We carried out a review of the data available to us about Ivydene on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Ivydene, you can give feedback on this service.
We found the following examples of good practice.
Visitors are provided with an infection prevention and control (IPC) pack upon entering the service. This contained essential personal protective equipment (PPE) for visitors use. The pack also contained a pen to reduce the risk of transmitting infection through sharing this equipment.
The provider had made adaptions to the layout of the service to promote good IPC practice. This included reconfiguring furniture to support social distancing and adapting a ground floor bedroom into a room where visitors could be safely supported to enter the home.
Staff had worked with people to help them understand how to reduce risks related to the pandemic. This included information and support around social distancing, the use of PPE and COVID-19 testing.
Staff had worked to minimise the impact of the pandemic on people’s wellbeing. They had worked with other services to help ensure people had access to social opportunities with their peers. Staff also supported people to stay in contact with their loved ones whilst physical visits were not possible.
The provider had effective systems in place to ensure the staff had appropriate levels of PPE available.
The service was visibly clean. There were effective cleaning schedules in place, which identified where frequently touched areas needed additional cleaning.
There was a registered manager at the service. 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 June 2016, we identified five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the Care Quality Commission (Registration) Regulations 2009. We asked the provider to make improvements in the areas of; person centred care, dignity and respect, safeguarding people from abuse and harm, assessing people’s healthcare needs, governance and monitoring of the service and the reporting of significant incidents to CQC. At this inspection, we found that improvements had been made and the provider had taken steps to meet the requirements of these regulations.
The registered manager started working at the service after the last inspection. They had devised and implemented an improvement plan for the service to make the improvements identified as being required at our last inspection. The registered manager and provider continued to monitor the service through a series of audits, checks and improvement plans in order to monitor the quality and safety of the service. The registered manager had also used feedback from complaints and questionnaires to make further improvements to the service.
People were involved in the planning of their care, being given choices about their daily lives and activities. Staff worked with people, tailoring their communication strategies to the individual in order to make communication meaningful and effective. Staff treated people with dignity, respect and were kind and caring in their interactions.
People were protected from the risk of harm. Staff took appropriate action to keep people safe when incidents occurred and the registered manager reported significant events which occurred in the home to relevant safeguarding bodies and CQC.
People’s healthcare needs were identified in their care plans. Staff were pro-active in ensuring that people had access to healthcare services when required. When people were reluctant to access these services, staff worked with people, families and other professionals to try to facilitate these appointments. The registered manager understood the need to for people to consent to their care and treatment, but also that some decisions had to be made in people’s ‘best interests’ if they lacked the capacity to make an informed choice.
There were sufficient staff in place to meet people’s needs. The registered manager had facilitated a large turnaround in staff since last inspection. Staff were supported appropriately through training, induction and supervision. Staff were subject to recruitment checks which helped to ensure they were of appropriate experience and character to work with people.
People were supported with a diet in line with their preference and their dietary requirements. They had access to planned activities outside the service and were encouraged to participate in everyday living tasks to promote their independent living skills.
A registered manager was not in place at the time of the inspection, although one of the managers had applied to be registered with CQC and their application was being processed. We were informed shortly after the inspection that the manager was no longer working at the home. 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. There was a lack of consistency in the management of the home and although staff felt the managers were supportive they did not feel the home was well- led.
We found fundamental standards were not being met and people’s safety was compromised in some areas.
People told us they did not feel safe and were scared of two other people who lived at Ivydene. They were not protected from the risk of physical or emotional harm due to the actions of other people. Individual risks were assessed and managed although these did not include examples of positive risk taking such as domestic tasks or the risks of physical abuse from other people.
There were inadequate numbers of permanent staff and the home was reliant on agency staff who had often not previously worked at the home. People were not always cared for with kindness and compassion.
People’s privacy was protected and they were involved in some decisions about their day to day care and meals but were not involved in other decisions about the service. Staff sought verbal consent from people on a day to day basis however, they did follow legislation designed to protect people’s freedom.
People were supported to access healthcare services when needed however it was not always clear from records what people’s longer term healthcare needs were or why they had been prescribed some medicines.
Some areas of the home were not suitable or accessible to people.
People were cared for by staff who had completed most essential training and were supported in their work although staff felt they did not have the necessary skills to support people who could become violent.
There were suitable systems in place to ensure the safe storage and administration of medicines. Healthcare professionals such as GPs, chiropodists, opticians and dentists were involved in people's care where necessary.
Weekly meetings with people were held to seek their views about some aspects of the service. People and relatives knew how to make complaints although one complaint had not been properly responded to.
Quality assurance arrangements had identified many but not all of the above concerns and the provider’s management team including the general manager and the area manager were visiting the home on a regular basis. We were not told about significant incidents which had occurred in the home as required.
In other ways, the home had an open culture. People and staff said the managers were approachable and they had contacted external professionals for support and guidance. Visitors were always welcomed.
People said they enjoyed their meals and received a choice of home cooked meals based on their needs and preferences. People were supported to engage in a planned and ad hoc individual activities of their choosing.
We identified six breaches of the HSCA regulations and one breach of the registration regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014
You can see what action we have taken in the full version of this report.