Archived: Primrose House

Primrose House is a residential care home for up to two people providing personal care to people living with mental health needs. The house was divided into two flats. At the time of inspection there were two people living at the home.

People’s experience of using this service and what we found

People received care from staff they knew. Staff had a good understanding of people's needs, choices and preferences. People were encouraged to make decisions about how their care was provided and their privacy and dignity were protected and promoted. Staff gained people's consent before providing personal care.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were involved in the planning of their care which was person centred and updated regularly. People were supported to express themselves, their views were acknowledged and acted upon. There was a complaints system in place and people were confident that any complaints would be responded to appropriately.

Staff understood their roles and responsibilities to safeguard people from the risk of harm. People were supported to access relevant health and social care professionals.

People’s medicines were managed in a safe way. People’s risks were assessed at regular intervals or as their needs changed. Care plans informed staff how to provide care that mitigated these known risks.

Staff were recruited using safe recruitment practices. Staff received training to enable them to meet people’s needs and were supported to carry out their roles. Staff were happy working at Primrose House and were proud of their relationships with the people they supported.

The management team continually monitored the quality of the service, identifying issues and making changes to improve the care and to help people to achieve their goals.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 10 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Primrose House is registered to provide accommodation and personal care support for up to two people with mental health needs and is a step down service from a larger service that provides more structured support. The home is divided into individual flats and at the time of our inspection there were two people living there.

The service is required to have a registered manager. There was a registered manager in post at the time of our inspection. 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.

People were supported to develop life and social skills and gain as much independence as possible. Their support was provided by a staff group, who shared a strong person centred ethos.

People felt safe in the home and received safe care and support. Staff had a good understanding of their role in safeguarding people and they knew how to report concerns. Staffing levels ensured that people received the support they required at the times they needed it.

The recruitment practices were thorough and protected people from being cared for by staff that were unsuitable to work at the service. Staff received the training and support required to enable them to understand and meet the care needs of each person.

People were supported to take their medicines as prescribed. Records showed that medicines were obtained, stored, administered and disposed of safely. People were supported to maintain good health as staff had the knowledge and skills to support them and there was prompt access to healthcare services when needed.

People were fully involved in decisions about their care and support needs and this had a positive impact on their ability to be as independent as possible. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005. Staff provided people with information to enable them to make informed decisions and encouraged people to make their own choices.

Staff were committed to the work they did and had good relationships with the people who lived in the home. People interacted in a relaxed way with staff, and people consistently spoke about the positive impact living in the home had made on their lives.

People were fully involved in the planning of their care and felt included in discussions, being able to have their say at each step of the way. Staff listened and respected people's views about the way they wanted their support to be delivered.

People participated in a range of activities within the service, the local community and further afield. The atmosphere in the home was very positive and people were enthusiastic about their future plans.

Staff were aware of the importance of managing complaints promptly in line with the provider’s policy. People living in the home and staff were confident that any issues would be addressed and that if they had concerns they would be listened to.

The service was well led and people and staff had full confidence in the leadership of the registered manager. The provider ensured that the service was well supported and effective systems were in place to assess and monitor the quality of service.

Primrose House is registered to provide accommodation and personal care support for up to two people with mental health needs and is a step down service from a larger home that provides more structured support. The home is divided into individual flats and at the time of our inspection there were two people living there.

The service is required to have a registered manager. At the time of inspection the registered manager was in the process of de registering with the Care Quality Commission. A manager was in post and they were aware that they would need to register as the manager for the service. 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 provider had not implemented effective governance systems and information about the safety of the service was not sufficiently monitored. Record keeping was inconsistent and as such it was difficult to for the provider to monitor and evaluate areas such as health and safety and staff training.

This was a breach of one regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

The systems in place to alert people in the event of a fire were not sufficient to minimise the risk of harm to people should a fire occur. This was rectified by the provider whilst the inspection was on going. Fire risk assessments and procedures were also not adequate; this has been rectified since the inspection took place.

People living in the home told us that they felt safe in their own flats. Staff understood the need to protect people from harm and knew what action they should take if they had any concerns.

Care plans were written in a person centred approach and detailed how people wished to be supported. They had been involved in decisions about their care. Care records contained individual risk assessments and risk management plans to protect people from identified risks and help to keep them safe but also enabled positive risk taking. They provided information to staff about action to be taken to minimise any risks whilst allowing people to be as independent as possible. Care plans and risk assessments had been regularly reviewed but people had not been involved in the review and their care plans and risk assessments had not been updated in light of the review findings.

There were sufficient staff to meet the needs of the people living in the flats and we observed on the day of our inspection that there were sufficient staff on duty. Recruitment procedures protected people from receiving unsafe care from care staff that were unsuitable to work at the service.

People were supported to take their medicines as prescribed. Records showed that medicines were obtained, stored, administered and disposed of safely; however the completion of medication administration record charts did not consistently reflect current guidelines. People were supported to maintain good health and had access to healthcare services when needed.

People were actively involved in decisions about their care and support needs. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

Staff had good relationships with the people who lived at the house. Staff were aware of the importance of managing complaints promptly and in line with the provider’s policy.

Staff and people living in the home were confident that issues would be addressed and that any concerns they had would be listened to by the manager.