Primrose Lodge Weymouth

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has remained good.This meant people’s needs were met through good organisation and delivery.

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 were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Care plans showed a high level of person-centred detail, showing staff had worked closely with people, their relatives and others important to them to ensure all their wishes and feelings were recorded. Care planning was focused on each person’s whole life, including their goals, skills, abilities and how they prefer to manage their health. Staff had spent time with people and their relatives to gain real insight, and demonstrated they knew people, their routines, wishes and preferences very well.

Staff enabled people to participate in person-centred activities and encouraged them to maintain hobbies and interests. Care plans outlined people’s enjoyment of activities and went into detail about how staff might get the best responses from individuals. People were encouraged to have goals and aspirations for the future, and staff worked hard to help people achieve these. One person’s care plan stated how listening and dancing to their favourite music brightened their mood and made them happy. They had a large collection of jewellery, handbags and key rings which was very important to them. They also enjoyed the company of others and looked forward to going out every week either with their family or with the activities co-ordinator.

Any changes in people’s needs were responded to and reflected in relevant electronic recording systems. People and their relatives confirmed they were actively involved with decisions about the care and support which they received.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Comprehensive assessments were undertaken before people moved into the service and people’s needs were fully reviewed to ensure their suitability for admission to the service, and to facilitate a smooth transition from one service to the other. The local authority spoke positively regarding the care provision and shared examples of how Primrose Lodge had made positive impact on people’s wellbeing. Admissions were planned gradually to manage the process of onboarding both people and staff to minimise any risk to people. One professional told us, “I was very impressed with Primrose Lodge and the way they accommodated [my client]. They gave them little jobs to complete in the care home which gave them a sense of purpose each day and promoted [their] independence. The staff seemed to know each resident well and were very person-centred. I found the home very warm and inviting.”

Staff made sure the multi-disciplinary team were involved when required. We reviewed records of people having regular input from other services; for example, speech and language therapy records were present and clear, there was input from the community mental health team, local GP surgery and frailty team. Staff worked hard to co-ordinate people’s appointments, making sure other professionals were aware of the person’s treatment and ongoing needs. Staff followed any guidance requested, and provided information and feedback to professionals when needed, such as the effect of medication changes.

The home regularly interacted with relatives, took on board feedback and implemented changes when required. People’s relatives and others important to them were invited to join a ‘Friends of Primrose’ group organised by the management. Regular ‘Friends of Primrose’ meetings were held during which ideas for the service were shared and discussed.

The home developed close links with the local community. For example, the home worked on garden projects with local students and residents. Regular events were being organised and advertised in the community including the home’s annual summer fete.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The provider ensured people’s care plans and records captured ways that met their needs for meaningful communication and decision-making. This enabled people to be active participants in their care if this was their wish. The home was compliant in meeting the Accessible Information Standard, (AIS). Person centred care plans detailed people’s individual communication needs, such as language, sensory aids such as glasses or hearing aids, and any additional resources that staff might use to help with communication, for example pictures, flash cards or technology. People who had difficulty with reading, writing or using digital services were supported to access information. Staff received training in Makaton language used to aid understanding and expression by signing a key word in a sentence to support communication for people with learning disability. The home used literature for people in different font sizes, easy read documents or audio versions to assist in sharing information with people. For example, easy read pictorial information leaflets were provided on various topics like how to make a complaint for people who find standard text difficult to understand.

Staff ensured assessments of people’s individual communication needs were shared with other professionals involved in their care and support when this was needed. People were appropriately involved in decisions about which personal information was being shared with other services. For example, people with a learning disability held individualised health and care passports when they needed hospital admission. These documents were developed with people and those important to them to help healthcare professionals understand how they communicated best, and if any support was needed to facilitate effective communication. Passports contained information about people’s preferred communication methods and any specific support they required including adjustments needed to make healthcare settings more accessible such as a quieter space or alternative communication method.

The provider recently reviewed a service user guide and developed a more user friendly and accessible welcome book for prospective residents containing key information about the service, accompanied by photos. We were told staff worked on the book together with people and relatives and were mainly guided by people’s wishes. The welcome book clearly detailed what to expect from the service on a day to day basis. We observed people reading, chatting and laughing about this book during the visit.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

The provider had a policy and procedure in place that set out the steps someone would need to take if they had a complaint, and information on how to complain was contained within the service user guide. We saw the posters and information showing how to raise an informal concern or make a formal complaint were distributed around the home; these were also provided in easy-to-read formats. The registered manager explained they had a complaint overview log and more in-depth information in reference to each complaint. For people who could not verbally communicate or understand written documents, we found there were appropriate advocates involved in their lives. Residents’ meetings were held regularly to support people to be actively involved in shaping the service.

People and their relatives confirmed they felt confident in the service taking appropriate actions should they raise a concern or complaint, which included looking into the issue thoroughly, communicating what was happening, being open about what had been found out and what the outcome was. The provider worked with people to agree solutions to concerns raised, and to measure the impact of the changes made. People, their relatives and others important to them confirmed they had meaningful involvement in service development and improvement through regular meetings and open communication. Relatives told us: “You can talk to any member of staff, messages will be passed on, and every request has been followed through” and “I have noconcerns of any miscommunications, and all concerns are raised with me promptly and accurately and discussed with my loved one for inclusion.”

All complaints received or concerns raised were used as opportunity to improve the service and the quality of care people received. Any lessons learned after a complaint had been shared with the whole team via handovers, staff team briefs, staff meeting and staff supervisions to ensure improvements made were embedded within the home.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People's care records demonstrated that when they required support and intervention of external health care professionals, this was provided. People were supported to attend health appointments and referrals to external health professionals were made in a timely manner for further assessment and or guidance. This demonstrated that people had access to the care they needed.

People were encouraged and supported to access regular health care reviews with strong focus on prevention from further health deterioration. The registered manager told us, “We have regular chats with residents, their families, District Nurses, GP’s and other medical professionals. We can also access people’s care and clinical records.”

We reviewed records showing out-of-hours services were contacted in emergencies as and when required. Staff told us about the use of 111 or 999, depending on the emergency level. Staff told us they would challenge any decisions made by other health professionals if they felt they were unfair or not reflective of the person's needs or wishes.The registered manager told us, “We ensure people are always listened to. For example, if they wish to go to the hospital or not, or if they want or don’t want to have a DNAR (Do Not Attempt Cardiopulmonary Resuscitation) order in place. We also ensure people understand they can change their mind whenever they wish to.”

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Relatives told us their loved ones had access to health care when needed and did not experience inequalities. There were multi-disciplinary records in place and regular reviews of people’s care plans and risk assessments to ensure they were a true reflection of people’s current and changing needs. For example, we reviewed care plan for a person who recently developed swallowing difficulties and were at high risk of choking. They were also at increasing risk of malnutrition and dehydration due to decreasing appetite. Person had been referred to Speech and Language Therapy Team (SALT) and were awaiting appointment to assess and create safe swallowing plan. Care plan had been reviewed with the person to reflect their changing needs which included guidance for staff to assist them with all their meals, encourage food and fluid intake and person’s wish to have a soft diet and pureed meat until the assessment by a specialist service takes place.

The registered manager told us, “We work with different residents, their families and other professionals to try and address any barriers and work on solutions that may help including different aids or equipment.”

The provider continued to engage well in the safeguarding process, raising safeguarding alerts in line with the local framework, and working well with local safeguarding professionals. Any lessons learned throughout this process were identified and shared with all stakeholders to evidence positive outcomes for people.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

People were supported to make decisions about their preferences for end of life care and to express their wishes around advanced care. People’s advanced decisions and what mattered to them at the end of life was recorded within electronic care plans. These included people’s religious beliefs and preferences.

The service worked well with external health and social care teams including palliative care specialists and others, to provide a dignified and pain-free deaths that were as comfortable as possible and to ensure any palliative care preferences and wishes were implemented and fully respected. Specialist palliative equipment and medicines were consistently available at short notice. Staff had received training in palliative care and understood the importance of people’s needs being met. Staff we spoke with showed empathy and understanding of caring for people at the end of their lives.

The home ensured that facilities and support were available for people’s family, friends and others important to them before and after a person died. The activity coordinator had developed ‘Butterfly Boxes’ containing toiletries and other items for family and significant others who may wish to stay at the home when their loved one was nearing the end of their life. The registered manager told us. “We had a resident who was approaching end of their life and their relative stayed with them for 5 days.”

One relative confirmed they felt listened to, informed and supported in the last days of a person’s life, “My [loved one] spent the last months of [their] life in Primrose Lodge. I could not have wished for a better place for [them] to be. The care, love and compassion [they] received was way beyond my expectations. It truly was a home from home. The staff not only cared for [my loved one] but for me and the rest of the family. We all felt cared for and welcome. I never once heard a cross word or impatience with anyone. To see your loved one spend their last days happy is all anyone could wish for.”