Primrose Lodge

At our last assessment, we rated this key question good. At this assessment the rating has changed to requires improvement.

The service had an exclusion criteria in place, however this was not appropriate for the type of service being delivered. The criteria did not provide enough detail or guidance for the admitting clinician to refer to when admitting a person into the service.

Clients were not seen in person by a doctor or clinician as part of their admission process and GP summaries had not been obtained in 5 of the 6 care records we reviewed, which suggests they had not been used to inform the admission assessment. Staff were relying solely on information self-reported by clients when making decisions about prescribing medicines for detoxification. This meant there was an increased risk of the admitting doctor missing key information relating to a client’s medical history that could impact on their safety and wellbeing during admission, particularly when they were undergoing detoxification that has associated risks.

During remote assessments, support workers were occasionally asked to carry out physical examinations on direction from the doctor, which they were not trained to do. We raised this with the provider following the inspection and they confirmed that they had asked staff to immediately cease this practice, which was not in line with their established assessment process.

However:

Staff had a good knowledge of safeguarding and there were clear processes in place around this.

Staff kept the service clean.

Staff ensured that allergies were clearly documented and communicated to staff.