Primrose House Care Home

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. This is the first assessment for this service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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.

Systems and processes were in place to promote people's safety. Staff understood and followed policies and procedures to report accidents and incidents. Records confirmed immediate actions were taken by staff who sought first aid, medical attention and made the required referrals if needed.

The management team reviewed these records and completed investigations which considered the possible cause and actions to reduce recurrence and learning being shared with staff.

Relatives confirmed they were informed of any incidents and accidents. A relative said, " [Relatives name] has had falls, and the staff called me straight away and let me know all the details."

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.

People were supported to safely access and transition between health care services. Hospital passports were in place and information was readily available to support people when attending appointments and in the event of a hospital admission.

Staff were aware of pre-planned appointments and ensured information was available, up to date and reflective of people's current support needs. People's needs were continually assessed and care plans and risk assessments detailed people's diverse needs and support.

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.

The service had a safeguarding policy in place, and the management team followed internal and external processes to keep people safe. Staff demonstrated a good understanding of how to keep people safe and the action to take to protect from harm and abuse.

People told us that they felt safe at the service, comments included, "I feel very safe here, staff are always close by if I need them and they are always happy to help" and, "There isn't anywhere safer for me, I'm not safe at home, but I am very safe here, it’s a wonderful place." Relatives also confirmed their loved ones were safe at the service. One relative told us "I feel [Relative name] is safe at the home."

We checked whether the service was working within the principles of the Mental Capacity Act 2005; whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. All legal applications had been made in accordance with Deprivation of Liberty Safeguards (DoLS). This meant people’s rights were fully respected. The manager kept a record of DoLS applications and authorisations, and this was regularly reviewed to make sure authorisations were current.

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 were identified and recorded within care plans. Care plans contained explanations of the control measures for staff to follow to keep people safe. People's individual risk assessments were detailed and person centered. These records were monitored, reviewed and updated when people's needs changed. However, some care plans contained historic information about people's needs and support which at times contradicted people's current needs. We discussed this with the registered manager who said this would be addressed.

Staff demonstrated a good understanding of specific risks relating to people's health conditions and took timely and appropriate action to mitigate and manage risks to people.

Identified risks to people were shared across the staff team and with external professionals. For example, where people had been identified as at risk of malnutrition, appropriate referrals were submitted to seek additional support and guidance on managing the potential risks.

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

Appropriate safety checks were completed on all relevant areas and equipment, ensuring functionality and compliance with safety requirements.

Fire safety was managed effectively. Staff took part in fire drills and knew how to support people safely in the event of an emergency. Personal emergency evacuation plans were available if people needed support in evacuating the building. Outside areas were secure and accessible. One staff member told us "We do fire drills regularly and there is always a fire marshal on every shift to support us."

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, relatives and staff felt adequate staffing levels were in place. People told us, "There is always staff about to help you if needed" and "I don’t have to wait long for them to help me. I use my call bell, and they are here within minutes." Staff told us "There is definitely enough staff I have worked in busier homes with a lot less staff. I have no concerns. The management team make every effort to cover the shift in the event of sickness and this weekend the registered manager worked the floor because we couldn't get sickness covered."

New staff members received a thorough induction, which included training sessions and shadowing more experienced staff. Staff completed a range of training courses which included person centred care, moving and handling and safeguarding. In addition to this the provider ensured that training around specific health conditions such as Parkinson's, dementia and diabetes was completed.

Staff were recruited safely; appropriate checks were carried out to protect people. The provider held regular staff team meetings and staff received regular supervisions and felt supported by the management team. One staff member told us " The management are really approachable and supportive."

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.

The home was exceptionally clean, with a fresh and welcoming atmosphere. Personal protective equipment was available throughout the service and staff demonstrated a good understanding of safe infection control and waste management practices.

The provider had an infection control policy in place, and all staff received appropriate training. Domestic staff followed cleaning schedules aligned with best practice guidance, and a review of these confirmed that daily and deep cleaning were being completed.

Improvements were needed to ensure people’s medicines were always managed safely as people did not always receive their medicines as prescribed. For example, medications administration records (MARs) showed that people who required time specific medicines to be given 30 to 60 minutes before food were administered alongside medicines that were required to be given with food.

MARs also showed where people received regular pain relief the required 4 hourly gap was not always considered or adhered to. We discussed this with the management team who stated they would complete a full medication review and address the shortfalls.

Where people received their medicines covertly, records confirmed these had been authorised by the GP, and a mental capacity assessment and best interest decision had been completed. Controlled drugs were managed safely in line with associated legislation.

Risk assessments for individuals prescribed blood thinning medication were completed. Information was available to inform staff of the potential complications associated with this type of medication.

Staff responsible for handling medication received training and the management team completed regular competencies checks to ensure correct practice was followed.