Archived: Ivybank Care Home

Updated 22 April 2015

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 inspection took place on 29 and 30 January 2015 and was unannounced. It was undertaken by two inspectors.

We looked at the information we held about the service prior to the inspection. We looked at information received from relatives, from the local authority commissioner and the statutory notifications the provider had sent us. A statutory notification is information about important events which the provider is required to send to us by law. The provider was asked to complete a provider

information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This information was received after the date we requested. We took this into account when we made the judgements in this report.

During our inspection we spoke with seven people who lived at the home and with three relatives. Some people’s needs meant that they were unable to verbally tell us how they found living at the home. We observed how staff supported people throughout the day. As part of our observations we used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with the registered manager, area manager, a cook, one nurse, three care staff, an activity worker, an administrator and one student on placement at the home. We also spoke with three healthcare professionals after our inspection. We looked at the care records of four people, the medicine management processes and at records maintained by the home about staffing, training and the quality of the service. Following our inspection the provider sent us further information which was used to support our judgment.

Updated 22 April 2015

This inspection took place on 29 and 30 January 2015 and was unannounced. At the last inspection in July 2014 we found that the provider was meeting the requirements of the three regulations we looked at. An earlier inspection in the year before we had considered more of the regulations and at that time we found that the provider was not meeting five of the regulations. They supplied an action plan which indicated how they would address the issues raised.

The home is registered to provide care and accommodation for up to 58 older people, some of whom may be living with dementia or have complex healthcare needs. Nursing care is also provided. On the day of our inspection there were 29 people at the home.

A manager was registered with us. 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 we spoke with told us they felt safe in the home and the staff made sure they were kept safe. We saw there were systems and processes in place to protect people from the risk of harm. People were supported by staff who had received training on how to protect people from abuse.

Effective recruitment and selection procedures were in place and we saw that appropriate checks had been undertaken before staff began work. The checks included obtaining references from previous employers to show staff employed were safe to work with people. Improvement was needed to the staffing arrangements to make sure there were enough staff to meet people’s needs.

We reviewed the systems for the management of medicines and found that people received their medicines safely.

The Mental Capacity Act 2005 (MCA) sets out what must be done to make sure that the human rights of people who may lack mental capacity to make decisions are protected, including when balancing autonomy and protection in relation to consent or refusal of care. The associated safeguards to the Act require providers to submit applications to a ‘Supervisory Body’ for authority to deprive someone of their liberty. We looked at whether the service was applying the safeguards appropriately. The registered manager and staff we spoke with understood the principles of the MCA and associated safeguards. They understood the importance of making decisions for people using formal legal safeguards.

People’s needs had been assessed and care plans developed to inform staff how to support people appropriately. Staff demonstrated an understanding of people’s individual needs and preferences. They knew how people communicated their needs and if people needed support in certain areas of their life such as assistance with their personal care. We saw staff talking and listening to people in a caring and respectful manner.

We have made a recommendation that the provider seeks guidance about how to improve access around the home.

People told us they were supported to eat and drink sufficient amounts to maintain their health but we found systems to monitor that people were getting enough to eat and drink needed improvement. Risks to people’s nutrition were minimised because staff understood the importance of offering appetising meals that were suitable for people’s individual dietary needs. People had access to healthcare professionals when this was required.

People who lived at the home, their relatives and other health professionals were encouraged to share their opinions about the quality of the service. We saw that the provider had a system in place for dealing with people’s concerns and complaints.

We found that whilst there were systems in place to monitor and improve the quality of the service provided, these were not always effective in ensuring the home was consistently well led. We found that some improvements were needed.