Primroses Home

Updated 16 September 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.

Inspection team

This inspection was carried out by 2 inspectors.

Service and service type

Primroses Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. 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

We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.

What we did before the inspection

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 sought feedback from the local authority who work with the service. We reviewed the information we already held about the service. This included their registration report and notifications. A notification is information about important events, which the provider is required to tell us about by law. We used all of this information to plan our inspection.

We used information gathered as part of monitoring activity that took place on 22 June 2023 to help plan the inspection and inform our judgements.

During the inspection

We reviewed a range of records. This included 2 people's care records. We looked at 2 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed. We reviewed multiple medicine administration records. We spoke with 3 members of staff including the registered manager, deputy manager and a support worker. We also spoke with 1 relative by telephone about their experience of the care provided.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We continued to seek clarification from the provider to validate evidence found. We looked at policies and procedures quality assurance records.

Updated 16 September 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance Care Quality Commission (CQC) follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Primroses Home is a care home registered to accommodate and support up to 3 people with learning disabilities, autistic people and people with mental health needs. At the time of the inspection, 3 people were living at the home. People living in the home had their own bedrooms and there were shared communal spaces, including lounges, a kitchen and a garden area.

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

The provider did not ensure they had robust systems in place to manage medicines. We saw 2 people were prescribed medicines on a when required basis (PRN). There not appropriate protocols in place to advise staff on what circumstances and how to give these medicines. This meant staff did not have the information to tell them when someone may need the medicine or how much to give. The provider’s quality assurance systems had failed to identify the issues we found in respect of medicines management.

Following the inspection, the provider sent us evidence to indicate they had made changes to improve medicines management.

Right Support:

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 home supported this practice. Staff were committed to supporting people in line with their preferences and supported people to receive their medicines safely and as prescribed.

People were supported to access healthcare services to promote their wellbeing and help them to live healthy lives. Staff managed risks to minimise restrictions, focusing on what people could do for themselves.

The home had effective infection, prevention and control measures to keep people safe, including good arrangements for keeping the premises clean and hygienic.

Right Care:

People received person centred care. Staff understood how to protect people from poor care and abuse. Staff had received training on how to recognise and report abuse and they knew how to apply it. People's care, treatment and support plans reflected their range of needs and staff knew people's needs well.

The service had enough appropriately skilled staff to meet people's needs and keep them safe. Safe recruitment processes were followed. People received their medicines as prescribed. People were able to express their views and make decisions about their care. Staff ensured people's privacy and dignity was respected and their independence promoted.

Right Culture:

There was a positive culture at the service and people benefited from being supported by happy staff which was reflected in the atmosphere at the service. The management team worked directly with people and led by example. Staff told us they enjoyed their job and making a positive difference to someone's life.

Learning from incidents and concerns was used to improve staff practice in caring and supporting people. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

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

Rating at last inspection

The last rating for this service was good (published 25 July 2018).

Why we inspected

This was a planned inspection based on when the home was previously inspected.

This was a focused inspection and the report only covers our findings in relation to the key questions Safe and Well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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.

We undertook this inspection to assess that the service is applying the principles of right support right care, right culture.

The overall rating for this service has now changed from good to requires improvement. We have made a recommendation to follow best practice guidance around quality assurance.

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.