Primrose Lodge Weymouth

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good.This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s needs were comprehensively assessed and included consideration of their physical and mental health, sensory, social and communication needs. Tools were used to effectively support the assessment of people’s health and care needs, and those were used by staff with the right understanding and skills.

People and all but 1 relative told us they were involved in care planning and reviews. Relatives told us, “I have been involved with my [loved one’s] care plan. I am consulted if there are any changes. My [loved one] no longer has the mental capacity to be involved in [their] care plan”and “I have regular contact with all staff and team leaders, and I am kept thoroughly informed about what’s happening. Due to [my loved one’s] confusion I take on the decisions about [their] care plan with advice from the team.”

Staff received training in how to support people with learning disabilities and people living with complex health conditions like diabetes, pressure ulcers or swallowing difficulties. For example, staff received training on using Makaton language, which is a communication system combining signs, symbols and speech to enhance communication for individuals with learning or communication difficulties. Staff applied their learning effectively and in line with best practice, which led to good outcomes for people’s care and support and promoted a good quality of life.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Care and support were planned and delivered in line with current evidence-based guidance, standards, best practice, legislation and best use of technology. Assessments of people’s needs were comprehensive, expected outcomes were identified, regularly reviewed and updated. Staff recognised and responded promptly and adequately to people’s changing needs. Appropriate referrals to external services such as the dietitian or occupational therapist were made in a timely manner to make sure people’s needs were met.

People and relatives confirmed all people’s day-to-day health and wellbeing needs were met, and people always experienced positive outcomes related to these needs. One relative told us, “When [my loved one] arrived at Primrose Lodge, the nurse practitioner that attends contacted me about medication and we were aiming to minimise the number of medicines prescribed. This was done but the staff noted that [my loved one] had been more agitated therefore some medicines have been reinstated. I am sure that the team are aware of [my loved one's] needs and respond accordingly.”

People's care plans outlined their food and drink preferences. There was guidance in place to support people to eat safely when they were at risk of choking or needed their food to be a certain consistency. Staff demonstrated good understanding of how to support people with this. Systems were in place to monitor people's nutritional intake and weight, and risks associated with dehydration and malnutrition. Care plans identified the level of support people needed fromstaff to prevent malnutrition and dehydration, and this information was available to the staff working in the kitchen. A member of staff told us, “The service has a really good rapport with the local dysphagia team, they deliver NHS based training, which is excellent. It can be started online but attending in person is the best.”

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The provider established effective systems and processes for referring people to external services and to maintain continuity of care. Plans for transition, referral and discharge considered people’s individual needs, circumstances, ongoing care arrangements and expected outcomes. This meant people’s care was effectively coordinated, to ensure they received timely and consistent support and treatment. For example, staff at Primrose Lodge were supporting 2 people to move there from another service specialising in supporting people with learning disability.Proactive strategies were implemented to anticipate and reduce distress by facilitating visits to Primrose Lodge prior to admission. As they used to share a bedroom for many years, it had been initially arranged for a larger bedroom to house 2 beds, and the second bedroom to act as a lounge area for them. Both rooms were furnished with items which they were familiar with and recognised. Support staff came to work with those individuals when they moved to Primrose Lodge to ensure continuity of support and minimise the impact of change on people’s health and wellbeing. Some of those staff stayed and are still working at Primrose Lodge 8 years later.

Staff worked with other health and social care partners to prevent or reduce the need for admissions to hospital. Health passports and transition plans were developed, maintained and used consistently. For example, when people needed hospitalisation, they held hospital and communication passports. This meant all relevant staff were able to access the information they needed to understand people’s needs and appropriately assess, plan and deliver their care, treatment and support. We received positive feedback from all 4 visiting health and care professionals that responded to our request about communication with the home and collaborative working. Comments included, “Staff work well with external stakeholders. Communication is generally good and clear and made in an appropriate way.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The provider established effective systems and processes to ensure people’s day-to-day health and wellbeing needs were being met, and people experienced positive outcomes related to these needs. We received positive feedback from people and relatives about the support people received to manage their health and wellbeing and enhance independence. One relative told us, “I do believe that staff respect [my loved one's] wishes. My [loved one] is quite independent and sometimes I think some staff can find it rather difficult to step back and let [them] do things for [themselves]. As expected, it has taken a while for [my loved one] to settle into being cared for, but I now think [they] wouldn't want to be anywhere else and enjoy a good relationship with most staff.”

Staff effectively empowered and supported people to be involved in or manage their own health, care and wellbeing needs as much as possible. A member of staff told us, “We encourage people to do as much as they can for themselves to promote their independence. For example, with washing and dressing but we will help them when needed. We listen and understand what their likes and dislikes are, and we always give them choice. If they have any preference, we will fit our support around them.” Staff told us they felt proud working at Primrose Lodge, and they felt people living there had good life.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The provider established robust processes for monitoring the effectiveness of people’s care, treatment and support and ensuring actions were taken to continuously improve it.

The provider actively sought and considered feedback from people, their relatives, professionals and stakeholders as appropriate when monitoring individual outcomes. Results were used to drive improvement. There were regular residents’ meetings and ‘Friends of Primrose Lodge’ relatives’ meetings where people expressed their opinions, wishes and preferences. We received positive feedback from people and relatives about their involvement in driving improvements. Comments included, “I have been spoken to informally, and I have offered my opinions informally, about how my loved one is happy, how [they] had thrived and how I am happy to see [them] in such a warm well managed, well-staffed and well-coordinated environment.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

The provider had established effective systems and processes to ensure people’s human and legal rights were always respected and they had maximum choice and control over their lives. Staff demonstrated good understanding and working knowledge of the key requirements of the Mental Capacity Act (MCA) including Deprivation of Liberty Safeguards (DoLS). People were involved in decisions about their care and treatment as much as possible and staff ensured all practicable steps were taken to help people make their own decisions.

People’s mental capacity to make decisions was assessed whenever this was necessary. Where people did not have the capacity to make particular decision they were given the information they needed in an accessible format of their choice, and where appropriate, their family, friends, legal representatives or advocates were involved. All decisions were taken in people’s best interests ensuring staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.