Inspection on 13/09/07 for Ivonbrook Care Home

This inspection was carried out on 13th September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 13/09/06

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 Key Unannounced Inspection 13th September 2007 09:45 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.V341754.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.V341754.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 Vacant Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Ivonbrook Care Home DS0000002061.V341754.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To admit the person named in variation V38675 in the category DE(E) dated 8 February 2007 13th September 2006 Date of last inspection Brief Description of the Service: Ivonbrook care home is situated in its own grounds in Darley Bridge village, near Matlock, 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.V341754.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection covering all the key national minimum standards and took place over a period of six hours on the 13th September. One of the Home’s owners, Mr. David Treasure, was present throughout the visit and assistance was also provided by senior staff, who were covering the vacant manager post on an interim basis. There was also the opportunity to meet with several of the care staff on duty. A range of documentation was examined, including a sample of individual resident care files, staffing rotas, training records, staff files, health and safety information and other relevant policies and procedures. A full tour of the premises was not undertaken on this occasion though communal areas and some bedrooms and bathrooms were also viewed. Prior to the inspection the Home had completed an Annual Quality Assurance Assessment form and this information was taken into account when planning the inspection visit. The Home had 29 residents at the time of the inspection and there was the opportunity to meet and talk with many of them, either individually or in small groups, during the visit. Several residents were also surveyed before the inspection in order to obtain their views. The Home had many visitors on the day of the inspection and there was the chance to talk with several relatives during the day. What the service does well: What has improved since the last inspection? Ivonbrook Care Home DS0000002061.V341754.R01.S.doc Version 5.2 Page 6 The Home has developed its risk assessment processes and this was reflected in care plans, particularly where there were complex nursing care needs identified. 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. The summary of this inspection report can be made available in other formats on request. Ivonbrook Care Home DS0000002061.V341754.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.V341754.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Outcomes for Standard 6 were not assessed as the Home does not provide an intermediate care service. Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. The Home did not have a comprehensive and systematic process for assessing the needs of all its prospective residents so that potentially their care needs are not fully met. EVIDENCE: Three care files were examined in detail. Two of the care files, which were for residents requiring nursing care, showed that a range of assessment information was obtained from other sources such as the local authority or community health services, particularly concerning specialist medical and Ivonbrook Care Home DS0000002061.V341754.R01.S.doc Version 5.2 Page 9 physical health needs. However, pre – admission information on the social, emotional and spiritual needs of residents continues to be sparse. The third care file for a person receiving residential care on an extended respite basis had no assessment information. Ivonbrook Care Home DS0000002061.V341754.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although care plans for nursing care were well –organised and informative, care plans for shorter stay residents were not complete, so that some residents did not have their care needs suitably planned. EVIDENCE: The sample of care plans viewed demonstrated that the nursing care needs of residents were assessed and set out in a detailed and organised way. There were clear medical history records evident and a wide range of risk assessments undertaken, which were kept under review. These included such areas as mobility and manual handling, skin integrity, psychological health, medication, oral hygiene, nutrition and fluid intake, social relationships and activities, religious and cultural interests, with any relevant daily routines also noted. Ivonbrook Care Home DS0000002061.V341754.R01.S.doc Version 5.2 Page 11 The actual care plans were clear with actions and aims set out. Records of any medical interventions, such as catheter care or wound management, were maintained and notes of contact from health professionals, such as G. P., physiotherapist, speech therapist, dentist, and optician were also kept. There was also evidence that these care plans were monitored regularly and adjusted appropriately. However, the care file for the person receiving residential care had no information at all apart from a record of a hospital appointment. It was explained that it was thought this was not necessary as the person was on respite care, though the resident had been at the Home for a period of three months when the file was examined. There was generally positive feedback from residents and relatives regarding the attitudes and interactions of staff on a day to basis and staff were observed working with residents in a warm and sensitive manner. Two visitors described staff as “marvellous” with their relative. However, there were a couple of comments suggesting that some staff could be a bit “rough” and “brusque” when using moving and handling techniques. The Home has a separate and secure treatment room for the storage of medication. Arrangements were satisfactory with appropriate medicine administration records kept and suitable systems in place for the ordering and disposal of medicines. Ivonbrook Care Home DS0000002061.V341754.R01.S.doc Version 5.2 Page 12 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. 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. The Home had an active approach to arranging recreational opportunities and contact with families, which enhanced the quality of life for residents. Residents were generally positive about catering standards and individual dietary needs and preferences were recognised. EVIDENCE: The Home has an activities coordinator who works with residents, mostly in small groups, on weekday afternoons and has a good awareness of residents’ social backgrounds and interests. Although there is no set programme a range of activities take place including reminiscence work, quizzes, board games, dominoes and soft ball games. Residents also have the use of a small quiet lounge, which has some snoezelan lighting equipment installed. There was one Ivonbrook Care Home DS0000002061.V341754.R01.S.doc Version 5.2 Page 13 comment from a resident suggesting that he/she could not access many of the activities because of poor vision. Since the last inspection a few staff at the Home have attended training sessions regarding social activities for people with dementia. The First Taste project still visits the Home providing musical activity sessions and also arranges regular trips out each month using community transport resources. Currently staff from the Home are reviewing programmes and planning further activities with the project. 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. There was no undue emphasis on routines at the Home, 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. Several residents mentioned that they used different lounges during the day and also liked to remain in their rooms at times and that their wishes would be respected 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 and said staff were welcoming. 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. However, there were some comments to the effect that they would like more variety and more fresh vegetables. One resident said that the food at tea – time had got a bit monotonous but this had improved when she raised the issue. 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.V341754.R01.S.doc Version 5.2 Page 14 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. 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. The Home is responsive to any complaints or concerns that are raised and promotes awareness of protection matters with staff so that the interests of residents are safeguarded. EVIDENCE: The Home has an accessible complaints policy and procedure, which is also displayed. It was stated that the Home has not received any formal complaints directly since the last inspection. However two complaints concerning several aspects of care practice at the Home were received at The Commission. The Home’s manager duly followed up one complaint and no significant actions were required. Social Services investigated issues raised in the other complaint and whilst there were no major problems substantiated the Home have agreed to have regular meetings with the local social services manager in order to monitor care standards and deal with any issues that might come up. Discussions with residents and relatives indicated that they were quite comfortable in raising any concerns with staff at the Home or the owners. Ivonbrook Care Home DS0000002061.V341754.R01.S.doc Version 5.2 Page 15 Discussions with the senior staff 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 staff spoken to confirmed that they have attended these courses. The Home has not had any involvement in any safeguarding/protection referrals since the last inspection. Ivonbrook Care Home DS0000002061.V341754.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents enjoy an environment that is generally comfortable and suited their needs. However, there are some areas that continue to require upgrading and review so that their safety can be fully met. EVIDENCE: There have been no changes to the premises since the last inspection, which remains generally well – maintained, with décor and furnishings satisfactory in communal areas. The bedrooms and bathrooms that were viewed were also satisfactorily maintained with equipment and adaptations in place to assist resident’ mobility needs. However, plans to re-carpet some bedrooms and Ivonbrook Care Home DS0000002061.V341754.R01.S.doc Version 5.2 Page 17 corridor areas have yet to be implemented. It was stated that a grant has now been received for this purpose and new carpets will be fitted in the near future. Resident call systems were observed to be working in various parts of the building and no immediately identifiable hazards were observed. However, it was noted that there was not an overall risk and hazard assessment for the Home environment in place. A fire risk assessment for the premises was undertaken last year but has not been reviewed since. The Home was generally clean and hygienic with no offensive odours. However, it was noted that, as at the previous inspection, individual bards of soap were left lying around in bathroom areas, even though liquid soap dispensers were available. The Home’s laundry was viewed. This was satisfactorily organised and equipped though the area remains in need of upgrading around floor surfaces and sink areas. Ivonbrook Care Home DS0000002061.V341754.R01.S.doc Version 5.2 Page 18 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. 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. The Agency has a structured approach to staff recruitment and development, which enhances the support and protection provided to residents. EVIDENCE: Staffing rotas were examined and showed that the Home was maintaining consistent staffing levels and have not used any agency cover. There is good continuity amongst qualified nursing staff though there is a degree of turnover amongst care workers. The Home regularly uses ‘adaptation nurses’ from abroad in the care worker role. The Home has an ethnically diverse staff group and discussions with management indicated that they monitor the situation and have not come across any communication difficulties or discrimination in this context. No related issues were raised on the day of the inspection during discussions with staff, residents and relatives. Several care staff were interviewed on the day of the inspection. Feedback indicated that they felt generally well supported in their work and were Ivonbrook Care Home DS0000002061.V341754.R01.S.doc Version 5.2 Page 19 comfortable in raising any issues with the management at the Home. It was also stated that points can be raised at staff meetings and also anonymously within the staff questionnaire system. Staff confirmed that they receive a relevant and regular range of training opportunities that includes mandatory courses in moving and handling, fire safety and basic food hygiene. Other courses have been initiated relating to specific resident needs such as peg feeding and motor neurone disease. The Home maintains a training schedule for all staff. A small sample of staff files was examined. The files were organised appropriately and contained relevant employment and recruitment information, including evidence of Criminal Record Bureau checks. However, it was noticed on one file that a verbal reference had been obtained rather than a second written reference. Ivonbrook Care Home DS0000002061.V341754.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home is generally well run in the interests of residents so that their welfare and safety is satisfactorily promoted. EVIDENCE: The registered manager for the Home left last month. A new manager has been recruited and is due to start early next month and will then apply for registration. In the interim two of the senior nursing staff have been covering this post. Discussions indicated that they have a great deal of experience at Ivonbrook Care Home DS0000002061.V341754.R01.S.doc Version 5.2 Page 21 the Home and are able to deploy their time effectively so as to cover the main managerial responsibilities. The Home’s owner, David Treasure, is also on hand regularly to provide advice and assistance. The Home has continued to use a questionnaire system with residents, relatives and staff since the last inspection and results from earlier in the year were analysed and summarised by the previous manager for any subsequent actions. Discussions with residents and relatives suggested that staff at the Home were open to and responsive to any points raised and the regular presence of the owners at the Home was seen as beneficial. The Home has a clear policy for the handling of residents’ personal monies, which are kept secure. Individual records of financial transactions are maintained. Relevant Health and Safety information is in place at the Home. For example, COSHH policies and procedures are displayed in the cleaner’s room and the kitchen. It was stated that the Home have recently started working to good practice guidance produced by the Food Standards Agency. The Home’s owner also stated that checks on equipment and utilities at the Home are up to date and in order. Fire Safety records were viewed and were not kept up to date in such areas as recording dates for fire drills, weekly fire alarm tests and emergency lighting checks. Ivonbrook Care Home DS0000002061.V341754.R01.S.doc Version 5.2 Page 22 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 1 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 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 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Ivonbrook Care Home DS0000002061.V341754.R01.S.doc Version 5.2 Page 23 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 all residents needs, preferences and abilities must be completed prior to admission. (Previous timescale of 31/10/06 not fully met) All residents must have an active and fully developed care plan Plans to fit replacement carpets in bedroom and corridor areas must be implemented The floor surface and sink area in the laundry must be upgraded. (Previous timescale of 30/11/06 not met) Up to date fire safety records must be maintained Timescale for action 31/10/07 2 3. 4. OP7 OP19 OP26 15 13 13 31/10/07 30/11/07 31/12/07 5. OP38 17 Schedule 4 15/10/07 Ivonbrook Care Home DS0000002061.V341754.R01.S.doc Version 5.2 Page 24 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. 3. 4. Refer to Standard OP8 OP19 OP26 OP29 Good Practice Recommendations Staff moving and handling skills should be kept under review A general hazard risk assessment of the premises should be undertaken and include a review of last year’s fire risk assessment. Individual bars of soap should not be left out in communal bathroom areas. The Home should ensure that two written references are obtained on staff before they start employment Ivonbrook Care Home DS0000002061.V341754.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V341754.R01.S.doc Version 5.2 Page 26 - 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. 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