11, 13 and 15 July 2015
During a routine inspection
This inspection was carried out on 11, 13 and 15 July 2015 and was unannounced.
Primrose Lodge provides accommodation and personal care for up to 21 older people including people who stay for a short stay, respite visit. It does not provide Nursing care. At the time of our Inspection there were14 people living at Primrose Lodge.
There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.
This is the first inspection of Primrose Lodge since the provider was reregistered on 16 March 2015 following a change to the name of the provider.
Care Quality Commission (CQC) is required to monitor the operation of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are put in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. At the time of the inspection no applications had been made to the local authority in relation to people who lived at the service. Although the registered manager told us that at least three people were being deprived of their liberty. Staff were unaware of their responsibility in relation to MCA and DoLS.
We saw that people living at the home did not always get their needs met in a timely way. We saw that care and support focused on completing tasks rather than people’s individual needs and preferences. Staff were required to assist people with personal care and support whilst also completing other ‘tasks’ such as cooking, laundry and cleaning. Staff could not always tell us what people’s individuals care needs were. For example staff were unable to tell us how people were supported to manage their continence.
Although the storage and recording of medicines were managed safely we saw staff did not wear gloves or wash their hands when administering medicines to people. Staff told us that the manager observed their practice but we did not see competency checks recorded.
We found that staff knowledge varied and in some cases staff were unable to demonstrate sufficient knowledge of how to manage peoples care safely. Most staff had supervision with their line manager but the meetings were intermittent and we found gaps where people had not received supervision. For example a person had returned to work following a period of absence and had not yet had supervision with their line manager to bring them up to speed with current events.
Care plans and risk assessments were not focused on people’s individual needs and preferences with many ‘tick box’ answers. There was little evidence of people or their relatives being involved, and staff were unaware of people’s individual needs or how to manage them effectively.
People’s nutritional needs were not always met, and food and fluid intake not managed effectively.
The management in the home was ineffective and many of the areas of concern that we found had not been picked up by the provider’s monitoring systems. There were no action improvement plans in place to demonstrate areas for improvement were being managed.
At this inspection we found the service to be in breach of regulations 9, 10, 12, 13, 14, 17 and 18 of the Health and Social care Act 2008 (Regulated activities) Regulations 2014.
The overall rating for this service is ‘Inadequate’ and the service is therefore in 'Special measures'.The service will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe."