This inspection took place on 27 and 29 July 2015, the first day of which was unannounced.
Ivydene Nursing Home is situated close to the town centre of Ivybridge. It is registered to provide nursing and/or personal care for up to 57 older people who may be living with physical or mental disabilities, including dementia. The home provided care and support to people with varying and at times complex care needs, including those who were no longer able to live safely at home, those with nursing needs and those who were living with dementia. The home is purpose built to provide three care areas, one for nursing care with 27 bedrooms, one for residential care with 13 bedrooms and one for people living with dementia with 15 bedrooms.
The home had a registered manager. 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.
Those people who were able to share their experiences with us told us they felt safe living at the home. One person told us “yes, I feel very safe and well cared for.” For people who were not able to tell us, we observed how staff interacted with them. We saw people smiling and talking freely to staff, people were happy to have staff sit next to them and to hold their hand, indicating they felt safe in the staff’s company.
People and relatives told us they felt the staff to be very kind and caring. They had confidence in the staff and spoke positively about the care they received. One person said “I have been here a long time and they look after me very well.” Another person said “the girls look after us really well.” A relative told us “we’re very happy with the way the staff care for (their relative’s name)” and another said “(staff name) has shown my mother great kindness.
Staff told us they supported people to remain as independent as possible and involved people in decisions about their care. Throughout our inspection, we saw staff were kind, caring and attentive to people and their relatives. During our observations in the dementia care unit we saw staff comforting people who had become anxious due to their memory loss and who were unsure of where they were or what was expected of them. Staff were patient, held people’s hands and repeated as often as was necessary the information people required to ease their anxieties. People were encouraged to take interest in the events around them and staff engaged them in conversations which people were easily able to participate in.
People told us there were sufficient staff on duty to meet their needs, telling us their call bells were answered within a “couple of minutes.” One person said “it was unusual to have to wait for attention.” One member of staff told us “I feel like there is enough staff, and you can sit and chat.” We saw staff in conversation with people and people being assisted unhurriedly which indicated there were enough staff on duty to meet people’s needs. Staff had been recruited safely. They were provided with the training necessary to understand and meet people’s care needs and any associated risks to their health and safety. They demonstrated a good understanding of how to keep people safe and how they would report their concerns should they have any. One member of staff told us “the home puts a lot of time into training” and another said they were encouraged to undertake “lots of training” including qualifications in health and social care. Staff told us they enjoyed working at the home, comments included “I’ve always enjoyed it” and “I love working here.” They told us their caring role was about “making sure this feels like home for them” and “treating the residents as if they were my own family.”
Risks to people’s safety and well-being had been assessed prior to their admission to the home and regularly reviewed. Care plans provided staff with clear guidance about how to meet people’s needs in the manner they preferred. People had prompt access to health care professionals such as GPs and occupational and physio-therapists as needed. People’s medication was managed safely and they received their medicines as prescribed.
We asked people their views of the meals provided at the home and we received a varied response. Some people told us, “yes the food is good” and “the food is fine with plenty of variety. I tell the chef what I would like and I have it”, while others said “the food is alright” and “the food is not to my liking, although it is edible the portions are too large.” We shared these views with the registered manager who confirmed they audit people’s views of the meals regularly and would look again at this issue. We observed people having their lunchtime meal. Staff explained to people the food that was available, showed them the plated meals to aid their choice and encouraged them to try the dishes. Staff checked with people the food was to their liking and we saw people were offered alternatives if they wished. Those people who required support to eat were assisted appropriately by staff.
People were supported to take part in a variety of leisure and social activities. The home employed an activity leader who was responsible for discussing people’s hobbies and interests with them and planning activities around these. Relatives told us they were able to visit the home at any time and were always made welcome: they confirmed they were also invited to participate in the planned activities. Throughout the inspection we saw staff engaged in a variety of activities with people: playing board games; painting people’s nails; quizzes; assisting people with daily tasks such as setting the table, as well as involving people, some with very limited upper body movement, in an adapted game of indoor skittles. The home had a greenhouse where people were encouraged to grow vegetables as well as raised beds for growing flowers. People told us they had picked some of the vegetables to have with their lunch.
People and their relatives told us the home was well managed. They knew who the registered manager was, with one person saying they were “a very familiar figure as she was always out and about in the home. She is very accessible and approachable.” People said they had no concerns over the care and support provided at the home. They said they had confidence in the registered manager or any of the staff to deal with issues promptly and effectively should they arise. Staff understood their roles and said the communication between themselves, the nurses and the registered manager was good.
The registered manager used a number of methods to gain people’s views of the care and support provided at the home, and to ensure people’s needs were met safely, including meeting with , surveys, comment cards and daily and monthly audits.