Inspection on 07/08/07 for Primrose Hill Care Home

This inspection was carried out on 7th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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.

Other inspections for this house

Primrose Hill Care Home 13/06/06

Primrose Hill Care Home 17/10/05

Primrose Hill Care Home 10/05/05

Primrose Hill Care Home 14/09/04

Primrose Hill Care Home 14/06/04

Primrose Hill Care Home 25/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Primrose Hill Care Home Thames Road Huntingdon Cambridgeshire PE29 1QW Lead Inspector Janie Buchanan Unannounced Inspection 7th August 2007 09:15 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Primrose Hill Care Home DS0000050384.V348194.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Primrose Hill Care Home DS0000050384.V348194.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Primrose Hill Care Home Address Thames Road Huntingdon Cambridgeshire PE29 1QW Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01480 450099 01480 454499 Abbey Healthcare (Kendal) Limited Linda Clare Martinez Care Home 60 Category(ies) of Dementia - over 65 years of age (23), Old age, registration, with number not falling within any other category (60), of places Physical disability (5) Primrose Hill Care Home DS0000050384.V348194.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age range of service users with the category of PD (physical disability) is 55 to 65 years of age 13th June 2006 Date of last inspection Brief Description of the Service: Primrose Hill is a purpose built nursing and residential home for older people in the outskirts of Huntingdon that has been registered with the Commission for Social Care Inspection since November 2003. It is owned by Abbey HealthCare Homes Ltd who operate a number of homes for older people throughout the country. The home offers 60 single ensuite bedrooms all of which meet the required minimum standards of 12 square metres. Accommodation is provided on three floors with the middle floor being a dedicated unit for twenty-three older people with dementia. Each floor contains a large dining/sitting room, two smaller sitting rooms and appropriate bathroom, toilet and shower room facilities. The weekly fees for the home vary between £482 and £725 depending on residents’ needs and funding arrangements. A copy of the CSCI latest inspection report is on display in the main entrance of the home. Primrose Hill Care Home DS0000050384.V348194.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place on the 7 August 2007 and was unannounced. The inspector spoke with four residents, two visiting relatives, the manager and three members of staff. Care practices were observed on the dementia unit over lunch; a tour of the home was undertaken; and a range of documents was viewed. Information was also provided from the home’s annual quality assurance assessment. A small number of completed comment cards from residents and their relatives, requesting feedback about the service, were also received. Thre requirements have been made as a result of this inspection. What the service does well: What has improved since the last inspection? There have been many hugely positive improvements at this home since its last inspection: • Care plans are now kept in residents’ bedrooms allowing them easy access to information affecting their care. This is excellent practice and both residents and relatives commented on how valuable it was having this information at hand. The home has recently purchased a 14-seater minibus that has been used to take residents out on a variety of trips to local places of interest. A large TV with surround sound has also been bought and there are regular cinema afternoons for residents. There are now three main dishes available every day for lunch, allowing residents genuine choice about what they eat. • • Primrose Hill Care Home DS0000050384.V348194.R01.S.doc Version 5.2 Page 6 • • • The garden has improved and there are now raised beds, a seating area and a pergola for residents to enjoy. Care staff have been issued with personal alcohol hand rub gel which helps reduce the risk of infection around the home. Corridors on the dementia unit have been made more interesting and stimulating for those residents who spend a lot of time wandering along them Residents are invited to sit on interview panels for prospective employees. This is excellent practice and ensures residents’ views will be sought on the people being employed to provide care for them. • What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Primrose Hill Care Home DS0000050384.V348194.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Primrose Hill Care Home DS0000050384.V348194.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5 Quality in this outcome area is good. Information about the home is available to help prospective residents choose if it is where they want to live and residents are fully assessed to ensure their needs can be met at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a Statement of Purpose and Resident Guide that give good information about the home and the services it offers. The Residents’ Guide is written in large print and includes photographs of life in the home. Each resident is issued with a contract that clearly states the terms and conditions of their stay at the home, as well as details of the fees to be paid and additional charges. The files of two recently admitted residents were viewed and each contained a comprehensive pre-admission assessment completed by the manager, as well as information from other sources. One resident told the inspector that he was ‘very impressed’ that both the manager and her deputy came to see him before he moved in. Residents and their families are encouraged to visit the home to assess its facilities. Primrose Hill Care Home DS0000050384.V348194.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. Care plans set out in detail the action to be taken by staff to ensure that all aspects of health and personal care needs of residents are met. Residents’ health is monitored closely and there is access to a range of health care services. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans for three residents were checked: details of residents’ social and life histories were noted, as were their needs in relation to their personal hygiene, dressing, mobility, communication and continence management. Residents’ needs had been reviewed regularly and signed by them where possible. The plans were kept in each resident’s bedroom giving them easy access to their care notes. This is practice is excellent. The inspector read through a care plan with one resident. This resident agreed that it was a good and accurate reflection of his needs. Residents’ health is closely monitored. Nutritional and pressure risk assessments are completed monthly for each resident, and residents are weighed regularly. Food and fluid charts are completed for all residents so that their intake can be monitored. Residents spoken to confirmed that they see a Primrose Hill Care Home DS0000050384.V348194.R01.S.doc Version 5.2 Page 10 range of health care professionals regularly and there was clear evidence of this in their care plans. The home has comprehensive policies and procedures in place in relation to medication, and only nursing staff administer it. Controlled drug recording and storage was checked and found to be in good order, although one bottle of Oramorph solution (a controlled drug) was not kept in a double locked cabinet. Residents spoken to reported that staff treated them respectfully and helped them in a way that they liked, although one reported that her bath sometimes felt rushed and she never had the chance for ‘ a good soak’. Primrose Hill Care Home DS0000050384.V348194.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. Social activities are well managed and provide stimulation and interest for people living in the home. Residents receive a healthy varied diet, offering them genuine choice in what they eat. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home employs two activity co-ordinators five days a week. As a result there is a busy and well-advertised programme in place including games, painting, garden walks and sing songs. The home has its own minibus and there have been recent trips out Woodgreen Animal Shelter, Hinchingbrook Country Park, shopping and six residents attended the Lord mayors pensioner’s lunch in June. One relative told the inspector: ‘Dad came back looking 10 years younger after his trip to Duxford Imperial war Museum’. A computer with internet access has recently been purchased and there is a weekly computer class for residents to attend. Families are involved in the life of the home and a monthly newsletter is published for residents, their visitors and friends. One resident’s sister visits regularly to play the piano. Relatives are also invited to attend the regular residents’ meetings. The inspector spoke with two visiting relatives who reported that they were always made to feel welcome by staff. One commented that staff made her children tuna sandwiches and cake recently. Primrose Hill Care Home DS0000050384.V348194.R01.S.doc Version 5.2 Page 12 The manager is improving links with local community groups and the Huntingdon branch of the Alzheimer’s Society now meets at the home every month. The home’s menu is excellent and offers residents a choice of three dishes each day for lunch. On the day of inspection residents were enjoying either pork, or salmon, or ham and leak pie. Residents also had a choice of baked or mashed potato. Primrose Hill Care Home DS0000050384.V348194.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. Residents have access to a complaints procedure and their complaints are handled appropriately This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure is well advertised around the home and each resident has a laminated copy of it in their bedrooms. There was good evidence that residents concerns and complaints are taken seriously. One resident wrote on a comment card: ‘my cardigan shrunk in the wash and I spoke to the manager and she gave me money for a new one’. Another resident told the inspector: ‘They put gravy on my omelette by accident, when I complained they apologised and offered to cook me a fresh omelette immediately. Staff have received training in protecting vulnerable adults provided as part of the home’s own in-house training program and also provided by the local adult protection team. The home has been involved in two adult protection concerns in the last year. The manager participated fully in their investigation and both allegations made were unfounded. Primrose Hill Care Home DS0000050384.V348194.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20, 21,25,26 Quality in this outcome area is good. Residents live in a clean and comfortable environment, however the strong smell of urine makes some areas of the home very unpleasant to be in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Primrose Hill is a large, spacious, modern and ‘hotel style’ home that has been purpose built to meet the needs of older people. The premises were observed to be bright and well maintained, with good quality furnishing and fittings in place. Each of the three floors has its own dining room and two sitting rooms. There are a total of four assisted bathrooms and three level access showers and all bedrooms have ensuite facilities. However there is no separate area for staff meetings or training to be held. This means that one of the residents’ lounges has to be used, and residents are asked to vacate this lounge when a meeting is held. Primrose Hill Care Home DS0000050384.V348194.R01.S.doc Version 5.2 Page 15 The manager continues to improve the environment of the dementia care unit: interesting reminiscence posters decorate long corridor walls to provide interest and stimulation for residents who wander along the corridors The garden has also improved since the last inspection. Raised flower beds have been installed containing brightly coloured and strong smelling plants and a large pergola and garden seating are available for residents. On the day of inspection a number residents from the dementia care unit were outside helping water the plants and enjoying the sun. Infection control is taken seriously, as well as alcohol gel being made available on all floors on the home, each member of staff has their own personal gel dispenser so they can clean their hands between delivering care to each resident. The CSCI has received two complaints from visitors to the home about the smell and one resident commented ‘sometimes it smells a bit’. On the day of inspection the entrance hallway and two bedrooms in the dementia unit smelled strongly of stale urine. Primrose Hill Care Home DS0000050384.V348194.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. Residents receive their care form well trained staff in sufficient numbers to meet their needs. EVIDENCE: Staffing levels are satisfactory. There are a total of 2-3 trained nurses and 11 carers on duty throughout the day to meet the needs of up to 60 residents. This gives a rough ratio of 1 staff member to 5 residents. The duty rota showed that these staffing levels were maintained and staff reported that they were rarely short staffed. Residents reported that staff came when needed and they only occasionally waited a long time for help. The personnel files for two recent members of staff were checked and contained evidence that appropriate pre-employment checks had been completed before they started working at the home. Residents are now invited to sit on interview panels for prospective employees, and one resident had actively been involved in the recruitment process of two recently employed staff. This is excellent practice and is to be commended. Training files showed that, in addition to mandatory training, staff had also undertaken training specific to the needs of older people such as dementia care, continence promotion, Huntington’s Disease and pressure care. 70 of the staff are from overseas and many do not have english as their first language. Despite this, residents and visitors spoken to reported that they could mostly understand and be understood by these staff. Primrose Hill Care Home DS0000050384.V348194.R01.S.doc Version 5.2 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35, 36, 38 Quality in this outcome area is good. The home is run in the best interests of its residents and feedback about the quality of the service they receive is regularly sought. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is qualified, experienced and is clearly committed to providing a good service. She has a clear vision for how the home should run and has been working hard, with considerable success, to improve standards. Feedback about the service is actively sought from residents and visitors to the home. As well as regular staff and residents/relatives meetings, ‘quality assurance’ leaflets are available in the entrance hall for visitors to fill in. These request comments about the cleanliness of the environment, the quality of staff and care planning. Primrose Hill Care Home DS0000050384.V348194.R01.S.doc Version 5.2 Page 18 A sample of residents’ cash sheets and fee payments were checked. It was of concern that no receipts were issued or kept for residents’ money spent on toiletries and other small items. Records showed that staff receive regular supervision of their working practices. Records concerning portable appliance testing, gas safety, fire checks, lift and hoist servicing were viewed and found to be in good order. No major health and safety hazards were viewed around the home. Primrose Hill Care Home DS0000050384.V348194.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 x x x 3 2 STAFFING Standard No Score 27 3 28 3 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 2 3 x 3 Primrose Hill Care Home DS0000050384.V348194.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2. Standard OP9 OP26 Regulation 13(2) 16(2)(k) Requirement Timescale for action 01/09/07 3. OP35 17(2) Schedule 4 All controlled drugs must be held in a double locked cabinet so that they are stored safely. The home must be kept free of 01/09/07 offensive smells so that residents can live in a pleasant environment. Receipts must be issued for all 01/09/07 residents’ monies so there is clear and accurate record of how their money is being spent. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Primrose Hill Care Home DS0000050384.V348194.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Cambridge Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Primrose Hill Care Home DS0000050384.V348194.R01.S.doc Version 5.2 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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