CQC report explained · a residential care home
What the CQC found at Primroses Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, September 2023
Requires Improvement; inspectors found kind, person-centred care but medicines checks and management systems were not reliable enough.
This was a planned, focused inspection on 9 August 2023. Two inspectors reviewed care and medicines records, staff files, management records and infection control arrangements. They spoke with staff and a relative, and observed care.
The main concern was medicines. Two people had medicines to take when needed, but there was no written guidance explaining when to give them or how much to give. The home’s medicines policy was not being followed.
Inspectors also found that quality checks had not identified these medicines problems. They did find enough staff, safe recruitment, suitable risk assessments, good infection control and care that respected people’s choices, dignity and independence.
The overall rating changed from Good at the previous inspection to Requires Improvement. Safe and Well-led were both rated Requires Improvement. The other three areas were not inspected at this visit, so their previous ratings were carried forward.
Person-centred support
People were supported to make choices, remain as independent as possible and receive care based on their preferences.
“People were supported to have maximum choice and control of their lives” from the report
Staffing and recruitment
Inspectors found enough staff with the right skills and experience. Recruitment checks, including DBS checks, were carried out.
“There were sufficient staff available with the right skills and experience to meet the individual needs of people who used the service.” from the report
Infection control
The home was clean and hygienic, with infection control audits and an enhanced cleaning programme.
“The home had effective infection, prevention and control measures to keep people safe” from the report
Positive culture
Inspectors found staff and managers were supportive and understood people’s individual needs.
“The registered manager and staff promoted a positive culture in the home.” from the report
Medicines guidance
seriousTwo people’s when-needed medicines did not have clear written instructions. This meant staff might not know when to give the medicine or the correct amount.
“This meant staff did not have the information to tell them when someone may need the medicine or how much to give” from the report
Quality checks
needs fixingThe home’s audits did not identify the medicines problems, and records of what had been checked were not routinely kept. Inspectors recommended following best practice for quality assurance.
“Quality assurance systems were not sufficiently robust to identify all concerns.” from the report
- 01What written instructions are now in place for each person’s when-needed medicine?
- 02How do you check that staff follow the medicines policy and record each audit?
- 03What evidence can you show that the medicines improvements reported after the inspection have been maintained?
- 04How will you identify and act on any future medicines or quality problems?
- 05What support is available to help people make choices and remain independent?
This was a focused inspection of Safe and Well-led only; the other ratings were carried forward from the previous inspection published on 25 July 2018. This explanation was written from the published report of 16 September 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, July 2018
Primroses Home was rated Good; inspectors found caring, person-centred support but some medicines and mental health records needed improvement.
This was the home’s first CQC inspection since it registered. It was unannounced and took place on 06 June 2018. Inspectors spoke with the manager, a care worker, a visiting health professional and one resident. They also checked care records, medicines records, staff files, rotas and safety records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough suitable staff, safe recruitment, caring relationships and detailed care plans. People had choices about meals and activities, and complaints had been investigated.
Inspectors identified some improvements. Medicines records were not always complete, some risk assessments lacked detail about mental health, and staff had not yet completed mental health training. The provider sent evidence after the inspection of updated medicines information, a medicines audit tool, mental health training and a DoLS application.
Caring relationships
Staff were seen offering emotional and practical support. Inspectors found that people’s privacy, dignity and independence were respected.
“Staff had caring relationships with people and demonstrated a compassionate and empathetic approach and an understanding of their individual needs.” from the report
Person-centred care
Care plans recorded people’s preferences and strengths. Staff supported activities and routines chosen by residents.
“The care plans focussed on people's strengths.” from the report
Safe staffing and recruitment
The home had staff on duty around the clock and checks were completed before staff started work.
“There were enough staff to meet the needs of people who used the service.” from the report
Working with professionals
The home made referrals and shared information with health and social care professionals when residents’ needs changed.
“There was evidence of the service working in partnership with other organisations to ensure the best quality support was provided to people using the service.” from the report
Mental health risk information
needs fixingRisk assessments did not always give enough detail about people’s mental health conditions. Inspectors recommended using best practice guidance so staff could manage these risks safely.
“However; we found that risk assessments did not always provide detailed information regarding people's mental health conditions.” from the report
Mental health training
needs fixingStaff had not completed training about mental health conditions, despite this being the home’s area of specialism. The provider later sent evidence that staff had completed mental health awareness training.
“However, we found that staff had not completed training around mental health conditions, which was an area of specialism for the service.” from the report
Food labelling
minorFood in the fridge was not labelled with opening dates or to show whether it was for staff or residents. The manager said this would be addressed.
“However; during the inspection it was found that the food in the fridge had not been labelled with opening dates or to identify what food was for staff and what food was for people using the service.” from the report
Welcome booklet restrictions
minorThe welcome booklet set fixed meal, visiting and laundry times. Inspectors said this might make care feel less personal and asked the home to review the information.
“However the welcome booklet did not always demonstrate a person-centred approach.” from the report
- 01How are medicines records now checked for opening dates, carried-forward medicines and prescription dates?
- 02How do you record and review risks linked to each resident’s mental health condition?
- 03What mental health training have staff completed, and how is their knowledge kept up to date?
- 04Have the weekly resident forums, staff meetings and feedback surveys now started?
- 05Have the meal, visiting and laundry arrangements in the welcome booklet been changed to reflect residents’ choices?
This was an unannounced first inspection covering the overall quality of the home and all five CQC questions, based on a limited sample including one care plan and one resident. This explanation was written from the published report of 26 July 2018 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 Primroses Home
2 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- September 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2018GoodSafe: GoodWell-led: Good
- October 2017
Registered with the Care Quality Commission on 10 October 2017.
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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