Ivy Cottage

Updated 14 July 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was a comprehensive inspection. It took place on 16th and 17th May and was unannounced. Before the inspection, we reviewed information from the provider. The registered manager had completed a Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed the last inspection report and other information including any notifications. Notifications are information we receive when a significant event happens, like a death or serious injury.

We spoke to the quality and compliance manager, the deputy manager, three support staff and two families. Some people were unable or unwilling to give us their views of the service. We have tried to maintain the peoples ‘voice’ through observation and feedback from families and professionals.

We looked at a range of support documents including, care and activity plans, medicine administration records, training records, staff files, supervision and appraisal records and policies and procedures. We also asked the provider to send us a range of documents including their business continuity and development plan after the inspection, which they did.

Updated 14 July 2018

This was a comprehensive inspection. It took place on 16th and 17th May and was unannounced. Ivy Cottage provides accommodation and personal care for five people with learning disabilities who may have complex needs.

At the time of the inspection four people were living at Ivy Cottage and there was one vacancy. The premises are purpose built on one level with good access for people with limited mobility or wheel chair users. It is set on Highlands Farm near the village of Woodchurch.

Each person had their own room with additional communal bathroom and separate wet room. There was also a lounge/diner and kitchen. There was a fenced rear garden with a paved seating area.

Ivy Cottage is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Ivy Cottage accommodates people with a learning disability and some with complex needs.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Rating at last inspection

At our last inspection we rated the service as good. At this inspection we found the evidence continued to support the overall rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

However, since the last inspection the service had not remained well-led. The registered manager had been absent for several months and a deputy manager with limited management experience had taken their place.

The provider had continued to deliver good service for the people who live there but, there had been a deterioration in the day to day support for staff especially in relation to staff supervision and appraisal.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated Good

People were protected from abuse with sufficient numbers of trained staff to meet people’s needs. Individual risk assessments provided staff with the information they needed to reduce and manage risks whilst ensuring people’s individual freedom and independence was respected.

Staff rostering ensured sufficient numbers of trained staff supported people’s activities, appointments and needs.

People received their medicines safely from trained staff. The service had worked with local health and social care professionals and sought guidance from the GP about the storage and administration of homely remedies as part of its regular auditing processes.

People’s individual needs were met through the design of the building. The service was clean, with measures in place to protect people from cross contamination and infection. Incidents had been recorded appropriately with systems to record follow up actions.

People’s needs and choices were assessed and reviewed regularly to reflect their needs and wishes. Support plans provided staff with clear guidelines about the support people needed in line with national guidelines.

Staff recruitment continued to follow safe procedures, ensuring statutory checks, induction training and shadowing of experienced staff, were all completed before new staff started work.

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.

Their consent was sought and external advocacy used where there were limitations to verbal communication, to ensure that the provider worked in line with the principles of the Mental Capacity Act 2005 (MCA) and associated Deprivation of Liberty Safeguards (DoLS).

People were supported to eat and drink to maintain a balanced diet and stay in good health. They helped to plan their menus and assisted in meal preparation.

People attended routine and specialist health appointments with appropriate referrals made to health and social care professionals as needed.

Staff knew the people well and treated them with kindness and dignity. People were happy and relaxed with staff and, there was a clear sense of mutual respect and equality. People were supported to express their views and were encouraged to raise issues formally and informally.

The deputy manager had an open-door policy and worked hard to support staff on a day to day basis. The absence of the registered manager had weakened support and training for staff, leaving the service without sufficient day to day management experience.

We found that key management tasks and recommendations from the provider’s internal audits had not been completed and have recommended that the provider support the deputy manager to address outstanding actions.