Ivy Lodge

Ivy Lodge is a residential care home providing regulated activity personal care for up to 10 people. The service provides support to people with a learning disability and autistic people. At the time of our inspection there were 10 people using the service.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

The provider was able to demonstrate they were meeting the underpinning principles of Right support, right care, right culture.

Right Support:

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff supported people to achieve their aspirations and goals.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcomes. Staff supported people to play an active role in maintaining their own health and wellbeing.

Staff did everything they could to avoid restraining people. The service recorded when staff restrained people, and staff learned from those incidents and how they might be avoided or reduced.

People had a choice about their living environment and were able to personalise their rooms. The service made sure people were fully involved in discussions about how they received support, including when they recruited staff.

Right Care:

Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.

Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.

Right Culture:

The service had evaluated the culture and quality of the service provided to make sure staff placed peoples wishes, needs and rights at the heart of everything they did. This ensured risks of a closed culture were recognised so that people received the right support. Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. Staff valued and acted upon people’s views.

Rating at last inspection

The last rating for this service was good (published 12 October 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The inspection was prompted in part due to concerns received about a closed culture, staff training and management. A decision was made for us to inspect and examine those risks.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe, effective and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ivy Lodge on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect

Ivy Lodge is registered to provide accommodation and personal care for up to 10 people with learning disabilities and other complex health needs. The home is a two storey, purpose built building with separate garden areas. There are 10 private bedrooms with en-suite facilities, two communal lounges, one small quiet lounge and two communal kitchen/dining rooms. On the day of our inspection 10 people were living at the home.

The service had a registered manager in place. 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.

People told us they felt safe and this was supported by information from relatives.

Staff were safely recruited and there were sufficient numbers of staff to keep people safe. Staff received regular training, supervision and appraisal and told us they felt supported.

Behavioural risk assessments were in place to keep people and others around them safe.

Other potential risks to people had been assessed for example, financial management, alcohol consumption and self-administering of medicines to enable people to retain their independence.

Medicines were stored and administered safely. PRN (as required) protocols were in place. People were promoted to manage their own medicines where they had the capacity to do this, but improvement was required to ensure how this was determined and carried out in accordance with the registered provider’s policy and procedure for the safe management of medicines.

We recommend the registered manager review the Medications Management Policy and Procedure and where appropriate, ensure people’s capacity to self-administer their medicine is recorded within care plans.

Controlled drugs were stored safely but there was not a separate register to record the receipt and administration. Once highlighted to the registered manager this was organised this immediately.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff understood the requirements of the Mental Capacity Act 2005. Capacity was assumed and where people lacked capacity decision specific mental capacity assessments had been completed.

People were supported with their hydration and nutrition needs. The home had been awarded the highest food hygiene rating of five for good hygiene practice when handling food.

People enjoyed a wide range of activities and were encouraged to maintain life skills and have maximum control over their lives. Staff supported people to retain their independence.

Peoples’ personal records were stored confidentially in a locked room.

Care plans contained person centred information including a person’s likes and dislikes. Staff were aware of peoples’ preferences.

Regular audits took place within the home to help monitor and drive improvements.

There were well established links with the community such as, a gardening plot in the community allotment and people took part in a variety of charity fund raising events.

Ivy Lodge is a care home registered to provide accommodation and personal care for up to 10 people with learning disabilities. The home is situated in the village of Thurnscoe. In the surrounding area there are shops and pubs. Public transport is easily accessible. All bedrooms have ensuite toilets. Bedrooms on the ground floor are accessible for people with mobility needs. Bedrooms on the first floor are accessed by stairs. There is an open plan lounge and kitchen on the ground floor.

The service had a registered manager at the time of inspection. 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.’

During the inspection people told us they were happy with their experience of life at Ivy Lodge. Throughout the inspection we saw that staff protected people’s safety and respected people’s dignity and rights. One person said, “I like living here because they help me, they talk to me when I am upset”.

People told us how they enjoyed a wide range of activities at the home. They told us how they were supported to take part in the local community and to get experience working. One person said, “I work in a children’s centre twice a week, helping with the kids. It’s what I have always wanted to do and it makes me so happy and proud”.

People’s needs had been identified, and from our observations, we found people’s needs were met by staff who knew them well.However, we found that some care records were not up to date and contained incomplete assessments. Whilst there was no evidence to suggest that these had negatively impacted upon people the lack of information , review and recording within some of the key documents means that people may not be protected against the risk of receiving inappropriate care and treatment

The provider had taken some steps to ensure that people’s mental capacity was assessed and that care was provided in accordance with peoples consent. However, we found improvements could be made to ensure that care and support plans enabled people to make decisions about their care and support as far as they are able.

We found that staff received a good level of training, however. there were outstanding mandatory training requirements, which the provider’s own records identified.

There were systems in place to monitor and improve the quality of the service provided. Checks and audits were undertaken to make sure full and safe procedures were adhered to, however, we saw that some care plans were out were out of date. These needed to be reviewed to ensure they reflected current practice.

Staff and people who used the service we spoke to told us the manager always had an open door policy and the service was well led.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we asked the provider to take at the end of the report.

People were supported to have adequate nutrition and hydration.

During our inspection we conducted a tour of the premises and found it was clean and tidy. There were systems in place to reduce the risk and spread of infection.

We found people's needs had been met by sufficient numbers of appropriate staff.

We found people were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records had been maintained.

The majority of people that we spoke with told us that they were happy living in the home and that they were provided with good care and attention. People told us they liked the staff and could go to them if they had any worries or concerns. One person told us 'The staff are brilliant. They show us the right way of doing things.' Two people told us they were not happy at the home. The registered manager was aware of this and was able to evidence to us the steps the service was taking to address this.

We saw that the home had appropriate systems in place to ensure that people received their medication safely. One person told us, 'I haven't got the confidence to look after my own tablets so the staff help me with them. I can stop worrying now because the staff make sure I get them at the right time.'

The provider had a satisfactory recruitment and selection procedure in place to ensure that staff were appropriately employed.

A complaints procedure was in place so that people could voice any concerns. People told us they knew how to complain and that staff always listened to them if they had any worries or concerns.