Archived: Primrose House

Primrose House provides personal care up to 6 people with learning and physical disabilities. The home is a single storey, purpose built building. There are disabled facilities and equipment and a sensory room on site. The home is staffed on a 24 hour basis including waking watch carers throughout the night. There were three people who lived at the home on the day of inspection.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service was last inspected on 14 and 21 May 2015. At this inspection we found the registered provider was not meeting all the fundamental standards. We identified breaches to Regulation 12, 17 and 18 of the Health and Social Care Act 2014. Suitable arrangements were not in place to ensure medicines were administered in line with current guidance. Paperwork and staff training was not up to date and staff were not suitably supported within their role.

Following the inspection in May 2015, we asked the registered provider to submit an action plan to show what changes they were going to make to become compliant with the appropriate regulations. The registered provider returned the action plan to demonstrate the improvements they intended to make. We used this inspection to look to see if the action plan had been completed and to ensure all fundamental standards were now being met.

At this comprehensive inspection carried out in June and July 2016, we found improvements had been made and the registered provider was now meeting all the required fundamental standards.

Feedback on service provision was positive. People spoke highly about the quality of service.

Improvements had been made to ensure staffing levels met people’s needs. Staffing arrangements were personalised to fit around the needs of the people who lived at the home. People had access to their own transport and were supported to access community activities of their choosing. Staff responded in a timely manner and people did not have to wait to have their needs met.

We observed staff demonstrating patience with people and taking time to sit with them to offer companionship and comfort. People were given time to carry out tasks as a means to promote independence and were not rushed.

Arrangements were in place to protect people from the risk of abuse. Staff had knowledge of safeguarding procedures and were aware of their responsibilities for reporting any concerns.

Suitable recruitment procedures were in place. Staff were checked before employment was secured. The staff turn-over at the home was low and people benefitted from having staff who knew them well.

Improvements has been made to ensure suitable arrangements were in place for managing and administering medicines. Regular audits of medicines were carried out by staff. Protocols for administering as and when medicines were in place and clearly detailed.

Detailed person centred care plans were in place for people who lived at the home. Care plans covered support needs and personal wishes. Plans were reviewed and updated at regular intervals and information was sought from appropriate professionals as and when required. Consent was gained wherever appropriate.

People’s healthcare needs were monitored and referrals were made to health professionals in a timely manner when health needs changed. Documentation regarding health needs of each person was comprehensive and concise.

Systems were in place to monitor and manage risk. Risks were reviewed on a monthly basis and a record was kept to show reviews had taken place.

We saw evidence of multidisciplinary working to ensure people’s dietary needs were addressed and managed in a safe way. Staff were knowledgeable of people’s needs and we observed good practice guidelines being consistently followed.

The registered provider had implemented a range of quality assurance systems to monitor the quality and effectiveness of the service provided. We saw action was taken when audits identified areas for improvement.

Staff were positive about the way the home was managed. Staff described the home as well-led and praised the commitment of the registered manager. Improvements had been made to administrative systems to ensure paperwork was up to date and easily accessible.

Staff had received training in The Mental Capacity Act 2005 and the associated Deprivation of Liberty Standards (DoLS.) We saw evidence these principles were put into practice when delivering care.

Improvements had been made to ensure staff were supported in their role. Staff told us they received supervisions and appraisals as a means for self-development. The registered manager had a training and development plan for all staff. We saw evidence staff were provided with relevant training to enable them to carry out their role.

Staff, people who lived at the home and their relatives all described the home as a good place to live.

One person living at Primrose House told us the importance of maintaining their independence was essential to them. They told us they were able to choose their own routines and lifestyles and these decisions were respected by staff. They said that staff supported them to maintain their independence but were quick to respond to their requests for assistance.

We saw that people's health care needs were supported by staff who they commented were 'friendly' and 'great'. Staff told us they were well trained and supported. We saw they were respectful of the needs of people living at the home.

People told us that the environment was comfortable and they were able to choose the d'cor of their bedrooms. They said, 'I have all my favourite football teams on my walls'.