Ivanhoe is a care home that is registered to provide accommodation and personal care for 26 older people, including those people living with dementia. The service is situated on a main road between Hessle and the city of Hull. It is close to local amenities and has parking facilities to the front and rear of the property. The service has mainly single bedroomsWe undertook this unannounced inspection on the 18 and 19 February 2016. There were 25 people using the service at the time of the inspection. At the last inspection on 21 January 2014, the registered provider was compliant in the areas we assessed.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
We found there were times when there was insufficient staff on duty, mainly at tea-time at the weekend. The registered provider told us they were addressing this and plans were underway to rearrange the staffing structure at these times.
We found the service was generally clean and tidy in communal areas and bedrooms. However, there were some areas of the environment and practice that could be improved in regards to good infection prevention and control. These were mentioned to the registered manager during the inspection to address.
We found staff were recruited safely although some documentation could be improved regarding the decisions made. For example, when it was difficult obtaining a reference from previous employers or when there were minor issues on disclosure and barring service checks but employment was to go ahead.
We found people received their medicines as prescribed. Medicines were obtained, stored, administered and recorded appropriately.
We found people’s health care needs were met. They had access to a range of community health care professionals when required. When people required closer monitoring due to their nutritional intake or risk of developing sores, this was completed consistently.
We found the registered provider worked within the Mental Capacity Act 2005 [MCA] and Deprivation of Liberty Safeguards [DoLS] with regards to making applications to the local authority when people who lacked capacity were deprived of their liberty. Staff had a good understanding of the need to obtain consent from people prior to delivering care and support.
People liked the meals provided to them and there was sufficient quantity and choice available. Staff supported people to eat their meals in a sensitive way when required. We saw there was plenty of drinks and snacks available in between meals.
Staff had received training in how to safeguard people from the risk of harm and abuse. They knew who to raise concerns with.
We saw staff had developed good relationships with people who used the service and treated them with dignity and respect. We saw people had their needs assessed prior to admission. This was added to when people were admitted to the service and plans of care were produced so staff had guidance in how to deliver care that met their preferences and wishes.
We saw people participated in a range of meaningful activities to promote their interests and help prevent them from feeling isolated in the service. Staff also helped them access community facilities.
Staff had access to a range of training in order to meet people’s needs. They also received induction, supervision, support and appraisal in order for them to feel confident when supporting people. There was a system to identify when refresher training was required.
There was a quality monitoring system in place which included audits and questionnaires. This helped to identify shortfalls so action could be taken to address them. People told us they felt able to complain and staff had a policy and procedure to provide guidance when complaints or concerns were raised with them.