Primrose House Nursing Home is part of HC-One Limited. They are registered to provide nursing care and support for people who require help with their daily lives, particularly people who may be living with dementia. The single storey building can accommodate up to 42 people. At this inspection 42 people were living at the home.

At the last inspection the service was rated good. At this inspection we found the service remained good.

People continued to remain safe from the potential harm of abuse or ill-treatment as staff knew how to recognise and respond to such concerns. People were supported by enough staff to meet their needs. People had their medicines when they needed them and were assisted to take them by trained and competent staff.

The provider followed safe recruitment procedures when employing new staff members.

People were assisted by a staff team who had the skills and training to effectively support them.

People continued to receive care that was effective and personalised to their individual needs and preferences. When changes occurred in people’s needs care and support plans were reviewed to reflect the changes.

People were supported to have choice and control over their lives. They were assisted by staff in the least restrictive way possible. Staff were aware of current guidance which directed their practice and people’s rights were protected by the staff who supported them.

People received support that continued to be caring and respectful and their privacy and dignity was valued by those providing assistance. People were supported by staff at times of upset and anxiety.

Staff members knew people’s likes and dislikes and supported them in the manner they preferred. People and their relatives were encouraged to raise any concerns or complaints and were confident they would be appropriately responded to. The provider had systems in place to address any issues raised with them.

The management team were approachable and supportive. Primrose House Nursing Home continued to be well-led. People, relatives and visitors were encouraged to be involved in decisions about Primrose House Nursing Home and their suggestions were valued by the provider.

Staff members felt valued as employees and their opinions and ideas were listened to by the provider. The provider had systems in place to monitor the quality of service and where necessary made changes to drive improvements.

Further information is in the detailed findings below.

During our visit we spoke to two people who used the service, one general practitioner four members of staff, the manager and five relatives. People who used the service and the relatives all commented that the home was clean and they or their relative were generally happy living there. Three of the relatives told us that they did not have any concerns about the welfare of their family member. One relative told us that they had two outstanding issues relating to care planning and ear syringing but they were not overly concerned about this. We also spoke to a general practitioner who told us that they did not have any concerns with the home and told us that the home ‘mostly seems fine’.

We found evidence to support the fact that there were sufficient staff in place to meet the health and welfare needs of the service users. We were shown examples of service improvement following learning from incidents, complaints and errors. We saw that the home had procedures in place to monitor, improve and protect the welfare of service users, however we noted some areas for improvement around the management of laundry services in order to protect service users from cross contamination.

We saw evidence that service users were offered choice but found that where the service users did not have capacity to consent, the provider had not always acted in accordance with legal requirement. Finally when we asked two service users and five relatives if they would recommend the care at Primrose House to anyone else, the replies were all ‘’yes’’ and the comments included, ‘definitely’ and ‘yes - very good’.

During our visit we saw that staff treated people with respect.

We spoke with a number of relatives. A relative told us their family member “is safer here then they were at home. I couldn’t look after (family member) anymore”. Another relative told us their family member “was ok here I have no worries”.

The majority of people living in the home required help from their family or an advocate who could act on their behalf to make decisions about their health and welfare.

The provider may wish to note that there was little evidence to show that people who used the service and/or their relatives were involved in developing or reviewing the plans of care

We have not received any information of concern from health or social care professionals about the safety and well-being of people who lived in the home.

The manager told us that checks were carried out with the Nursing and Midwifery Council (NMC) to ensure the nursing staff employed by the home kept their professional registrations up to date. The training records showed that all staff had access to or had received training which included safeguarding adults.

We saw records which showed that checks were carried out to ensure the health and welfare of people who lived in the home was maintained.

We saw a copy of the findings from resident’s survey dated August 2012. Overall, the findings of the surveys were that people were generally satisfied with the service offered by Primrose House.

This inspection took place on 19 February 2015 and was unannounced.

Primrose House Nursing Home is part of HC-One Limited. They are registered to provide accommodation, nursing care and support for people who require help with their daily lives, particularly for people who may be living with dementia. The single storey building can accommodate up to 42 people. The home is located in the village of Haslington and is close to shops and other local amenities.

Primrose House Nursing Home has a registered manager who has been managing the home for over three years. 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 2008 and associated Regulations about how the service is run.

At our last inspection in December 2013 the service was meeting most of the regulations inspected. However we asked the provider to take action to make improvements in respect of how people were able to consent to care and treatment. Following the inspection the registered manager sent us an action plan explaining how consent to care would be met and by when.

During this inspection we found that all of the issues had been addressed.

People living at the home, relatives and staff were very positive about the home especially about the activities on offer and the management of the service.

We observed how staff spoke and interacted with people and found that they were supported with dignity and respect.

We found the staff had a good understanding of peoples care and support needs and we found care plans to be detailed and focused on the individual person. Staff had a good understanding and knowledge of each person’s preferences and people’s individual care needs. Staff also understood how to support people if they lacked capacity to include the requirements of the Deprivation of Liberty Safeguards

We noted the service had a complaints procedure, details of which were displayed in the foyer of the premises and people said they were confident that they could raise their opinions and discuss any issues with the registered manager or any staff member who was available.

Primrose House had robust recruitment policies and procedures in place to ensure staff were suitable to work with vulnerable people. This included standardised application forms, the provision of written references and a structured interview process being undertaken to enable the management of the home to have adequate information before employing staff.

Staff were provided with three monthly structured supervision sessions and regular updated training and development courses to assist them to build on their knowledge and skills.

The provider had systems in place to monitor and review the standards of the services provided at Primrose House. These included a self -assessment tool that looked at the safety, management, residents well -being, environment and nutrition.