Primrose Hill Nursing Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

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

This meant people’s needs were not always met.

This service scored 61 (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 did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

People were not always aware of or involved in their care planning. One person told us they did not know whether they had a care plan.

We found that information recorded in care plans was not always accurate or person‑centred. For example, one person’s skin integrity care plan did not reflect their current treatment needs. Although we were told care evaluations were carried out monthly, people’s current needs were not always reflected in their care records. This meant care was not always consistently personalised and staff did not always have clear, up‑to‑date guidance on how to support people in a way that respected their individual preferences and circumstances.

However, staff told us they understood people’s individual needs and preferences and aimed to deliver care in line with this.

There were some shortfalls in how the provider understood the diverse health and care needs of people, so care was not always joined‑up, flexible or supportive of choice and continuity.

We found these systems were not always consistently effective. Care plans and risk assessments were not always accurate or sufficiently detailed, for example in areas such as behaviour support planning, skin integrity and communication needs. This meant staff did not always have clear or up‑to‑date information to follow, which could impact the continuity of care, for example where changes to people’s needs were not reflected in care plans, staff may not respond consistently. As a result, we could not be assured that people consistently received coordinated and personalised care.

However, people were supported to access different services to meet their needs, and there was evidence of involvement from healthcare professionals, including GPs. Staff told us they worked together and shared information to support continuity of care.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Relatives told us they were kept informed about people’s care and any changes in health.

Staff were able to describe how they shared information with people in a way they could understand. One staff member told us, “If someone is nonverbal, we’ve been given some cue cards. They can look at them and tell me what they want. I carry them around.”

During the inspection, we observed staff communicating with people throughout the day and providing information when offering support, such as explaining what they were doing when assisting with care or offering choices.

The provider did not always ensure people were fully involved in decisions about their care or consistently informed of changes. While systems were in place to gather feedback and respond to concerns, these were not always consistently effective.

One person told us they were unsure whether they had a care plan. In addition, care plans were not always accurate or up to date, which meant people’s needs and information about their care were not always clearly reflected in how care was delivered.

We also identified occasions where people’s communication needs were not always clearly reflected in care records or consistently supported in practice, which may have limited their ability to be involved in decisions about their care. This meant they may not always have been able to fully participate in discussions about their care.

However, some people and relatives told us they were involved in day‑to‑day decisions. One relative told us, “Yeah, they ask him what he wants and give him choices.” Relatives also told us they felt able to raise concerns and would speak to staff if needed.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

Relatives told us they were able to access other healthcare professionals when required and did not raise any concerns.

People were able to access care and support in line with their needs, and records confirmed care and interventions were provided as required.

Staff told us they supported people to communicate their needs and provided assistance when required.

Staff spoke positively about treating people equally. One staff member told us, “We treat everyone the same and are honest and open.”

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

People did not always experience care and support in an equitable way. We identified inconsistencies in how people’s needs were met, which may impact outcomes.

We observed differences in people’s experiences within the service environment. At times, people on the first floor were seen walking in the corridors with limited engagement or meaningful activity. The layout of the service meant this area offered less space and fewer opportunities for interaction compared to the ground floor. In contrast, the ground floor provided more spacious communal areas and access to the garden. This meant opportunities for stimulation were not always consistent, which may impact people’s wellbeing.

However, staff told us they aimed to treat people equally and we observed staff supporting people with their day-to-day needs.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

The registered manger told us they worked with external professionals to support people’s care. For example, they liaised with local hospice to seek advice and guidance when needed. They also told us that GPs and family members were involved in people’s care, and care plans were updated to reflect any changes in people’s needs, helping to support coordinated care.