Archived: Ivyhouse Care Home

Updated 10 November 2016

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 unannounced inspection took place on 22 September. The inspection was undertaken by two inspectors.

We looked at the information we had about this provider. Providers are required to notify the Care Quality Commission about specific events and incidents that occur including serious injuries to people receiving care and any safeguarding matters. Appropriate notifications had been sent by the registered provider. We reviewed the information from notifications to help us plan the areas we wanted to focus our inspection on. We sought the views of the commissioners; people who purchase this service on behalf of the people living at Ivyhouse.

During the inspection we met with all 27 of the people who were living at the home and spoke at length with ten people. We spent time observing day to day life and the support people were offered. We spoke with three relatives of people to gain their views of the home. We used our Short Observation Framework for Inspection (SOFI) observation tool to ensure we captured the experiences of people who were unable to verbally share these with us. We spoke at length with the regional quality manager, the person with day to day responsibility for the running of the home, a registered nurse and four care staff.

We sampled some records including parts of four people’s care plans and the medication administration records on Cornflower and Daffodil Units. This was to see if people were receiving their care as planned. We looked at the registered provider’s quality assurance and audit records to see how the provider monitored the quality of the service.

Updated 10 November 2016

We had previously carried out an unannounced comprehensive inspection of this service on 25 and 26 January and 03 February 2016. Breaches of legal requirements were found. There was also evidence at that time that people's needs had not been well met. We gave the home an overall rating of Inadequate and the service remained in 'special measures.' After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. In August 2016 the registered provider took the decision to close this home. They have done this carefully and decided to remain open until everyone had moved to new accommodation.

At our last inspection we were concerned that people were not being kept safe. There were not enough staff on duty and staff were not being delegated to meet people’s needs. People could not be certain their medicines would be managed and administered safely. The nursing care provided had not consistently been well planned or delivered to ensure people’s health care needs were met. At this inspection we found significant improvements had taken place however people were still not receiving a service that was consistently providing safe care.

Ivyhouse is registered to provide nursing care and accommodation for up to 76 older people who may also be living with dementia. At the time of our inspection there were 27 people living at Ivyhouse on Daffodil and Cornflower Units. During our inspection people were being assessed for new care homes and some people were being supported to move out.

There was no registered manager in post, but the registered provider had ensured someone was in day to day control of the home. They were present throughout our inspection and were supported by a member of the registered provider’s management team. 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.

We completed this unannounced inspection on 22 September 2016. We planned this inspection to provide assurance that plans were in place to provide an adequate level of care and support to people until the home closes. We only looked at the key question of safe. This report only covers our findings in relation to the key question of safe. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Ivyhouse on our website at www.cqc.org.uk.

While the provider had taken some action to improve the management of medicines this was not consistent across the home. Medicated creams and tablets administered directly from boxes were not well managed. People could not be confident they would always receive these as prescribed.

Risks people were exposed to because of their medical conditions had not always been identified, assessed and well planned for. People could not be confident they would always receive care that protected them from harm.

Although there were less people using the service the provider had not reduced the number of staff working at the service. This had resulted in staff having more time to spend with people and time to focus on their needs. People told us the staff were caring and responsive to their needs. People told us they felt safe and medicines that were administered from a blister pack were well managed.

People told us they enjoyed the food and we observed people being provided with the support they needed to eat and drink. People appeared well presented and staff took action when necessary to maintain their dignity. People were supported when necessary to access a range of health care professionals.

A range of checks and audits had been developed to drive forward improvement at this service and to ensure people safely received the care and support they required until they left the service.

As Ivyhouse is a service in special measures it will be kept under review while it is open. Where necessary, another inspection will be conducted whilst the home remains open. The findings of future inspections could lead to us taking urgent action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.