Primrose Hill Nursing Home

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement.

This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 60 (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 always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

People told us they were able to seek support when needed. One person told us, “If I feel unwell, I push the bell or call out,” and said they were able to get up and go to bed when they chose.

We observed staff interacting positively with people throughout the inspection. For example, one staff member was seen speaking with a person about attending the hairdresser, engaging in friendly conversation before supporting them to attend independently using their walking aid.

Staff were also observed supporting people with their day-to-day needs, such as offering and preparing drinks at regular intervals.

However, feedback from people at the service suggested that people’s experiences were not always consistent. For example, 1 person told us, “Most respect you, but some turn their back on you”.

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. People’s wishes, preferences, choices and rights were not always clearly recorded, known or consistently respected, which meant their care did not always meet their individual needs.

One person told us, “The food isn’t wonderful, it just gets dolloped on a plate.” Another person told us, “I do not like the food.” During lunch we observed that food was not always eaten and was later removed after which dessert was given.

We also found that people’s individual needs were not always consistently met. For instance, when we attempted to engage with one person, they did not have their hearing aid in place, despite staff being asked to check the batteries during the inspection. We found that records did not accurately reflect their needs. As a result, we could not be fully assured that the person’s communication needs were being consistently met.

However, we observed some positive interactions where staff adapted their approach to support people, including helping them to maintain routines and make choices about their care. One relative told us, “Yes overall I think so. They do give her choice, especially when getting dressed, that’s when she expresses her preferences most.”

The provider promoted people’s independence and supported them to have choice and control over their care, treatment and wellbeing.

People and relatives told us they were supported to make choices about their care. One relative told us, “[Person’s name] is offered choices for food and drinks and can choose themself. [Person’s name] hasn’t got full capacity, sometimes they will say one thing and then change their mind.” This showed that people were supported to express preferences about their care.

Staff told us they encouraged people to remain independent where possible. One staff member explained they supported people to carry out tasks for themselves, such as eating and aspects of personal care, where this could be done safely. People were also supported to manage aspects of their own health where appropriate, such as administering their own insulin. This helped people retain their independence and have control over aspects of their health and wellbeing.

During the inspection, we observed people taking part in activities, where staff supported engagement and interaction to promote wellbeing and choice.

The provider did not always recognise and respond to people’s immediate needs in a safe and timely way.

On the day of inspection, we observed an occasion where a person's immediate needs were not responded to appropriately. A person was provided with the incorrect fluid consistency, which did not match their assessed needs. Staff told us the member of staff supporting the person had been moved to assist and it had been assumed they had read the care plan. This meant the person's immediate health needs were not identified and responded to appropriately, placing them at risk of choking and aspiration.

One staff member told us, “I don’t have time to look in care plans.” This suggested staff did not always refer to care records when responding to people’s needs.

However, some people told us they were able to seek support when needed, and we observed staff present in communal areas who responded to people’s requests throughout the day.

The provider did not always effectively promote staff wellbeing or provide consistent support, which may impact staff’s ability to deliver person‑centred care.

Staff feedback highlighted some inconsistencies in the support and leadership within the service. One staff member told us, “I get on okay with the manager, but it would be nice if they came on the floor more or checked in with us. I don’t feel I get much support when things go wrong.” However, another staff member told us, “I like my workplace and management, they support the staff.” The registered manager described initiatives such as ‘you said, we did’ and stated the service had been finalists in the West Midlands Care Awards. This indicated that systems were in place to support staff, although these were not always experienced consistently across the service.