CQC report explained · a residential care home
What the CQC found at Primrose Neurological Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, October 2020
Rated Requires Improvement; inspectors found good safe, effective and well-led care, but two areas were not inspected and the overall rating stayed the same.
This was an unannounced focused inspection on 29 September 2020. One inspector and a medicines pharmacist inspector spoke with people, relatives and staff, and checked care, medicines, recruitment and management records.
The home was rated Good for Safe, Effective and Well-led. Inspectors found improvements in medicines, risk assessments, staffing, person-centred care and quality checks. People said they felt safe, trusted staff and were happy with the care.
The overall rating remained Requires Improvement because Caring and Responsive were not inspected during this visit. Their previous ratings were used in the overall score. The report says the home was no longer breaching regulations found at the previous inspection.
Safer medicines
Medicines systems had improved. Records showed the help people needed, and audits identified where improvements were required.
“Systems were in place for the safe handling, administration and storage of medicines.” from the report
Staff understood people's needs
Staff knew people's risks, preferences and goals. They used care plans and followed health professionals' instructions.
“Staff sought and recorded people's preferences and staff knew these and people's needs.” from the report
Kind and respectful care
People told inspectors they were happy, felt safe and trusted staff. Relatives raised no concerns about the care being provided.
“People told us they felt safe and they trusted staff.” from the report
Improved oversight
The home had audits covering medicines, the environment, infection control and incidents. Staff said the service had improved.
“Effective quality audits were carried out in areas such as medicines, environment, infection prevention control and incidents and accidents.” from the report
Overall rating remains Requires Improvement
needs fixingThe overall rating did not improve because Caring and Responsive were not checked at this inspection. Their previous ratings were used in the overall score.
“The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection.” from the report
Manager registration was not complete
minorThere was no manager registered with the CQC when inspectors visited. A new manager had started and intended to begin the registration process.
“The service did not have a manager registered with the Care Quality Commission at the time of the inspection.” from the report
- 01What were the previous ratings for Caring and Responsive, and when will these areas next be inspected?
- 02Has the new manager completed the process of registering with the CQC?
- 03How are you checking that people's care plans, risk assessments and medicines records remain up to date?
- 04Which staff training was delayed because of COVID-19, and has all of it now been completed?
- 05How do you involve residents and relatives in decisions and changes at the home?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were used in the overall rating. This explanation was written from the published report of 17 October 2020 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, August 2019
Rated Requires Improvement; inspectors found kind relationships, but risks, staffing, care planning and leadership were not reliable.
This was an unannounced inspection over two days. Inspectors spoke with everyone living at the home, staff and visiting professionals. They checked care records, staff files, medicines records, incidents, training and quality checks.
The home was not consistently safe or person-centred. Risk assessments were missing or out of date. Staffing levels and staff skills did not always meet people's needs. Care plans were not always current, and some people lacked clear goals or knew what would happen next.
People described trusting relationships with staff, who were kind and respectful. However, people also reported boredom, limited activities and little choice at mealtimes. All five areas were rated Requires Improvement. The report says a new manager and operations manager had started an action plan after the inspection.
Kind relationships
People described staff as kind, and inspectors saw respectful and trusting relationships. Staff knew people's likes and dislikes.
“We saw people had built trusting relationships with staff and were keen to spend time with them outside of the service.” from the report
Access to outside support
People could access healthcare professionals and attend appointments. Some people made good progress when they received specialist external support.
“Where people had been supported to access to healthcare and specialist support from external professionals these people had made good progress.” from the report
Accessible building
The building had been designed for people with brain injuries and limited mobility. The garden and corridors were accessible.
“The garden was fully accessible and corridors were wide enough to accommodate people who used wheelchairs.” from the report
Risk management
seriousSome people with high-risk health needs did not have clear emergency risk assessments. Inspectors found that poor risk management exposed people to avoidable harm.
“We found people with high risk health needs did not have a risk assessment to instruct staff on what to do in an emergency.” from the report
Staffing and skills
seriousThere were not always enough staff to provide required supervision or support people to go out. Staff did not have enough specialist skills, training or supervision.
“The provider had not ensured staffing levels in the home were sufficient to meet people's needs and keep them safe.” from the report
Care planning
needs fixingCare plans were sometimes more than a year out of date and did not consistently include people's goals, risks or whole-life needs.
“We saw some plans had not been reviewed for over a year.” from the report
Activities and stimulation
needs fixingPeople could take part in some activities outside the home, but several people described boredom and long periods in their rooms.
“There were very few therapeutic activities taking place.” from the report
Food choice
needs fixingPeople said meals offered limited choice. Inspectors also found that one person's use of high-protein substitutes had not been properly checked or monitored.
“They told us they had cereal and toast for breakfast and sandwich for lunch every day.” from the report
Leadership and checks
seriousThe home had experienced several manager changes and gaps in management. Its quality checks had not found the problems identified during the inspection.
“The provider had not ensured effective quality assurance processes were in place.” from the report
- 01How many staff are now available for people who need one-to-one support or line-of-sight supervision?
- 02What specialist brain injury and neurological-condition training have staff completed, and how often are they supervised?
- 03How are risk assessments kept up to date when a person's health or behaviour changes?
- 04How are residents now helped to set goals, work towards independence and understand the purpose and next step of their stay?
- 05What regular activities and meal choices are now available inside the home?
This was an unannounced inspection of the whole care home, including accommodation and care, and all five key questions were rated Requires Improvement. This explanation was written from the published report of 28 August 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 Neurological Centre
2 rated inspections over a year: the service has held its Requires improvement rating throughout.
- October 2020Requires improvementcurrent ratingstayed Requires improvementSafe: GoodEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Good
Read what inspectors found at Primrose Neurological Centre →
- August 2019Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
Read what inspectors found at Primrose Neurological Centre →
- July 2018
Registered with the Care Quality Commission on 20 July 2018.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
85 live-in carers within about an hour of Lancashire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.