Archived: Primrose Court Care Home

We carried out an early morning inspection and we spoke with the manager, four members of staff and three people who used the service.

The summary is based on our observations during the inspection, speaking with people using the service, and the staff supporting them and from looking at records.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

We looked at one person's care file relating to the concern that this person was being neglected. We had received information that staff were not supporting this person to eat appropriately and their weight was not being monitored. We referred these concerns to safeguarding. This person was still in bed at the time of inspection but staff we spoke with said they were eating really well at present. This persons care file evidenced that weight and the malnutrition universal screening tool (MUST) was being recorded weekly and the person had been referred to the dietician.

Is the service well-led?

Concerns were raised about the manager not supporting staff and night staff having to do extra work to make it easy for the day staff. This included getting people up very early, even if they did not want to get up.

We spoke with staff who all stated that the manager is very supportive. Night staff we spoke with said each person who used the service was different and had different needs. We observed that the majority of people stayed in their rooms or in bed for breakfast and that the day staff dealt with this.

Is the service effective?

Concerns were raised about the lack of food choice, the cook could not order any extra food and if a person who used the service had a biscuit this had to be written down. We observed the cook making breakfast and saw choice was offered. The cook said that they can order what extra food they need. We were also told it would be impossible to count biscuits as the people who used the service could help themselves if they wanted. We did not evidence this at the time of inspection due to people eating their breakfast. Two people who used the service who were up in the dining room were living with a dementia and unable to verify this.

Is the service caring?

People were supported by kind and attentive staff. We saw that staff asked people if they wanted to get up or have their breakfast in their room. We also observed people being offered a hot drink if they woke up early. We spoke with one person who used the service who was still in bed and stated that they liked to get up after breakfast.

Is the service responsive?

We observed night staff passing on information to day staff about the type of night they had experienced and peoples care needs. The member of staff on night duty suggested that three people who used the service needed to see a doctor that day. We observed the day staff arranging these appointments as soon as the surgery opened.

What people told us:

We spoke with three people who used the service, the manager and four members of staff. People who used the service said 'I really like it here, did not at first because I was sad to leave my home, I have been here three years now and have no problems at all.' 'I am offered choice with whatever I do.' and 'Staff are wonderful.'

Staff we spoke with said 'Everyone living here are different with different needs and we respect that.' 'We like to make sure we have time to sit with the residents and have a chat.' and 'My manager is really good and will support you whatever.'

The manager informed us that they have now changed all double rooms to single rooms. They now have 20 single bedrooms and are at present updating this information with CQC.

The inspection team consisted of one inspector. During the inspection, we spoke with four people out of 15 people living at Primrose Court, one relative, the manager, activity coordinator and five staff. We looked at three sets of care records. We also observed care practices within the home.

The service had a manager in post who at present is going through the registration process with CQC. The management of the home was good and we saw strong leadership in place and a positive environment for people and staff. Staff spoke highly of their manager and the support which they received.

We set out to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Everyone we spoke with told us they felt safe and secure living at the home. Staff we spoke with understood the procedures which they needed to follow to ensure that people were safe.

Primrose Court was clean, hygienic and well maintained; although the provider may wish to note that the resident's toilets were in need of updating. There were good processes in place that ensured infection prevention and control of the home.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care home. While no applications had been submitted to the local authorising authority, the home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards and there was evidence to show that this had been followed appropriately. Staff had received training in relation to these topics along with the safeguarding of vulnerable adults and had an understanding of the actions to take. This meant that people were safeguarded as required.

Peoples care plans were person centred and provided information on their life history and what is 'important to me'.

Is the service effective?

People all had their needs assessed and had individual care records which set out their care needs. People we spoke with knew about their care plans and told us they had been involved in discussions about their needs.

It was clear from our observations and from speaking with staff that they had a good understanding of the care and support needs of people living at the home and that they knew them well. Assessments included needs for any equipment, mobility aids and specialist dietary requirements.

People spoke highly of the staff and said that they were happy with the care that had been delivered and their needs had been met.

People had access to a range of health care professionals some of which visited the home and all was documented in the care files.

There was a flexible but robust activities schedule in place which catered for everyone's needs. Activities were provided individually and in a group.

People were encouraged to maintain links with their local community by attending local events and each Monday morning the library across the road held a coffee morning for the people who used the service.

The local school visited to talk to the people who used the service about World War One and sent a picture collage of the information they learnt. Primrose Court framed this collage and put it in the entrance hall.

Is the service caring?

People were supported by kind and attentive staff who showed patience and gave encouragement when supporting people, whilst helping them to remain independent.

Care plans were individualised and included people's preferences, interests, aspirations and diverse needs. Our observations of the care provided showed that staff were very knowledgeable about people's needs and wishes.

People told us that they were happy with the care and support provided to them.

Is the service responsive?

There was clear evidence contained within people's care plans to show how they worked with other health and social care professionals.

People told us that they knew how to make a complaint if they needed to.

The home was responsive to people's needs, wishes and preferences. We saw that changes were made when needed, such as menus and activities. People were offered a choice each morning of what they wanted to do that day and everyone had the chance to go out each morning to a place of their choosing such as the local coffee shop, park or supermarket.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. People and their relatives told us they were kept informed of changes which affected them.

There were systems in place to assure the quality of the service they provided. The way the service was run was regularly reviewed. Actions were put in place when needed and in the main we were able to see that these actions had been addressed.

Regular audits were carried out which were used to identify changes and improvements to minimise any risks to people and staff.

We saw people had completed a customer satisfaction survey. This was reviewed and an action plan developed where needed.

There were enough staff on duty at all times and staff had time to sit with the people who used the service. Staff also joined people for a short service by the St John the Evangelist church.

What people said

People who were able to express their views told us they were satisfied with the care and support they received. One person told us, 'The staff are very good and there is always enough of them.' Another said, 'The staff are marvellous.'

Everyone we spoke with told us they enjoyed living at the home and they were happy with the care provided. People told us, 'I like it here it is fun, we have a laugh and a joke,' and 'We go to the library every Monday, I am learning how to use the computer and want a lap top now,' and 'Staff are smashing I have no complaints everyone is friendly.'

Relatives also spoke positively of the staff and the care provided to their relatives. The relative we spoke with said, 'It is brilliant here no faults at all, she is very well cared for.'

Staff told us they enjoyed working at Primrose Court. Staff spoke highly of their team and of their manager. One staff member told us, 'Everyone gets on, the manager is lovely very approachable.' Another told us, 'I have been here three years, best place I have ever worked, such a lovely atmosphere, the residents are lovely.' and 'We are like one big family.'

We spent time talking with several people who were happy with the staff and the care provided. We spoke with one person who said, "The staff are all obliging, if I want anything, they'll try and get it". Another person told us, "I get on well with all of them".

We looked at care plans for people living in the home and ways in which people's nutritional needs were met. We found that specific dietary needs were catered for and people had choices about the food they ate.

We saw evidence that there were a range of systems and processes in place to monitor the quality of care provided and opportunities for people living in the service, their relatives and staff to provide feedback.

We saw that staff employed had been through recruitment checks prior to commencing employment.

The provider had taken steps to protect people from the risk of abuse by ensuring that there were procedures in place and staff had been trained to recognise abuse and raise concerns.

There was a complaints procedure in place and people living in the service and their relatives were clear about what they should do if they had any concerns.

During the visit, we spoke with seven people who used the service and discussed the issues raised at the previous inspections. All of the people we spoke with told us that they really liked the home; thought the staff were excellent at their jobs; and felt their care needs were met. They said, 'The staff are wonderful', 'They are excellent bunch and this is like home from home' and 'The staff are lovely and kind.'

From our observations, we found that the care staff supported people in a sensitive manner. Staff discussed people with a sense of genuine warmth and the people told us the home was run much like a large family. We found that staff had a good understanding of how to best meet each person's care needs. We saw that staff involved people in discussions and always sought their views.

We found that the new manager had taken proactive steps to ensure the home was compliant in all areas. We found that care people were now receiving was meeting their needs.