Ivy Gate Lodge

Ivy Gate Lodge is a care home providing nursing care to up to 72 people. The service is located in Southport and provides support to older people and people living with dementia. Accommodation is provided across three floors in one modern adapted building. At the time of our inspection, there were 23 people living at the home. Due to the number of people supported, only two floors were in use at the time of the inspection.

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

People were exposed to risk of harm as the provider had failed to ensure risks were managed appropriately. Staff did not always follow the control measures recorded in people’s care plans to keep people safe. There was a system in place to record and analyse accidents and incidents. However, appropriate follow up action was not always taken. Our observations showed there were enough staff to meet people’s needs, however they were not always deployed effectively.

There were systems in place to monitor the quality and safety of the service. Audits demonstrated concerns with areas of care provision were generally identified and addressed. However, concerns we found with risk management and staff deployment had not been identified.

There was a complaints management system in place. However, not all records were updated to show complaints had been handled in a timely manner.

Inconsistent management had negatively affected the culture of the staff team. Staff explained they often felt unsupported in their roles due to lack of effective leadership. Some staff commented support had improved since the provider had been more present in the home. People and their relatives shared concerns about the approachability and visibility of management.

Staff did not always see people's privacy and dignity as a priority and failed to take action to ensure people's private space and possessions were respected.

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.

Medicines were safely managed. Systems were in place to ensure safeguarding referrals were made when required. Effective systems were in place to ensure infection prevention and control processes were safely operated.

Staff received an induction and completed mandatory training to enable them to carry out their job roles effectively. Detailed care plans were in place which guided staff on the level of support people needed with food and drink. People and relatives provided mixed feedback about the quality of the food. Some relatives told us the food was of a high standard, but others felt that the quality could be improved.

The home was appropriately designed to meet people’s needs and a high standard of interior design created a homely environment. People's individual rooms were personalised with items of their choice.

People's care plans contained contact details for the health professionals involved in people's care and support. Detailed communication care plans were in place to guide staff on how to effectively communicate with people according to their needs and preferences.

Staff treated people with kindness. We observed many caring interactions during the inspection. For example, a person was admitted to the home on the day of the inspection and staff went above and beyond to reassure the person and their relatives to ensure they settled in.

An activities programme was in place and there were dedicated staff to provide social activity for people. The provider had developed an action plan to improve the choice of activities.

Detailed care plans were in place to guide staff on how to support people with long term health conditions. Areas of clinical care such as wound care, catheter care and diabetes were well recorded and managed.

The provider was cooperative with external stakeholders. They embraced the inspection process as a learning opportunity and was open and honest when sharing information.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 1 March 2022 and this is the first inspection.

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.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment at this inspection. Please see the action we have told the provider to take at the end of this report.

We have made a recommendation about complaints management and quality monitoring systems and staff culture.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.