Primrose House

Updated 28 March 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by one Inspector.

Service and service type

Primrose House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the Provider Information Return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We also reviewed additional information we held about the service, this included previous inspection reports and statutory notifications. A statutory notification contains information about certain incidents and events the provider is required to notify us about by law.

During the inspection

We spoke with 6 members of staff. This included the registered manager, care staff, maintenance staff and the providers care standards manager. We spoke with 4 people who lived at the service and a visiting professional.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records, including people’s care records, staff recruitment files, records relating to safety checks including fire safety and accident and incident records. We also reviewed medicines records and records relating to monitoring and quality assurance.

Following our site visit we contacted 2 people’s relatives. We also received further clarification and documentation from the service to validate evidence found.

Updated 28 March 2023

About the service

Primrose House is a service which provides care and support for up to 30 older people, some of whom are living with dementia. At the time of the inspection there were 19 people living at the service. The home is purpose built with communal spaces and bedrooms on each of the three floors.

Peoples’ experience of using this service and what we found

Our observations showed people appeared at ease with staff. A healthcare professional spoke positively of the service and the care and treatment provided. Risks of abuse to people were minimised because the service had safeguarding systems and processes. Staff understood safeguarding reporting processes.

The environment was safe. Health and safety checks, together with effective checks of the environment were completed. People’s medicines were safely managed, pre-employment recruitment checks were undertaken and there were sufficient staff on duty. The provider currently had a significant reliance on agency staff to ensure staffing levels were met. This was being addressed through a recruitment campaign to attract permanent staff.

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 service supported this practice. There were systems in place to ensure that when people were deprived of their liberty, this was done with the appropriate legal authority. Where people had others acting lawfully on their behalf, appropriate records were maintained.

People, their relatives and a healthcare professional gave us positive feedback about the quality of care people received. The feedback about the registered manager from people and staff was positive. There were systems to obtain feedback from people, their relatives and staff. Quality monitoring systems were in place at service and provider level.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update:

The last rating for this service was Good (published 17 December 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained Good based on the findings of this inspection.

Follow Up:

We will continue to monitor information we receive about the service, which will help inform when we next inspect.