Inspection on 13/09/06 for Ivonbrook Care Home

This inspection was carried out on 13th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ivonbrook Care Home 25/11/08

Ivonbrook Care Home 13/09/07

Ivonbrook Care Home 24/10/05

Ivonbrook Care Home 07/06/05

Ivonbrook Care Home 03/08/04

Ivonbrook Care Home 28/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Ivonbrook Care Home Eversleigh Rise Darley Bridge Matlock Derbyshire DE4 2JW Lead Inspector Ray Coonan Unannounced Inspection 13th September 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ivonbrook Care Home DS0000002061.V308958.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ivonbrook Care Home DS0000002061.V308958.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ivonbrook Care Home Address Eversleigh Rise Darley Bridge Matlock Derbyshire DE4 2JW 01629 735306 01629 735441 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) David Treasure Mr A Wright, Mrs Glenys Pamela Wright, Alison Treasure Mrs Jenni Anne Treasure Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Ivonbrook Care Home DS0000002061.V308958.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th October 2005 Brief Description of the Service: Ivonbrook care home is situated in its own grounds in Darley Bridge village, and provides nursing and personal care for up to 40 persons aged 65 years and over. The home is purpose built and the facilities are on 2 floors; stairs and a passenger lift access the floors. All bedrooms are single rooms; 12 rooms have en-suite facilities. There are 2 lounges, dining rooms and a small quiet lounge area. Residents have access to a garden. At the time of this inspection the Home’s fees ranged from £300 to £550. Ivonbrook Care Home DS0000002061.V308958.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of seven and a half hours on the 13th September. The manager of the Home, Jenni Treasure, was present for the majority of the visit, as was the Home’s owner, David Treasure. There was the opportunity to meet with some of the staff on duty, including qualified nurses, care workers, the cook and the activities coordinator. There were also discussions with several residents on an individual basis and also visiting relatives. Most parts of the premises were viewed including bedrooms and bathrooms. A range of documentation was examined, such as several individual care plans, staffing records, relevant policies and procedures and health and safety records. What the service does well: What has improved since the last inspection? The Home has benefited from a consistent management presence since the last inspection and a much more considered and organised approach to the general running of the service has been developed. Care planning methods and files are more ordered and reviewed appropriately. Arrangements for staff supervision and appraisal are now in place and more relevant induction training has been established. Ivonbrook Care Home DS0000002061.V308958.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ivonbrook Care Home DS0000002061.V308958.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ivonbrook Care Home DS0000002061.V308958.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. (Standard 6 is not applicable to this service) Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Appropriate assessments were undertaken with potential residents though not all areas of need were fully explored and thereby fully met. EVIDENCE: Several care plans were examined in detail and showed that assessment information on prospective residents’ needs was obtained by the Home. This included care review information from the local authority social services department and/or nursing assessments from the health authority with any specialist needs detailed. This information subsequently informed the development of individual care plans though it was noted that in some instances information on the social, emotional and spiritual needs and interests of residents was sparse. Ivonbrook Care Home DS0000002061.V308958.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents had their health and personal care needs satisfactorily promoted though their overall care would be enhanced through more explicit assessments in some areas. EVIDENCE: Three individual care plans were examined in detail, including two plans for nursing care, one of which related to a resident who had only been at the Home for two months. In general the plans were well ordered and accessible with systematic assessments undertaken at the Home. Potential risk areas such as skin integrity and mobility were assessed though there was not always a separate, full moving and handling assessment with explicit guidance notes for staff. Since the last inspection the manager has developed a nutritional assessment tool, which was routinely used and the cook confirmed that she receives relevant information on any dietary needs for new residents. Ivonbrook Care Home DS0000002061.V308958.R01.S.doc Version 5.2 Page 10 Overall the health care plans for residents were comprehensive and any personal hygiene and continence management issues well documented. Regular weight records were kept as necessary and any aids or adaptations relating to mobility or pressure sore relief were obtained. One resident had significant and complex physical disability needs and there was detailed care planning information in place with staff receiving specialist advice and training. There was evidence that care plans were regularly monitored through a named nurse system and assessments reviewed accordingly. There was positive feedback from residents and their relatives regarding the general attitudes and care practice of staff and their general competence and interactions were seen as sensitive and appropriate. There was evidence that support from community health services were obtained as necessary, including G.P., community nursing, optician, chiropody and dental care. However the social and spiritual needs and interests of residents were not as systematically planned for in care plans. The Home has a separate and secure treatment room for the storage of medication. These arrangements were satisfactory with clear records of administration maintained. The pharmacist undertakes regular audits of these arrangements and systems for the disposal of medicines have been put in place. Ivonbrook Care Home DS0000002061.V308958.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A good range of activities was available to residents and contacts with families and friends were appropriately encouraged and facilitated. Residents had a satisfactory standard of meals provided at the Home, with their individual dietary needs and preferences recognised. EVIDENCE: The Home has an activities coordinator who works with residents, mostly in small groups, on weekday afternoons. Although there is no set programme a range of activities take place including reminiscence work, quizzes, board games, dominoes and soft ball games. The First Taste project visits the Home regularly, providing musical activity sessions and also arrange regular trips out each month using community transport resources. Records are kept of resident participation in these activities. There were no residents with specific cultural needs. Religious services took place at the Home on a regular basis. Some residents used audio material in their rooms though it was considered by the Home that the levels of hearing Ivonbrook Care Home DS0000002061.V308958.R01.S.doc Version 5.2 Page 12 impairment amongst the resident group did not necessitate the installation of a loop system in communal areas. Corridors were of an appropriate size for wheelchair use and in general residents were observed using the various parts of the Home as they wished, including the small quiet lounge, which had some snoezelan lighting equipment installed. There were many visitors to the Home on the day of the inspection visit and from conversations with several relatives it was clear that their involvement in the life of the Home was encouraged and several visited on a daily basis for long periods of time. They were positive about communication with staff and managers. It was noted that quite a few residents were from local areas, as were the staff who had in several instances a good knowledge of the resident’s background and family history. Residents spoken to were generally happy with the standards of catering at the Home and confirmed that staff were aware of their individual likes and dislikes and that alternatives to the daily menu were available. Weekly menus were seen to be of good variety and nutritious. Any special diets were catered for and there were several residents requiring their food to be liquidised and this was presented in an appropriate manner. There were two main dining areas in use with residents requiring assistance grouped together. However, some residents were seen to have their meals in their rooms on request. Ivonbrook Care Home DS0000002061.V308958.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have their complaints responded to appropriately and are suitably safeguarded from abuse. EVIDENCE: The Home has an accessible complaints policy and procedure, which is also displayed. The Home keeps satisfactory records of any complaints received and how they were responded to. A formal complaint was received at the Commission prior to the inspection, concerning inadequate staffing levels and an aspect of infection control. These issues were considered and were not substantiated at the time of the inspection visit. Discussions with the manager and an examination of training records indicated that there was an appropriate level of information on abuse and protection issues at the Home with material available on local procedures and protocols for dealing with any referral. Externally led training has been arranged for staff generally and the manager has also attended the local social services led inter agency training sessions. However, one staff member who had been at the Home for several months did not have a clear working knowledge of protection issues. Ivonbrook Care Home DS0000002061.V308958.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall residents enjoyed an environment that was safe and comfortable though there are some aspects of maintenance due for renewal. EVIDENCE: The Home was generally well maintained and free from odours, though on the day of the visit there were problems with cleaning staff not turning in. A maintenance book is kept for any items needing attention and general décor and furnishings were satisfactory in both communal and bedroom areas. Bedrooms were of an appropriate size, comfortably furbished and personalised by residents. However, in many bedrooms and in corridor areas, carpets were showing signs of significant wear and tear. Residents had door locks available for the bedrooms and call systems were seen to be working appropriately. Ivonbrook Care Home DS0000002061.V308958.R01.S.doc Version 5.2 Page 15 There were bathroom and toilet facilities suitably located throughout the Home with fixed hoist facilities available for residents with mobility difficulties. Some bathrooms were cluttered and untidy and in one instance used inappropriately for the storage of several wheelchairs. In one bathroom an individual bar of soap had been left lying around though generally soap dispensers were in use. The Home’s laundry was viewed and this was suitably organised and equipped. However, the floor surface was badly damaged in areas and the sink and surrounding plasterwork were similarly in a state of disrepair. The Home had sluice areas on each floor though these were not kept locked. Ivonbrook Care Home DS0000002061.V308958.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ interests were supported through an organised approach to staff development and recruitment. EVIDENCE: Samples of current and recent staffing rotas were viewed. Generally, satisfactory staffing levels were maintained with staff appropriately deployed. However, levels were down on the occasional shift. There had been a degree of staff turnover since the last inspection and there is a steady throughput of ‘adaptation’ nurses from abroad working as carers. However, the Home retains a core group of experienced staff who have worked at the Home for a considerable time both as carers or qualified nurses. Residents spoken to commented positively on the commitment of staff and their competence. The Home now has up to 80 of its care staff NVQ trained. Staff development was promoted and monitored systematically with clear records maintained. Training programmes showed that mandatory care training such as moving and handling and basic food hygiene were arranged on a regular basis and training links had been established with the local social services department in such areas as ‘Skills for Care’ induction training programmes. However, one member of staff had missed out on several courses due to the pattern of her working hours and this had not been picked Ivonbrook Care Home DS0000002061.V308958.R01.S.doc Version 5.2 Page 17 up. Staff confirmed that regular training opportunities were available and included input on dementia. Other specific input had been arranged in such areas as challenging behaviour and infection control though not on any ongoing basis. The Home had recently had its ‘Investors in People’ award reviewed and received a positive report. A small sample of staff files were viewed, which showed that necessary recruitment and selection processes were followed with appropriate interview records and references and criminal record bureau checks taken up. Ivonbrook Care Home DS0000002061.V308958.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users interests were enhanced through The Home being run in an organised manner, which satisfactorily promotes their health and safety. EVIDENCE: Since the last inspection a permanent manager has been appointed at the Home and has subsequently been registered with The Commission. The manager has up to date nursing qualifications and is currently undertaking NVQ training in Management. Discussions with the manager indicated that she has developed a clear sense of priorities for the Home and monitors standards through a variety of measures such as staff meetings, resident and relative meetings and a resident questionnaire. Staff confirmed that they receive 1:1 supervision time and also appraisals on a regular basis. Ivonbrook Care Home DS0000002061.V308958.R01.S.doc Version 5.2 Page 19 The Home had a clear policy for the handling of residents’ personal monies, which were kept secure. Individual records were maintained and were clear with double signatures for individual transactions. The Home had relevant health and safety policies and procedures in place. The Environmental Health Officer had visited in July and the subsequent report indicated that food safety practices at the Home were satisfactory and that the premises, structure and equipment at the Home were in a satisfactory state of repair. A fire safety risk assessment of the premises had taken place last June. Fire safety records were examined and were up to date and clearly maintained. Accident records were also viewed and were suitably detailed and monitored by the manager. Records for the monitoring of electrical equipment and water temperatures were also up to date. Ivonbrook Care Home DS0000002061.V308958.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 2 X X 2 X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Ivonbrook Care Home DS0000002061.V308958.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14 Requirement A fuller assessment of residents needs, preferences and abilities must be completed prior to admission. A programme for the replacement of worn carpeting throughout the Home must be established. The floor surface and sink area in the laundry must be upgraded. Timescale for action 31/10/06 2. OP19 13 31/10/06 3. OP26 13 30/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP7 OP7 Good Practice Recommendations More explicit moving and handling risk assessments should be developed. Care plans should contain more details of the social, emotional and spiritual needs of residents. DS0000002061.V308958.R01.S.doc Version 5.2 Page 22 Ivonbrook Care Home 3. 4. 5. 6. 7. 8. OP18 OP21 OP26 OP30 OP30 OP36 The manager should monitor staff awareness of abuse and protection issues. Bathrooms should not be used for storage. Sluice rooms should have door locks. Ongoing training opportunities for staff should be provided in such areas as challenging behaviour and infection control. The manager should keep under review staff attendance at mandatory care courses. Records should be kept of 1:1 supervision with staff. Ivonbrook Care Home DS0000002061.V308958.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ivonbrook Care Home DS0000002061.V308958.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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