Primrose House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At the last inspection we rated this key good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff did not always make sure people’s care and treatment was effective. Staff had not ensured the assessments were fully completed and although staff could find all relevant information it was not always recorded in the electronic assessment. We discussed for people who have a dementia the benefit of making more use of their information about lived history in the assessment so this can be followed through into the care records. The management team immediately addressed this matter.

The staff team planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. People had mixed views about the food. Most people found it was enjoyable and some did not. People said, “The food is really excellent,” “The food is quite good most of the time,” “The food is not bad,” and, “Yesterday they served a plate of macaroni cheese, nothing with it like peas to give it a bit of colour and older people don’t like pasta much.” We observed the meals being offered were varied and nutritious. The catering staff regularly reviewed the menus, they had recognised more variety was needed at times and had developed a new menu, which the management team actively encouraged them to put in place.

Staff worked well across teams and services to support people. They shared information about people’s needs when they moved between different services, so people only needed to tell their story once. Staff worked with local healthcare professionals and sought advice when required. Staff work very effectively as a team to ensure people’s support needs were met.

Staff supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff assisted people to live healthier lives and, where possible, reduce their future needs for care and support. Staff liaised with external health and social care professionals to ensure people received consistent care and support. A person said, “I was in hospital for a long time. I’m in a good place now and staff know what they are doing. Usually, the doctor comes on a Thursday, you see the nurse and they will pass on the message.”

Overall staff ensured everyone could access the care, support and treatment they need when they need it. Improvements were required to how people were supported to maintain their cleanliness, nail care, and ensuring people had received fluids. The new regional management team took immediate action to resolve these issues. People and relatives professionals had mixed views about the service. A relative said, “The whole atmosphere is dull. There is very little going on and nothing at weekends. [Person] has had fingernails with poo under them and dinner spilt all over her clothes.” Another relative said, “Regular staff are struggling because there are no management and there is favouritism amongst some of the staff.” The management team were acting to make improvements.

Staff told people about their rights around consent and respected these when delivering person-centred care and treatment. People made their own choices and decisions on a day-to-day basis about what they did, what they ate and how they filled their time. A person had recently moved to the service and thought they could not leave the service unless accompanied, which was not the case. We raised this with staff who immediately addressed the misunderstanding. Staff understood the requirements of the Mental Capacity Act and associated codes of practice. They completed capacity assessments and ‘best interests’ decisions. However, staff were not always completing decision specific assessments for areas other than the one related to whether a DoLS authorisation was needed. They had not considered completing them for all aspects of care where staff were imposing restrictions. The management team took immediate action to extend the capacity assessments and ‘best interests’ decisions to cover all areas were people were subject to restrictions.