Inspection on 26/09/08 for Ivy House Nursing Home

This inspection was carried out on 26th September 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Ivy House Nursing Home 08/01/08

Ivy House Nursing Home 30/10/06

Ivy House Nursing Home 14/03/06

Ivy House Nursing Home 14/12/05

Ivy House Nursing Home 20/01/05

Ivy House Nursing Home 25/05/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ivy House Nursing Home Hollin Wood Close Moorhead Lane Shipley West Yorkshire BD18 4LG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Liz Cuddington     Date: 2 6 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Ivy House Nursing Home Hollin Wood Close Moorhead Lane Shipley West Yorkshire BD18 4LG 01274591476 01274591477 patrickberry@fsmail.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Patrick Berry Type of registration: Number of places registered: Holberry Care Ltd care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: See below 1. Service users remaining in the home that fall under the category of older people will be named individually in separate covering letters of registration. As these service users die or move from the home they will be removed from the registration certificate and a new certificate will be issued. This process to continue until none of these service users remain in the home. It has been agreed that no charges will be made when new cerificates are issued as part of this process. Date of last inspection Brief description of the care home Ivy House is a detached Victorian property, which has been converted and extended to provide the care home it is today. The home is registered to provide care, with Care Homes for Older People Page 4 of 28 Over 65 40 10 15 0 0 0 Brief description of the care home nursing, for up to forty residents of both genders. The accommodation provides thirtytwo single bedrooms and four double rooms. There are a number of communal areas, including lounges, dining area and bathrooms. The home is in a quiet residential area close to the village of Saltaire. The gardens and patio areas are well maintained and are accessible to residents. The main entrance has a ramp and there is ample car parking to the side and front of the home. There are additional charges for chiropody and hairdressing. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated it is likely that enforcement action will be taken. The purpose of this inspection was to assess the quality of the care and support received by the people who live at Ivy House. The visit to the home was carried out Care Homes for Older People Page 6 of 28 over one day by one inspector. The last key inspection was in January 2008. The methods used to gather information included conversations with the people living at the home, their relatives and the staff, as well as looking at care plans and examining other records. We received the homes self-assessment questionnaire before the inspection visit. This gave us a lot of useful information about the home and helped us plan the visit. The fees charged are variable and depend upon the level of the individuals care and support needs. We would like to thank the people who live at the home, their relatives and the staff, for their welcome and hospitality and for taking the time to talk and share their views during the visit. What the care home does well: What has improved since the last inspection? All the requirements we made at the last key inspection have been met. The staff who administer medication now make sure that the systems they follow are completely safe. Staff are kept up to date with peoples changing needs. Wherever possible, the people who live at Ivy House and their relatives are involved in developing and reviewing their care plans. The written documentation reflects an improved staff attitude towards maintaining peoples dignity. Care Homes for Older People Page 8 of 28 More than half of the care staff have now achieved a National Vocational Qualification and other staff are in the process of completing the award. The staff recruitment procedures have been reviewed, to make sure they are as thorough as possible. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed before they are admitted to the home, to make sure their needs can be met. Evidence: The care plans included pre-admission assessments completed by the home. Before moving into Ivy House, peoples needs are assessed to make sure that the home is able to meet their needs. This assessment forms the basis for the individual plan of care and support. People said that they were given enough information about the home before deciding to move in, and they had also received a contract. Where possible the home encourages people and their families to visit the home and talk to the people who already live at the home, their relatives and the staff. The home Care Homes for Older People Page 11 of 28 Evidence: invites them to come and spend time at the home, share a meal and maybe take part in the days activities. This means that the home can get to know the persons needs and the individual has the information he or she needs to make a decision. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and healthcare needs are met. People are protected by the medication administration systems. Staff treat people with respect, care and consideration at all times. Evidence: People receive the medical and healthcare support they need and any concerns about peoples health are followed up. Everyone we spoke to said the care and support provided at Ivy House is of a good standard. Peoples relatives said they are very satisfied with the care offered. They felt that the staff know what they are doing and understand peoples needs. Our observations confirmed that the staff understand peoples care needs. For example, when helping someone to transfer from a chair to a wheelchair the staff Care Homes for Older People Page 13 of 28 Evidence: knew exactly how the person liked to be assisted. If someone slips to the floor, the home have a lifting cushion to help them rise up. This is less stressful and less invasive than using a traditional hoist. We did see one incident of someone being supported when walking, in a way that is not safe and footplates on the wheelchairs were not always being used. The manager said this would be rectified straight away. Three care plans were looked at, to make sure that peoples health and personal care needs are being met in the way each person prefers. The plans cover each area of the individuals care needs. They all contain enough information to guide staff in how to care for and support each person. The care plans are straightforward, well organised and easy to follow and each area of a persons needs is detailed. Because the system is computerised the plans can easily be updated when someones needs change. The people themselves, and their relatives if they wish, are involved in reviewing and updating the care plans. The plans are all reviewed monthly by the staff, to make sure they still reflect the individuals care and support needs. People said that staff are very good and understand their needs. They said staff do what people want, in the way people prefer. People said they are happy with the care they receive. When someone is cared for in their room, a contact sheet is now completed each time a member of staff goes in. This shows when staff visited and details any care and support that was given. During our visit, one family told us that the staff did a fabulous job looking after their relative. The daily records are kept up to date and include information on significant occurrences. There are systems for highlighting information that needs to be passed onto the next group of staff. Detailed medical records are kept showing, for example, when the GP visited and the outcome, as well as any further healthcare suppport that is needed. The medicines are kept safe and secure and the Medicines Administration Record (MAR) charts are securely stored. For security, the medicine cabinet was locked during Care Homes for Older People Page 14 of 28 Evidence: the time between giving each person their medication. Most of the medicines are supplied by the pharmacy in a monitored dosage system, but some is kept in the original packaging. The MAR charts, which must show clearly the quantities of medicines received and in stock for each person, were examined. The medicines supplied in the monitored dosage system appeared to be administered and recorded accurately. There were signatures to confirm that staff had administered the medicine. The records of amounts received, administered and in stock of some medicines that were supplied in their original packaging were accurate. However, a brought forward system would make it easier to check all quantities of medicines, to confirm that administration is always accurate. During the visit, all the staff were seen to treat people with respect and maintain their dignity. The people who commented said that they receive the care they need and are supported to maintain their independence for as long as they are able. Peoples relatives confirmed this. Everyone said the staff listen and act on what they say. Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to take part in a range of activities. People are offered a good choice of meals to make sure their dietary needs and preferences are met. Evidence: The staff provide a range of activities for people to take part in, if they wish. At present the activities include singing, dancing and music, playing dominoes, bingo, ball and other games and pampering sessions. An external activities organiser comes into the home to take music and dancing sessions. People said they had been on many outings to places of interest such as Bolton Abbey and Ilkley, as well as shopping trips, visits to the cinema and to museums. One person told us about the places he had been to and his plans for future outings. One persons relatives told us about the special celebrations for the persons 90th birthday and said how much they had all enjoyed it. Peoples care plans include life histories, which help staff to know people better and Care Homes for Older People Page 16 of 28 Evidence: plan activities they will enjoy. People said they like the meals. The home offers a choice of two main courses and two desserts at lunchtime, as well as a choice at other mealtimes. The cook is very knowledgeable about peoples particular likes and dislikes and makes every effort to give people the foods they will enjoy. People who eat a soft diet are offered their meals in an appetising way and staff were seen to assist people who needed help, in a calm and discreet manner, following the persons own pace. The cook explained how the menus are planned, to include the wishes of the people who live at the home and to meet any special dietary needs. There are always alternatives available if people do not want the choices on the menu. A record is kept of exactly what foods are served each day, as this can vary from the planned menu. People are offered hot and cold drinks throughout the day. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are aware of how to raise a concern or make a complaint if they are dissatisfied with the service. Most staff have received suitable training and understand the adult protection policies and procedures, which makes sure that people at the home are safe. Evidence: Any complaints or concerns are recorded in a complaints file. The actions taken and the outcomes are recorded. Staff said they know what to do if anyone has concerns. The relatives said the home responds appropriately to any concerns. People said they know what to do if they have a concern or complaint. One relative said they had recently made a complaint about the laundry and were waiting for a response from the manager. Newly employed staff are made aware of the homes whistle blowing policies and procedures, to be used if they suspect abuse or see examples of poor practice. Most of the care staff have had adult protection training, and further refresher training is planned. All the appropriate policies and procedures are in place to guide staff. Care Homes for Older People Page 18 of 28 Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a safe, comfortable, attractive and generally well-maintained environment. Evidence: The home is clean and generally well maintained and everyone we spoke to said the home is always kept fresh and clean. The bedrooms are gradually having new carpets fitted and the hallways and lounges have recently been re-painted. A new shower has recently been fitted in one bedroom. The rooms are comfortably furnished and have a welcoming feel. There are sufficient, accessible toilets and bathrooms on both floors of the house. Staff are employed to help look after the maintenance of the house and grounds as well as keeping the gardens tidy. The gardens are attractive and there is seating for people to use in the better weather. New dining room furniture and side tables had recently been provided, as part of the homes ongoing refurbishment programme. One of the ground floor rooms is mainly used as a hairdressing room. It was in a poor Care Homes for Older People Page 20 of 28 Evidence: state of decor and was full of items not connected with hairdressing. The laundry assistant said this room is also used for ironing. We were told that before any ironing or hairdressing could take place, the room had to be emptied of clutter. This seemed to be put in the hallway and returned after the hairdressing or ironing was completed. It was a very unattractive room for people to go to have their hair done. The manager said this room would be improved. Protective gloves and aprons are available for staff to use when necessary. The home uses red bags for soiled linen, as part of their infection control measures. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient staff are employed to meet peoples needs. People are protected by thorough recruitment procedures, which ensure that staff are suitable to work with people who live at the home. Suitable training is provided to make sure staff have the skills and knowledge they require to be able to meet peoples needs. Evidence: The staff rotas, and peoples comments, confirmed our observations that there are enough staff on duty to meet peoples care, social and leisure needs. There are six care staff and two nurses on duty during the day, five care staff and one nurse during the evening and four waking staff during the night, including one nurse. The staff confirmed that staffing levels are adjusted to meet peoples needs. People said there are always plenty of staff around and our observations confirmed this. Because of their high levels of dependency, some people were receiving one to one attention from the staff. All new staff complete an application form and provide two written references. Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) register checks are Care Homes for Older People Page 22 of 28 Evidence: obtained and no new staff begin work until these checks have been completed satisfactorily. The members of staff we spoke to confirmed that the procedures are thorough. There is plenty of training available for staff. All the staff we spoke to said the training is good and keeps them up to date. The home keeps good records of staff training, which also shows when updates are needed. All new care staff complete induction training which meets the Skills for Care criteria. This gives them good basic training to help them do their job effectively, and provides a sound basis for taking a National Vocational Qualification (NVQ) course. In addition staff attend training courses covering all areas of the general principles of care. The nursing staff have had training updates including advanced wound care, pressure area care and palliative care. The housekeeping and catering staff are also enrolled on NVQ level 2 courses relevant to their roles. Eleven care staff have achieved an NVQ in care. Four staff are enrolled on the level 2 course and three are taking the level 3 award. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is safe and well managed, in the best interests of the people who live there. Evidence: The manager has the necessary experience and qualifications to manage the home, in the best interests of the people who live there. The manager attends training to keep up his professional development. The records and the staff confirmed that all staff have regular one to one supervision meetings with their line manager. This supports staff to plan their personal and professional development and gives them the opportunity to discuss any areas of concern in a confidential setting. Peoples personal information is stored in locked cabinets or on a secure computer system when it is not being used. Where the home helps people to manage their personal finances, accurate records are kept of all transactions and all monies are Care Homes for Older People Page 24 of 28 Evidence: securely stored. The homes policies and procedures are kept up to date; to make sure they provide relevant information to guide staff on how to act in every situation. All the regular health and safety checks for the home are carried out in a timely manner. These measures make sure that the health, safety and welfare of the people at the home is promoted and safeguarded. The laundry is well organised and peoples personal clothing, as well as their bedding and towels, are properly cared for. The home has a range of quality assurance systems in place, to help determine the quality of service the home offers. These include surveys for the people who live at the home and their relatives, meetings for people and their relatives, staff meetings and regular audit checks. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!