Primrose House

Updated 19 December 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

An inspector, a medicines inspector, a specialist professional advisor and 2 Experts by Experience carried out this inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Primrose House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Primrose House is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used this information to plan our inspection.

During the inspection

We spoke with 9 people who lived at the service and 14 relatives, about their experience of the care they received. We spoke with 10 staff: the regional manager, the registered manager, the operations support manager, the provider’s representative, 1 senior care worker and 5 care staff. We received email feedback from 14 staff. We reviewed a range of documents relating to the safety and management of the home. This included 9 medicine administration records with accompanying documentation and 14 care plans. We looked at medicines audits, training records and records associated with the provider’s quality monitoring systems.

Updated 19 December 2023

Primrose House is a residential care home providing personal and nursing care to up to 65 people. The service provides support to older people, some of whom were living with dementia and people with an enduring mental health condition. At the time of our inspection there were 40 people using the service.

People’s experience of using this service and what we found

People, relatives and staff felt the home had improved since the last inspection. The provider now had a more structured approach to quality assurance (QA); however a small number of audits hadn’t been completed consistently. Management reviewed the findings from audits, but the system needed a more in-depth analysis of findings to ensure lessons were learnt and shared. Particularly in relation to incidents, safeguarding concerns and complaints. Medicines were managed well, however records to support staff in their safe use required improvement. We have made a recommendation about this.

Opportunities for people, relatives and staff to share their views had improved. People and relatives gave positive feedback about the care provided. Staff felt morale, teamwork and the atmosphere in the home had improved.

There were enough staff to meet people’s needs and new staff were recruited safely. Some relatives felt there had been a lot of staff changes recently. Some staff interacted well with people but this was inconsistent, especially in one particular area of the home.

The home was clean and staff followed the provider's IPC practices. A new system had been implemented to deal with laundry to help prevent the spread of infections.

People were supported to have enough to eat and drink. Changes had been made to improve people’s dining experience.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service this practice.

Opportunities for people, relatives and staff to share their views had improved.

The quality of people’s care plans had improved and were much more personalised. They included information about people’s preferences and what they were able to do for themselves.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 17 December 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements, however the provider continued to be in breach of regulation 17.

At our last inspection we recommended that the provider reviews how staff were deployed. At this inspection we found this had been completed and improvements made.

Enforcement

We have identified a continued breach in relation to medicines records.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.