Ivy Court

Ivy Court is a residential care home built over 2 floors. Each floor has dining and lounge areas. The service provides care to older people and younger adults, people living with dementia, sensory impairment and those with a physical disability. The service can support up to 70 people. At the time of inspection 48 people were using the service.

People’s experience of using this service and what we found

Some people did not receive appropriate support at lunchtime, and specialised diets were not always provided to those who needed them. People’s daily records did not always match the care provided to them. The management team told us they would address these concerns.

There had been some changes in the management of the serviced in the past year and there was a new manager, who had very recently come into post. The quality assurance systems in the service had been disrupted to some extent and had failed to identify the concerns we saw at the inspection.

We asked the management team to refer concerns raised with us by people who used the service to the local authority safeguarding team. Although, most people felt safe living at Ivy Court and where risks to people had been identified there was good guidance in place for staff.

There were enough to keep people safe and recruitment and selection procedures were in place to make sure suitable staff were employed. People received their medicines safely and as prescribed. The environment was spacious, well laid out and clean and tidy.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff worked closely with relevant health care professionals to make sure people received appropriate care when they needed it. Systems were in place which enabled people, their relatives, and staff to provide feedback on the service and suggestions for improvements. Information from feedback was used to develop and improve the service.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 10 February 2023).

Why we inspected

The inspection was prompted in part by notification of an incident in which a person who used the service sustained a serious injury. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident showed potential concerns about the management of risk of scalds. This inspection examined those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe section of this full report.

This report only covers our findings in relation to the key questions safe and well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ivy Court on our website at www.cqc.org.uk.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

The overall rating for the service has changed from good to requires improvement. This is based on the findings of this inspection. Please see the safe and well-led sections of this full report.

We have found evidence that the provider needs to make improvements. We have identified breaches of regulation in relation to the safety and management of the service.

You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Ivy Court is a purpose-built care home which has 2 floors. Each floor has its own dining and lounge areas. It provides accommodation and personal care for up to 70 people. Peoples' needs were varied and included people living with dementia. At the time of our inspection there were 39 people using the service.

People's experience of using this service and what we found

People were happy living at Ivy Court. They told us staff were kind towards them and knew their needs well. People were encouraged to make their own choices and retain their independence and people's care plans were individualised and person-centred.

People felt safe living at Ivy Court and where risks to people had been identified there was good guidance in place for staff. Staff were able to tell us how they kept people safe and had a good knowledge of how to identify and report a potential safeguarding concern.

People lived in an environment that was checked for its safety and suitable for their needs. The environment was spacious and well laid out and was kept clean and tidy by a team of housekeeping staff.

People were cared for by a sufficient number of staff who had been trained and demonstrated competence in their roles. Staff received the support they required through continual learning and development and regular supervision with their line manager.

The manager was involved in initiatives to help assist with the pre-assessment stage for people. Appropriately trained staff safely administered medicines and people received the medicines they required in line with their prescription.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People and staff said the service was well led and they felt their opinions were sought and listened to. The manager worked alongside the staff and was very visible, they knew people well and focused on delivering person centred care.

The provider had systems in place to monitor the service and improve outcomes for people. The manager monitored accidents and incidents and identified any actions that needed to be taken to prevent future occurrences.

The manager had a clear drive to improve the service for the benefit of people living at Ivy Court. They had developed strong links with external providers and had plans in place for further development.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was Good (report published 04 March 2020).

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Why we inspected

This focused inspection was prompted by a review of the information we held about this service. We only inspected the key questions, safe and well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Stenson Court is a residential care home providing accommodation and personal care for up to 62 people. At the time of the inspection there were 30 people living at the home. Accommodation is provided in two buildings, however only one was in use. All people at Stenson Court are to be moved to a new, purpose-built home a short distance away. The Stenson Court site will be re-developed to produce another purpose-built home. People will be able to move back to the Stenson Court site should they wish to do so.

People's experience of using this service and what we found

Medication was predominantly managed safely. However, improvements were required in the recording of 'as and when required' medication. The provider was completing medication audits, but these had not identified the issues found at this inspection. Staff's competency to administer medication was regularly assessed. People said they enjoyed living at Stenson Court and staff said it was a good place to work. Everyone thought the home was a safe place to live and work in. Risks to people were assessed, enabling them to enjoy their lives and take acceptable risks, whilst keeping safe. The home reported, investigated and recorded accidents and incidents and safeguarding concerns.

People's needs and choices were assessed before they moved to the home and their care was delivered in accordance with current legislation and guidance. New staff members were provided with effective support when they first started work and a programme of regular training updates supported staff to keep their skills and knowledge up to date. Staff worked in partnership with a multi-disciplinary team to enable people to live healthier lives or manage long term medical conditions. People were supported to eat and drink enough to maintain a healthy diet. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The home had a warm, welcoming and friendly atmosphere with staff providing care and support in a way people liked. We met staff who were caring and compassionate. We saw positive interactions taking place between people, staff and each-other during our visit. Staff observed people's privacy, dignity and confidentiality and encouraged and supported them to be independent. People had access to advocates, if required.

Care records contained enough detail to support staff to deliver person centred care in accordance with people's preferences and wishes. Person centred activities that encouraged physical, mental and social stimulation were available. End of life care plans were in place for those people who wished to engage with staff regarding end of life care planning. The provider supported people to spend their final days with dignity and pain free.

People were involved in making decisions, had access to a complaints procedure and their views sought through surveys and care reviews. There were various systems in place to ensure that aspects of the service were quality assured and actions taken, where shortfalls were identified. The manager and staff worked with other organisations for the benefit of people using the service. The new manager was committed to drive improvements where they could.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 5 April 2016). There was also an inspection on 28 May 2018 however, the report following that inspection was withdrawn as there was an issue with some of the information that we gathered.

Why we inspected

This is a planned re-inspection because of the issue highlighted above.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

The service has a registered manager who has been registered with the Care Quality Commission since January 2011. 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.

Stenson Court is a care home situated in Balby, Doncaster which is registered to accommodate up to 30 people. The service is provided by Runwood Homes Limited. At the time of the inspection the home was providing residential care for 24 people, some of whom had been diagnosed with dementia.

The requirements of the Mental Capacity Act 2005 were in place to protect people who may not have the capacity to make decisions for themselves. 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 balancing autonomy and protection in relation to consent or refusal of care or treatment.

Staff knew how to recognise and respond to abuse correctly. They had a clear understanding of the procedures in place to safeguard vulnerable people from abuse.

People’s physical health was monitored as required. This included the monitoring of people’s health conditions and symptoms so appropriate referrals to health professionals could be made.

There were sufficient staff with the right skills and competencies to meet the assessed needs of people living in the home. Staff told us they felt supported by the registered manager and provider. Yearly appraisals had not been completed but were scheduled to take place in the next three months.

Staff were aware of people’s nutritional needs and made sure they supported people to have a healthy diet, with choices of a good variety of food and drink. People we spoke with told us they enjoyed the meals and there was always something on the menu they liked.

People were able to access some activities although there was no dedicated activity co-ordinator. People told us they had enjoyed ‘Mother’s day’ with parties and involvement from the local community. We saw people enjoying each other’s company sitting and chatting in the café area.

There was a strong and visible person centred culture in the service. (Person centred means that care is tailored to meet the needs and aspirations of each individual.) We found the service had a friendly relaxed atmosphere which felt homely. Staff approached people in a kind and caring way which encouraged people to express how and when they needed support. Everyone we spoke with told us that they felt that the staff knew them and their likes and dislikes.

Staff told us they felt supported and they could raise any concerns with the registered manager and felt that they were listened to. People told us they were aware of the complaints procedure and said staff would assist them if they needed to use it.

There were effective systems in place to monitor and improve the quality of the service provided. We saw copies of reports produced by the registered manager and the provider. The reports included any actions required and these were checked each month to determine progress.