We inspected the service on 31 October 2016 and the visit was unannounced.Primrose Lodge is a residential care home and provides care for up to 15 people. There were 15 people were using the service when we visited and many were living with dementia.
At the time of our inspection there was a registered manager in place. It is a requirement that the service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
Relatives had no concerns about their family members’ safety. Staff understood their responsibilities to protect people from abuse and avoidable harm and to remain safe. The provider had procedures in place to manage incidents and accidents. These included seeking the support of health care professionals to reduce future occurrences. Risks to people’s health and well-being were assessed and reviewed. For example, where a person was at risk of damage to their skin, staff had up to date guidance available to them that they followed.
Staff that applied to work for the provider had checks on their suitability carried out before they started their employment. This included references from their previous employer. We found that the provider had employed suitable numbers of staff to meet people’s support requirements.
People received their prescribed medicines safely by trained staff who were assessed for their competency. The provider had made guidance available to staff on the safe handling of people’s medicines that we saw them following. This included staff storing people’s medicines safely.
Staff had the necessary skills and knowledge to offer effective care to people. Staff received training in areas such as health and safety and infection control. Staff received an induction when they started working for the provider so that they were aware of their responsibilities. Staff also received regular guidance and feedback from a manager to make sure they were offering care that met people’s care requirements.
People were supported in line with the Mental Capacity Act 2005. People were asked for their consent when staff offered their support. Where there were concerns about people’s ability to make decisions, the registered manager had assessed people’s mental capacity. The provider told us they would make improvements to make sure that these assessments always followed the requirements of the Act. The registered manager had made applications to the appropriate body where they had sought to deprive a person of their liberties.
People and their relatives were satisfied with the food and drink available to them. We saw that mealtimes were enjoyed by people. The provider had sought specialist advice where there were concerns about people’s eating and drinking. People were supported to maintain their health and well-being. This included having access to healthcare services such as to their GP and physiotherapist.
People’s dignity and privacy was respected by staff who showed kindness and compassion. We saw that people’s care records were stored safely and staff spoke about people’s care requirements in private. People’s families could visit without undue restriction to maintain relationships that were important to them.
People were supported to retain skills to maintain their independence. For example, some people required extra time to enable them to walk and we saw staff offering this. Some people were involved in decisions about how their care was provided. Other people received the support from their representatives who were involved in making decisions about their care to make sure it was provided in ways that were important to people.
People undertook activities that they were interested in. We saw people spending time with staff members in ways which they enjoyed.
People’s representatives had opportunities to contribute to the planning and review of their family members’ care. We found that people’s care plans were focused on them as individuals and detailed their preferences and individual support requirements. This meant that staff had up to date guidance when offering care to people. Staff knew about the people they cared for including their preferences for how they wanted their care to be carried out.
People’s relatives knew how to make a complaint. The provider displayed their complaints procedure so that visitors knew the procedure to follow should they have wanted to make a complaint.
Staff felt supported by the registered manager. They were knowledgeable about their responsibilities including how to report their concerns about the unsafe or inappropriate practice of their colleagues should they have needed to.
The service was well-led and people’s relatives and staff confirmed this. The provider had made available to people, their relatives and staff opportunities to give feedback about the quality of the service. The registered manager told us that if improvements were suggested, they would take action.
The provider had arranged for checks on the quality of the service to be undertaken to make sure it was of a good standard. For example, checks on the cleanliness of the home took place. The registered manager was aware of their registration responsibilities including notifying CQC of significant incidents that occurred at the home.