CQC report explained · a residential care home
What the CQC found at Primrose Hill Farm
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Staff understood people's risks, staffing levels were maintained and medicines were generally managed safely, although some expired medicines had not been identified for disposal and fire-risk assessments for emollients were missing.
- Effective?
- Good
- People's care achieved good outcomes and supported their quality of life. Staff understood people's needs, supported choice and independence, and helped people access food, healthcare and specialist support.
- Caring?
- Good
- The report does not give a separate Caring rating. Inspectors said people were treated with dignity and respect and were involved in shaping their care.
- Responsive?
- Good
- The report does not give a separate Responsive rating. Inspectors found person-centred care planning, meaningful activities and support for people's interests and goals.
- Well-led?
- Good
- The home had a positive culture, supportive management and systems for audits, feedback and improvement. However, its systems had not identified the medicines and capacity-record issues before the inspection.
What inspectors found, January 2023
Rated Good; inspectors found safe, person-centred care, with some medicines and capacity records needing improvement.
Inspectors visited the home without notice on 15 and 17 November 2022. They spoke with 10 people, four relatives, 17 staff and two visiting professionals. They also checked care, medicines, staff and management records.
The home supported 35 people with learning disabilities and/or autism. Inspectors found people were safe, treated with dignity and supported to make choices, stay independent and take part in meaningful activities. Staff supported people's health needs and worked with other services.
The overall rating was Good. Safe, Effective and Well-led were each rated Good. Inspectors found some issues with expired medicines, fire-risk checks for emollient creams and one capacity assessment, but the provider acted during or immediately after the inspection.
Choice and independence
People were supported to make choices, maintain their independence and take part in activities that mattered to them. Care was delivered in the least restrictive way possible.
“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” from the report
Kind, respectful relationships
Inspectors found positive relationships between people and longstanding staff. People and relatives said people were happy, and staff treated people with dignity and respect.
“People were treated with dignity and respect and were involved in shaping their care.” from the report
Skilled support
Staff received training relevant to their roles, including specialist training for conditions such as diabetes and epilepsy. Staff understood people's individual needs.
“Staff received training relevant to their roles and felt they had the skills and knowledge required to meet people's needs.” from the report
Health support
People were supported to attend healthcare appointments and had health action plans. The home adapted appointments when attending a surgery was distressing for someone.
“People had health action plans in place.” from the report
Positive management
The management team had a clear vision, gathered feedback and used audits and action plans to monitor the service. Staff said they felt supported.
“The management team worked closely with staff and had a clear vision for the service.” from the report
Expired medicines
needs fixingThe home's systems had not always identified when expired medicines needed to be disposed of. The provider took immediate action after inspectors raised this.
“However, systems in place had not always highlighted when expired medications should have been disposed of.” from the report
Fire risk from creams
needs fixingRisk assessments had not been completed for the increased fire risk linked to emollient creams. The provider introduced a policy, informed staff and displayed signs during the inspection.
“However, risk assessments were not in place to consider the increased fire risk from emollients.” from the report
Capacity record
needs fixingOne person's capacity to make an unwise decision had not been fully assessed and recorded. The provider took immediate steps to address this.
“However, we found one instance where a person's capacity to make an unwise decision had not been fully assessed and documented.” from the report
- 01How do you now check for and dispose of expired medicines?
- 02What risk assessment and staff guidance are in place for the fire risk from emollient creams?
- 03How do you make sure capacity assessments are complete, decision-specific and kept up to date?
- 04How will you involve my relative in their care plan, choices and monthly goals?
- 05How do you use feedback from people, relatives and professionals to improve each house?
This inspection examined the overall service and rated Safe, Effective and Well-led; the report does not give separate ratings for Caring or Responsive. This explanation was written from the published report of 6 January 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, February 2019
Rated Good; inspectors found safe, kind and personalised care, with some plans to improve information formats and training records.
This was an unannounced scheduled inspection on 22 January 2019. One inspector and two experts by experience spoke with people, staff, managers, a healthcare professional and relatives. They also reviewed care records, incident and complaint records, and quality checks.
The home supports 39 people under 65 with mental health problems, learning disabilities or autism. It is made up of seven self-contained houses. Inspectors found enough staff, safe medicines practice, suitable training, person-centred care and good support with health, food, activities and community life.
People were treated with kindness, dignity and respect. Staff understood people's needs and communication methods, and supported people to make choices and maintain independence. The home was also found to be well managed, with people, relatives and professionals involved in reviewing the service.
The overall rating was Good, and all five areas were rated Good. This was the same overall rating as the previous inspection, published in June 2016.
Safe staffing and risk support
Inspectors found enough staff to meet people's needs, including two-to-one support when required. Staff knew people well and understood how to manage risks.
“There were enough staff on duty to meet people's needs.” from the report
Kind and respectful care
Staff responded quickly when people were distressed or uncomfortable. People had privacy in their own rooms and were supported to make choices.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Personalised support
Care plans included people's interests, wishes and communication methods. People were supported to take part in activities, prepare food and visit family.
“Care and support plans were developed for each person and considered the interests, wishes and aspirations of the individual” from the report
Good health support
People were supported to attend healthcare appointments and improve their health. Staff communicated with outside professionals to provide consistent care.
“People were well supported to improve their health.” from the report
Open management
People, relatives, staff and professionals were asked for their views. Staff said they could raise issues and felt supported by managers.
“Staff said they felt well supported in their work by the managers.” from the report
Accessible information still developing
minorSome information was available in pictures, but the provider planned to expand the range of formats. Ask which formats are available for your relative now.
“we were advised of the provider's intentions to explore and expand on the range of formats available.” from the report
Training records being updated
minorStaff training records were up to date during the inspection, but central records were still being updated to improve management oversight.
“work was underway to update many centrally held records to ensure the management retained a good oversight of any staff training and development needs.” from the report
Complaints information
minorOne relative could not recall receiving the complaints procedure, although they found staff and managers approachable. Ask how families and residents are given this information.
“A relative advised that they were comfortable raising issues of concern, and whilst they could not recall being given the complaints procedure” from the report
- 01What accessible formats are available for care plans, house information and complaints information?
- 02How will you make sure my relative's communication preferences are understood by every staff member?
- 03How are central staff training records kept up to date, and what training is relevant to my relative's needs?
- 04How will my relative be involved in decisions about meals, activities, healthcare and their care plan?
- 05How can my relative and family raise a complaint, and how will we be told what action has been taken?
This was an unannounced scheduled inspection that looked at the overall quality of the care home, including care and premises, and rated all five areas. This explanation was written from the published report of 27 February 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Primrose Hill Farm
3 rated inspections over 6 years: the service has held its Good rating throughout.
- January 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2019Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- July 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 29 December 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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