additional improvements in future. There were enough competent staff on duty to meet people’s needs, and staff were supported by regular 1-to-1 supervision meetings with a line manager.”

“Person centred care plans were developed with the person and their relatives as required and regularly reviewed. Communication aids were available for anyone requiring additional support. . Appropriate referrals were made to healthcare professionals who gave positive feedback about the service. There was a clear ethos of providing care until people’s needs could no longer be met by the provider. The provider worked with community healthcare professionals to enable them to remain at Friary House whenever possible.”

“The provider had various audits in place, which reviewed the service and records. However, these needed further analysis as there was not always evidence themes and trends had been analysed . Audits needed to become more embedded into the day-to-day service and utilised more fully to give a clearer overview of the service and to drive further improvements. While the provider shared information about learning during handover sessions, additional work on audits would enable further analysis of the service and improvements.”

“Staff asked people to consent to care before delivery however more learning was needed in the area of the Mental Capacity Act (MCA). MCA assessments and best interest decisions had not”

“always been made according to the MCA’s principles, and relatives who had lasting powers of attorney were not always consulted when decision making.”

“Staff were kind and took time to learn about people’s history. People were supported to maintain their health enabling them to live fulfilled and safe lives and staff responded to call bells quickly. The provider was also supportive to the staff team, arranging an external supplier of health and well-being services including an extensive period of funded counselling sessions. The registered manager was well respected by staff, relatives and healthcare professionals. There was an open culture in the service, and people and staff were not afraid to speak up should they feel a need to. The service had improved a great deal since our previous inspection and breaches in 3 of the 5 previous warning notices had been met. However, there was a continuing breach in the area of safe management of medicines and in governance of the service. We have asked the provider to submit an action plan to tell us how they will further improve practice in these areas.”