This inspection took place on 9, 10 and 16 May 2016. The first day was unannounced. The home is registered to provide nursing care and accommodation for up to 38 older people, some of whom may be living with dementia or have complex healthcare needs. During our inspection there were 35 people living at the home. This was the first inspection of Ivybank Care Home since a new provider took over from a previous provider in November 2015.
Ivybank had a registered manager in post. .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 told us how 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. Despite this we saw some isolated incidents of poor staff practice that did not promote people’s safety. This included a member of staff letting in a visitor to the home without checking their identity.
Effective recruitment and selection procedures were in place and appropriate checks had been undertaken before new staff began work. The checks included obtaining references from previous employers to show staff employed were safe to work with people.
There were not always enough staff on duty to ensure people’s needs were met. Recruitment was in progress to ensure there would be sufficient numbers of staff available to meet people’s individual needs. We reviewed the systems for the management of medicines and found that people received their medicines safely.
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. People told us they were involved in the planning of their care and were asked how they wanted to be supported. Staff were kind and caring, and respected people’s privacy however we observed domestic staff not seeking permission to enter people’s bedrooms.
The registered manager had approached the appropriate authority when it was felt there was a risk people were being supported in a way which could restrict their freedom. Staff had been provided with training about the Mental Capacity Act 2005 (MCA) but not all staff were aware that Deprivation of Liberty applications had been submitted for some people.
People were offered a range of food, drinks and snacks that met their cultural, dietary and health needs. Some people expressed their views about the lack of variety of the meals but the provider was already in the process of consulting with people and updating the menus.
People had access to a range of healthcare when this was required.
There was a programme of activities available within the home which involved various group activities and less frequently, activities on an individual basis. The frequency of activities was reduced when the activity worker had to cover for other staff absences. The provider had plans to improve the range and frequency of activities on offer to people to provide stimulation, and to reduce the chance of people being socially isolated.
People who lived at the home and their relatives 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. People and their relatives said they knew how to raise any concerns
and most were confident that these would be taken seriously and looked into.
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.