Primrose Lodge Weymouth

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good.

At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Openness and transparency about safety was actively encouraged and embedded in the service. Staff understood their responsibilities to raise concerns and report incidents and near misses; they were fully supported when they did so. The registered manager told us, “We’ve always been a home that prides itself on a no blame culture. We learn lessons from mistakes and share this experience with all staff. We will continue to support staff where needed”. When something went wrong, there was anthorough review and investigation that involved all relevant staff, partner organisations and people who use the service with a strong focus on improvement and preventing reoccurrence.

People and their relatives confirmed they felt confident to raise concerns, felt they were listened to and believed actions would follow. One relative told us, ‘I have no doubt my concerns, should they arise, be addressed immediately and promptly.’

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The service worked with people and those close to them to establish their plan of care and comprehensive individual transition plans, prior to the person moving between services to eliminate any risks and to ensure the person received continuity of care. Pre-assessment paperwork was always completed involving people, relatives and partners prior to people moving into the service and shared with staff. Assessments of needs were communicated with staff when people moved into the service or returned from a hospital stay via daily handovers. One professional told us, “I supported [person’s name] to move to Weymouth and Primrose Lodge placement is working really well. The residential contract was set up in a timely manner and the communication with the home has been excellent.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People and their relatives confirmed they felt the service provided by Primrose Lodge was safe.

The provider established effective safeguarding systems, policies and procedures and managed safeguarding concerns promptly, using local safeguarding procedures whenever necessary. There was a consistent approach to safeguarding and matters were always dealt with in an open, transparent and objective way. Where required, investigations were thorough.
All staff had received safeguarding training and demonstrated a comprehensive awareness and understanding of their roles and responsibilities. Staff knew how to recognise the signs and symptoms of abuse and who they would report concerns to both internally and externally. They told us they felt confident management would listen and act if they raised concerns.

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. People had the necessary assessments in place to ensure their rights had been fully respected. The provider followed principles and requirements of Mental Capacity Act (MCA) where people were deprived of their liberty, whether under the Deprivation of Liberty Safeguards (DoLS) or through an order by the Court of Protection. There was a clear understanding of DoLS, they were used appropriately and only when it is in the best interest of the person.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risks to people’s health, safety and welfare were identified for example, risks associated with people’s mobility, swallowing difficulties and malnutrition. These risks were assessed before they started to use the service and added to as needed. Risk assessments were created and maintained within the provider electronic recording system, updated regularly and as things changed. Relevant health and safety concerns were included in people’s care plans.

Staff told us they were given enough information about people’s risks and how to keep people safe when providing their care. For example, how to support people with complex behaviours, swallowing difficulties or diabetes.

People and their relatives felt involved in managing risks, and risk assessments were person-centred, proportionate and reviewed regularly. All but 1 relative including people’s legal representatives, told us they were, when appropriate, involved in creating and reviewing people’s care plans. Comments included, “There has just been a care plan review. We are always involved in decisions about [our loved one’s] care.”

The provider embedded a proactive approach to anticipating and managing risks to people. People were enabled to take positive risks to maximise their control over care and support. They were also actively involved in managing their own risks along with their relatives, friends and others important to them. Restrictions were minimised so people felt safe but also had the most freedom possible – regardless of disability or other needs. The registered manager told us, “We can’t always wrap people in cotton wool, especially if they don’t want to be, residents have the right to risk. For example, we support [person’s name] who loves to dance, sing and entertain. [They] used to do this as a profession and wanted to continue to do so. At one venue we were concerned [they] may fall of the stage. However, [they] were still able to perform but seated in a chair, still shaking [their] shoulders about and tapping [their] foot.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The provider took all possible action to assess and reduce the risk of injury caused by people’s living environment and liaised with other organisations to do so whenever needed. Effective arrangements were in place to monitor the safety and upkeep of the premises, bringing in professionally qualified people to complete the necessary environmental and equipment checks. Staff were clear about their responsibilities regarding premises and equipment. We observed staff using equipment correctly to meet statutory requirements and support people to stay safe.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

People expressed that they were happy with staff supporting them. People felt there were sufficient staff on duty. All but 1 relative agreed. Comments included, “I have never been a witness to any staff shortages. Every time I have visited, which is several times a week, there is always evidence of staff present and available, even when I cannot make my loved one’s medical appointment, there has always been someone at hand. And this includes social events they’re keen to attend.”

There were enough competent staff on duty when we visited. Staff had the right mix of skills to make sure that practice was safe and they were able to respond to unforeseen events. The service regularly reviewed staffing levels and adapted them to people’s changing needs. Staff told us that they felt supported and received appropriate training and supervisions to enable them to fulfil their roles.

Appropriate recruitment checks were carried out as standard practice. Recruitment processes were robust, and staff were recruited safely. The registered managertold us they had no vacancies and staff retention was very good, so they had not needed to use agency staff to cover absences for many years. The registered manager told us, “We believe Primrose Lodge staff are a very important part of the home and to resident’s overall wellbeing. We are very proud of our recruitment, retention and staff personal development.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People were protected as much as possible from the risk of infection because premises and equipment are kept clean and hygienic. They were supported to maintain their own personal hygiene in line with their needs and preferences.

Infection prevention and control was at the core of the service and staff had received training with regular updates. Staff understood their role and responsibilities for maintaining high standards of cleanliness and hygiene in the premises and their own personal hygiene, including hand hygiene. Housekeeping staff told us they conducted daily cleaning schedules and checks to ensure processes were being followed and all areas were being cleaned. During the site visit we saw cleaning taking place. Cleaning records demonstrated what was being cleaned.

We observed the service was clean and free from odours. Personal Protective Equipment (PPE) such as disposable gloves and aprons was available throughout the service, and we observed staff using PPE safely and appropriately.

Managers at the service had oversight of infection prevention and control (IPC) and carried out regular audits and checks of all aspects of infection control. The provider’s IPC policy was up to date. Infection prevention and control procedures were robust, in line with the providers policy.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Medicines records showed that they were given as prescribed for people. Personalised protocols were in place for all medicines prescribed ‘when required.’ People’s wishes and preferences about how they like taking their medicines were clearly recorded in their care plans. We observed staff giving medicines safely and in a kind and caring way, taking time with people, and asking if any ‘when required’ medicines were needed. We observed people’s individual preferences for how they liked to take their medicines were respected by staff. One relative told us, “I have been present on several occasions when [my loved one] has received [their] medication. Staff are professional about encouraging [my loved one] to take [their] meds and staying with [them] to ensure they are taken. It is also clear that we should not disturb staff while they are dispensing / delivering meds.”

Medicines were stored correctly and disposed of safely. Staff kept accurate medicines records. Staff told us they felt well supported regarding medicines management, and that they felt that the systems in place were effective. They told us they had training, and competency checks to make sure they gave medicines safely. They were able to describe how medicines errors or incidents were recorded and followed up, and they knew the procedure to follow if people refused to take their prescribed medication. Medicines incidents or errors were reported and investigated.