We carried out a review of the data available to us about Primrose House Nursing Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Primrose House Nursing Home, you can give feedback on this service.
Primrose House Nursing Home is a care home registered to provide accommodation and nursing care for a maximum of 26 older people, some of whom may have dementia. The home may also admit people with a physical disability. At this inspection there were 25 people living in the home.
People’s experience of using this service
People and their representatives were satisfied with the care provided. Staff treated people with respect and dignity. People felt safe in the home. Risk assessments had been documented. Risks to people’s health and wellbeing had been assessed. There was detailed guidance for staff on how to minimise risks to people.
There were arrangements to protect people from abuse. Staff had received training on how to safeguard people and were aware of the procedure to follow if they suspected that people were subject to abuse.
People received their prescribed medicines. There were suitable arrangements for the safe administration of medicines.
There were sufficient staff to attend to people’s needs. Staff had been carefully recruited and essential pre-employment checks had been carried out. They had received training and had knowledge and skills to support people. Staff were supported in their roles and duties. There were arrangements for staff support, supervision and appraisals.
The premises were clean and tidy. There was a record of essential maintenance carried out. Fire safety arrangements were in place.
People’s nutritional and dietary needs and preferences were met. Staff supported people to have a healthy and nutritious diet.
People could access the services of healthcare professionals when needed. Their healthcare needs had been assessed and attended to.
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. The policies and systems in the services supported this practice.
The service provided people with person-centred care and support that met their individual needs and preferences. People’s care needs had been carefully assessed prior to them coming to the home. Staff were knowledgeable regarding these needs.
People could participate in a range of social and therapeutic activities. The service arranged events to celebrate special cultural and religious days.
There was a complaints procedure and people knew how to complain. Complaints recorded had been promptly responded to.
The service was well managed. Management monitored the quality of the services provided via regular audits and checks. The results of the recent satisfaction survey indicated that people and their representatives were satisfied with the care and services provided.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection:
The last rating for this service was good (published 22 September 2017).
Why we inspected:
This was a planned inspection based on the previous rating.
Follow up:
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
At our last comprehensive inspection on 28 April and 1 May 2015 we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the service did not have suitable arrangements in place for meeting the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguard (DoLS) regarding restrictions placed on people.
After the comprehensive inspection, the registered provider sent us an action plan telling us how they would meet legal requirements. We undertook a focused inspection on 26 January 2017 and found that they had followed their plan and they had met legal requirements in relation to the MCA and DoLS.
There were suitable arrangements to protect people from harm and abuse and care workers demonstrated an understanding of how to recognise different forms of abuse and how to report these. Risks in relation to treatment and care provided were assessed and risk management plans ensured that identified risks were minimised. The service followed safe recruitment practices and sufficient staff were deployed to ensure people’s needs had been met. The arrangements for the administration of medicines were satisfactory and medicines administration record charts (MAR) had been properly completed.
The premises were kept clean and tidy to a high standard. No unpleasant odours were detected anywhere in the building. Infection control measures were in place. There was a record of essential inspections and maintenance carried out. There were arrangements for fire safety which included alarm checks, drills and training. Personal emergency and evacuation plans (PEEP) were prepared for people to ensure their safety in an emergency.
People’s healthcare needs were carefully monitored and attended to. The dietary needs of people had been assessed and most people were satisfied with the meals provided. However, some people were not fully satisfied with the meals provided and we have made a recommendation for improvement in this area.
There was an activities programme which was arranged to meet the needs and choices of people. This included meeting the needs of people with dementia and promoting the independence of people.
The CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS ensures that an individual being deprived of their liberty is monitored and the reasons why they are being restricted are regularly reviewed to make sure it is still in the person’s best interests. We noted that the home had suitable arrangements in place to comply with the MCA and DoLS.
Care workers worked well as a team and there was effective communication among them. Care workers had received a comprehensive induction and training programme. There were arrangements for support, supervision and appraisals of care workers.
Care workers prepared appropriate and up to date care plans which involved people and their representatives. The home had a varied activities programme to ensure that people could participate in social and therapeutic activities.
The service listened to people who used the service and responded appropriately. There were opportunities for people to express their views and experiences regarding the care and management of the home. Regular residents’ and relatives' meetings had been held for people and their suggestions and concerns noted. Complaints made had been carefully recorded and promptly responded to.
Comprehensive audits and regular checks of the service had been carried out by the registered manager and senior managers of the company. Audits were carried out three monthly and included checks on care documentation, medicines, and maintenance of the home. A recent satisfaction survey indicated that people were very satisfied with the care provided. There was an action plan accompanying the survey.
At our last comprehensive inspection on 28 April and 1 May 2015 we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the service did not have suitable arrangements in place for meeting the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguard (DoLS) regarding restrictions placed on people.
After the comprehensive inspection, the registered provider sent us an action plan telling us how they would meet legal requirements. We undertook this focused inspection on 26 January 2017 to check they had followed their plan and to confirm they now met legal requirements in relation to the MCA and DoLS.
This report only covers our findings in relation to the MCA and DoLS. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Primrose House Nursing Home’ on our website at www.cqc.org.uk’.
At this focused inspection, we found that the provider had taken action to comply with The MCA and DoLS. This included ensuring that the home had the appropriate guidance, assessments and other care documentation. Options that were less restrictive were explored before bedrails were used. The necessary consultations with professionals had been undertaken before applications were made to restrict people’s liberty.
Care workers and senior staff had been provided with appropriate training. Documented evidence of this was seen by us. When interviewed, they were knowledgeable regarding The MCA and DoLS.
People who used the service informed us that they were satisfied with the care provided. We observed that they appeared well cared for.
This inspection took place on 28 April and 2015 and was unannounced.
During a previous inspection of Primrose House in November 2013 we found that the home not meeting the requirements of the law in relation to management of medicines. We carried out a follow up inspection in March 2014 and found that the service was meeting the regulation and there were no concerns.
Primrose House is a nursing home situated in Harrow and is registered to provide care with nursing to up to 24 older people. At the time of our inspection there were 22 people living at the home, the majority of whom had dementia.
There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People who lived at the home told us that they felt safe, and this was confirmed by family members whom we spoke with.
People were protected from the risk of abuse. Staff members had received training in safeguarding, and were able to demonstrate their understanding of what this meant for the people they were supporting. They were also knowledgeable about their role in ensuring that people were safe and that concerns were reported appropriately.
Medicines at the home were well managed. People’s medicines were stored, managed and given to them appropriately. Records of medicines were well maintained.
Staff at the home supported people in a caring and respectful way, and responded promptly to meet their needs and requests. There were enough staff members on duty to meet the physical and other needs of people living at the home. People who remained in their rooms for some or part of the day were regularly checked on.
Staff who worked at the home received regular relevant training and were knowledgeable about their roles and responsibilities. Appropriate checks took place as part of the recruitment process to ensure that staff were suitable for the work that they would be undertaking. All staff members received regular supervision form a manager, and those whom we spoke with told us that they felt well supported.
The home was generally meeting the requirements of The Mental Capacity Act 2005 (MCA). Assessments of capacity had been undertaken and applications for Deprivation of Liberty Safeguards (DoLS) had been made to the relevant local authority. The majority of staff had received training undertaken training in MCA and DoLS, and those we spoke with were able to describe their roles and responsibilities in relation to supporting people who lacked capacity to make decisions. However the risk assessments for people regarding use of bedrails did not show that this was the least restrictive option available to meet their needs which is a requirement of the MCA.
People’s nutritional needs were well met. Meals were nutritionally balanced and met individual health and cultural requirements as outlined in people’s care plans. Alternatives were offered where required, and drinks and snacks were offered to people throughout the day. People’s food and liquid intake was recorded and monitored. Health professionals were involved where there were concerns about nutritional needs.
Care plans and risk assessments were person centred and provided guidance for staff, but it was not always easy to access information that was linked within the care documentation. The registered manager was showed us a new, more accessible care planning tool that they would be introducing as care plans were reviewed and updated.
The home provided a range of individual and group activities for people to participate in throughout the week. Staff members engaged people supportively in participation in activities. People’s cultural and religious needs were supported by the home and this was confirmed by a family member.
People and their family members that we spoke with knew how to complain. There was a picture-assisted version of the home’s complaints procedure, and this was discussed with at the regular monthly service user’s meeting.
Care documentation showed that people’s health needs were regularly reviewed. The home liaised with health professionals to ensure that people received the support that they needed.
There were systems in place to review and monitor the quality of the service, and we saw that action plans had been put in place and addressed where there were concerns. Policies and procedures were up to date and staff members were required to sign that they had read and understood any new or amended ones.
People who used the service, their relatives and staff members spoke positively about the management of the home.
We found one breach of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.