Primrose Hill Nursing Home

Updated 14 November 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

This inspection was carried out by 2 inspectors and an Expert By Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Primrose Hill Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Primrose Hill Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 4 people who used the service and 4 relatives about their experience of the care provided. We observed peoples care to help us understand the experience of people who could not talk with us. We also spoke with 11 staff, including care staff, nurses, the registered manager, and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records, these included 10 people’s care records, medicines administration records, training, recruitment records and quality assurance records.

Updated 14 November 2023

About the service

Primrose Hill is a nursing home providing personal and nursing care for to up to 50 people. The service provides support to people living with dementia, mental health needs and those with a

physical disability. At the time of our inspection there were 46 people using the service.

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

Governance systems did not consistently ensure people always had access to their prescribed medicines and records were always completed. Medicines were stored and administered safely, and we saw the issues identified had not impacted on people.

People were safeguarded from abuse by staff that understood how to recognise the signs and take action to protect people. Where people had risks to their safety, these were assessed, and plans put in place to reduce the risks. Infection prevention control measures were in place at the home and staff understood and followed these. Where incidents occurred, people had a review of relevant risk assessments and plans to prevent recurrence and incidents were monitored to look for themes and trends.

Staff were recruited safely and given an induction and training to support them in their role. There were sufficient staff to meet people’s needs and the registered manager reviewed this using a dependency tool to ensure safe staffing levels were consistently available.

People had their needs assessed and care plans were put in place to meet those needs. Staff were given any updates about people’s needs daily in regular handover meetings. People had a choice of food and drinks and any risks relating to nutrition and hydration were assessed and planned for.

People had access to support with their health needs and plans were in place to give guidance for staff on how to support them effectively.

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.

Care plan audits were in place to ensure they were accurate and up to date. There were systems in place to learn from complaints, safeguarding and other incidents to ensure improvements were made. Feedback was sought from people, relatives, and other visitors to the home to check on the quality of the care people received. The provider worked in partnership with other organisations to seek support for people living in the home.

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

Rating at last inspection and update

The last rating for this service was requires improvement (9 May 2023).

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

The last rating for this service was requires improvement (published 9 May 2023). The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.

Why we inspected

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We received concerns in relation to the management of medicines and people’s nursing care needs. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. We found no evidence during this inspection that people were at risk of harm from this concern, however some improvements were needed. .

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Primrose Hill Nursing Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.