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Inspection on 04/09/09 for Primrose House Nursing Home

Also see our care home review for Primrose House Nursing Home for more information

This is the latest available inspection report for this service, carried out on 4th September 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Annual service review Name of Service: Primrose House Nursing Home The quality rating for this care home is: The rating was made on: two star good service 0 1 1 0 2 0 0 8 A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Judith Brindle Date of this annual service review: 0 4 0 9 2 0 0 9 Annual Service Review Page 1 of 9 Information about the service Address of service: 765-767 Kenton Lane Harrow Weald Middx HA3 6AH 02089544442 02089545376 hassam.cader@btinternet.com Telephone number: Fax number: Email address: Provider web address:   Name of registered provider(s): Conditions of registration: Category(ies) : dementia old age, not falling within any other category Conditions of registration: Mrs Raziya Banu Cader,Hassam Cader Number of places (if applicable): Under 65 Over 65 23 0 0 23 The maximum number of service users who can be accommodated is: 23 The registered person may provide the following category of service only: Care Home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Have there been any changes in the ownership, management or the No service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service Primrose House Nursing Home provides nursing care for up to 23 elderly persons, some of whom have dementia care needs. Mr and Mrs Cader own the care home. Mr Cader is also the registered manager. The home is a large detached house close to Harrow Weald. It has three floors, with lift access. There are 17 single rooms, and 3 shared rooms. There are bedrooms on each Annual Service Review Page 2 of 9 0 1 1 0 2 0 0 8 floor. Four bedrooms have either an ensuite toilet or an ensuite toilet and bath. Communal rooms are located on the ground floor. The care home has a large, accessible, well maintained garden. There is parking for several cars on the forecourt of the home. Information and documentation about the service, and the fees are available from the care home. Annual Service Review Page 3 of 9 Service update since the last key inspection or annual service review: What did we do for this annual service review? We looked at all the information that we have received, or asked for, since the last key inspection. This included; The annual quality assurance assessment (AQAA) pre inspection paperwork that was supplied to us by the service, within the timescales set by us. The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Also we received verbal feedback from the administrator/director of the care home, who told us that the requirements and the recommendations from the previous key inspection had been met by the service. 9 feedback surveys from people using the service, 6 relatives feedback surveys, 5 from staff members, and 4 from Health and/or Social Care professionals were returned to us at the time of writing this review. We also spoke with one relative/friend of a person using the service. We looked at information we have about how the service has managed any complaints, and what the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. We also looked at the previous key inspection and the results of any other visits that we have made to the service in the last 12 months, relevant information from other organisations, and what other people have told us about the service. What has this told us about the service? We received the AQAA (Annual Quality Assurance Assessment/pre inspection paperwork), prior to this review, within the timescale set by us. This document was comprehensively completed and gave us the essential information about the service that was asked for. Previous inspection and the AQAA told us that the care home has documents (statement of purpose and service user guide) that provide information about the agency, and give details of the service that it provides to people. AQAA told us that the Service Users Guide had been updated to include easy read sections, to make the information more accessible to people using the service. Feedback from a relatives of people using the service told us that their friends/relatives did get enough information about the care service to help them make decisions about moving in to Primrose House Nursing Home. Previous inspections and the AQAA told us that each person using the service has a plan of care, and that the care plans include new references to the Mental Capacity Act, Deprivation of Liberty Safeguards, and to the Dignity in Care Challenge. We were also told that all staff have up to date training on any developments relating to the Mental Capacity Act, DOLS (deprivation of liberty safeguards) and the Dignity In Care Challenge. We were told by feedback from staff that they were given up to date information about the needs of the people that they support or care for, and that they were given enough time to meet assessed needs of the people they support and care for. Feedback from health and social care professionals told us that the service manages medication well, and that the care home was an overall excellent service provider, the home is providing a very caring supportive service, the home meets the care needs well but one comment told us that the home should ensure that residents Annual Service Review Page 4 of 9 are comfortable at all times, and another told us that the home could be more aware of patients individual health needs in particular acute changes. A relative of a person using the service told us that they felt that Primrose House nursing home meets the needs of their friend/relative. We were also told by relatives/friends of people using the service that the home keeps in touch with them, and keeps them updated with important issues affecting the person using the service. People using the service told us they receive the care and support that they need, and that staff are available when they need them, and listen and act upon what they say. They told us that activities are arranged, and that they know who to speak to if they are unhappy. We were told from the AQAA that the home listens to the person using the service, and told us of how the equality and diversity needs of the person using the service are met. We were told that the home continues to have a mixed workforce of staff from different countries and cultures who speak various languages. We were told that the mix in personnel allows for the support of the promotion of diversity of religious beliefs, and that the home continues to celebrate different cultural events e.g. Chinese New Year, St. Patricks Day, St Georges Day etc. AQAA told us that on these occasions the care home creates a special menu and organises activities e.g. music, sing along. We were also told from the AQAA that Primrose House Nursing Home continues to arrange training specific to the needs of individual residents e.g. on the Mental Capacity Act, Equality & Diversity and Safe Feeding & Swallowing and continues to arrange for new staff to undertake a twelve week Dementia Care training course to enable them to cater better for the needs of our existing dementia Residents. AQAA told us of developments made to meet the various communication needs of people using the service, which includes creating books Spanish and Polish and have also created another picture book with basic translated words for our ethnic non English speaking Residents. This most recent book was in Bulgarian. We were told of other documents that had been recorded in pictorial format, so enable information to be more accessible to people who have difficulty in reading. We were told that the home will introduce a larger easy read pictorial food menu for people using the service who have dementia care needs and a reality orientation board to be displayed in the sun lounge. AQAA told us that the care home has developed reminiscence resources as well as the type of the books/videos delivered by the Harrow Housebound Library Service, and we were told the social activity programme for people using the service has been improved. We were informed that people using the service have participated in a guided historic trip to Harrow Museum and that there have been many celebrations and functions held within the Home over the year for events during the year (e.g. Chinese New Year, Pancake Day, Queens birthday and each residents birthday). Feedback from some people using the service told us that they felt that there could be more activities arranged that they can take part in. The home could continue to develop the number and choice of activities for people using the service. Feedback from a relative/friend of a person using the service told us that they would like more interaction between staff and patients, a bit more one to one with patients and carers, more activities and one to one chats. This was discussed with the administrator/director of the care home who told us that he would look into this issue, Annual Service Review Page 5 of 9 and he was positive about developing the interaction between staff and residents to improve the well being of people using the service. We were also told that the care home has improved the resources for our AfroCaribbean residents with the assistance of a specific link nurse who is the local psychogeriatric nurse, and that a new hairdresser who visits the home weekly, specialises in Afro-Caribbean haircare. Feedback from friends relatives of people using the service told us that the care service always responds to the different needs of individual people. Staff feedback told us that they feel that they have enough support, experience and knowledge to meet the different needs of people who use the service, and that appropriate checks are carried out during the recruitment process. They told us that they receive support and are listened to, and have the opportunity to attend monthly staff meetings. Comments from staff included we care for their (residents) well being. Feedback from relatives/friends of people using the service told us that they felt that care staff have the right skills and experience to look after people properly. It is evident from previous inspection, and the AQAA that there is an appropriate complaints policy/procedure, available to people using the service and to others. AQAA told us that the complaints and the homes safeguarding policies/procedures have been developed into a pictorial format to make the information more accessible to people using the service, and within the last twelve months there has been no complaints. Most feedback from relatives/friends of people using the service told us that they know how to make a complaint about the care provided by the care service if they need to, but feedback from two relatives/friends told us that they did not know the procedure for making a complaint, and one told us that they couldnt remember how to make a complaint. The home should ensure that all people who have contact with the home have knowledge and understanding of the complaints procedure. This was discussed with the administrator/director of the care home, who spoke of taking action to ensure that all stakeholders were aware of the complaints procedure. We were told that the home has a safeguarding adults policy/procedure, and that staff receive safeguarding adults training. AQAA told us that there have been no safeguarding referrals made in the past twelve months. AQAA told us that the improvements had been made to the environment, and that the redecoration programme of the home had been completed. This told us that a requirement with regard to completing the redecoration of bedrooms had been met by the service. Other improvements included significantly improving the lighting in the communal areas of the home and we were told that the environment is now bright and homely, whilst before looked institutional. We were also told that the home is rearranging the sun lounge area in the home to include defined areas for dining, activities and for our library. AQAA also told us that the home now displays more meaningful art work in the lounges which comprise of enlarged reminiscent advertisements e.g. Marmite, Bovril and Gordons Gin etc. as recommended by The Alzheimers Society, and have taken steps to expand the sensory garden with the inclusion of giant sunflowers, various herb patches and large scented flowers. People using the service told us via feedback surveys that the home is clean. Comments from residents included the home is nice, its comfortable, everything is fine. Annual Service Review Page 6 of 9 AQAA told us that staff receive staff induction training, and also receive varied and appropriate training to ensure that all staff have the ability to carry out their roles and responsibilities. Staff feedback surveys told us that their induction covered everything that they need to know to do their job, and that they receive varied training. AQAA told us that three quarters of the staff are NVQ (National Vocational Qualification level 2 and/or 3 in health and care) trained (or equivalent) and have attended a variety of relevant courses over the year specific to the individual needs of residents. This training includes Mental Capacity, MUST & Nutrition, and Dementia Care etc. AQAA told us that there are plans to provide further specialist training in Dementia Care for specific members of our staff e.g cook, activity coordinator etc. Staff feedback told us that they are given training that helps them understand and meet the individual needs of people, keeps them up to date with new ways of working and gives them enough knowledge about health care and medication. A comment from a staff member included teaching sessions could be more frequent about new things such as swine flu. Feedback from a relative/friend of a person using the service told us that some staff may not understand some aspects of the English language. We discussed this with the administrator/director of the care home, who told us that twelve staff (including domestic staff) were shortly commencing an English language City and Guilds communication course. This is positive. A comment from a relative of a person using the service told us that the home has helped them understand their relatives dementia care needs, and has worked with the relative in resolving issues regarding the needs of the person using the service. AQAA told us that appropriate up to date policies and procedures are in place to ensure that the rights and best interests of people using the service are safeguarded. Staff told us that the home keeps them informed of up to date policies and procedures, and has improved in all areas, everything is ok, the home does care for staff and the people who live in the home. Feedback from a relative of a person using the service commented that they had always found them (staff) to be very friendly and helpful. Other comments from friends/relatives of people using the service included the level of nursing care is carried out extremely well, and that everybody is very friendly, Primrose House has been an excellent nursing home, and Primrose House has been a tremendous support to myself (the relative/friend of a person using the service) and my (relative), staff are excellent. AQAA told us that the home has recruited a Deputy Manager to ensure the care standards of the Home were being met. We were told that here has been no change in management since the last inspection. Information obtained from the AQAA record told us that that there has been several improvements made to the service since the last key inspection, and that the home is aware of on going developments that could be made to the service and takes action to put these in place. What are we going to do as a result of this annual service review? Annual Service Review Page 7 of 9 It is evident from the information received about the agency since the key unannounced inspection (01/10/2008) that our judgement is that the care home is still providing a good service to people using the service. However we can inspect the service at any time if we have concerns about the quality of the service or the safety of the people using the service. Annual Service Review Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Annual service review CQC General Public 0870 240 7535 (national contact centre) Our duty to regulate social care services is set out in the Care Standards Act 2000. The content of which can be found on our website. Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a copy of the findings in a different format or language please contact our helpline or go to our website. 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