Inspection on 10/02/09 for Ivydene

This inspection was carried out on 10th February 2009.

CSCI found this care home to be providing an Excellent 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

Ivydene 12/02/07

Ivydene 21/12/05

Ivydene 11/08/05

Ivydene 29/11/04

Ivydene 27/07/04

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Ivydene 1 Station Road Ormesby St Margaret Great Yarmouth Norfolk NR29 3PU     The quality rating for this care home is:   three star excellent 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: Susan Golphin     Date: 1 0 0 2 2 0 0 9 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. that people have said are important to them: They reflect the things 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 Adults (18-65 years) 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 Adults (18-65 years) Page 2 of 26 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Ivydene 1 Station Road Ormesby St Margaret Great Yarmouth Norfolk NR29 3PU 01493731320 NOFAX# maureenmartin1@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Maureen Martin care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Ivydene is situated in the village of Ormesby St Margaret, close to Great Yarmouth, with a variety of facilities provided locally. It is owned and managed by Mrs Maureen Martin and her immediate family. Ivydene is a two-storey house with an attached bungalow in the grounds and offers accommodation in single rooms to people with enduring mental illness. The garden extends to the side and rear of the house and there is off street parking to the front of the property.The weekly fees range from £325 to £505 and there may be additional on costs depending on individual and assessed needs of prospective residents. Information about the service can be obtained from the manager. 16 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 26 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: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection takes into account all the information received by the Commission since the last inspection carried out on 12 February 2007. The unannounced visit took place over one day, 7 hours in total. The registered provider and manager Mrs Maureen Martin and other key staff were present throughout the inspection. During the course of the day we were able to talk to residents and staff and examine a small sample of records relating to people living and working in the home and the running of the business. The Commission received a high level of response from people commenting on the service including residents, staff, relatives and other health care professionals. All the responses were positive and constructive about the service and how the service is delivered. One resident said the service is excellent and you would be hard pressed to find anything better another resident said no improvements are needed this is a lovely safe place to be. One of the responses from a relative read they listen to residents and value them - it is a lovely place and people are well cared for and Care Homes for Adults (18-65 years) Page 5 of 26 supported. Staff comments included I have gained valuable knowledge and skill working here - and we are encouraged to look for new ways of working and keep ideas fresh - so that residents get the best care. In October 2008 one of the registered providers Mr Barry Martin died suddenly and unexpectedly. As a family run business the past four months have been difficult for the remaining family members and staff. For some residents it has been a particular sad time as they have lived at the home for many years and had a close working relationship and friendship with Mr Martin. Mrs Martin said that the family are coming to terms with the loss and changes have had to be made to the way the service is being managed and operated to take account of Mr Martins death. Despite this traumatic event, it is evident from the discussions on the day and from general observations that the high standards of care have been maintained in a consistent and professional way. What the care home does well: What has improved since the last inspection? 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. Care Homes for Adults (18-65 years) Page 7 of 26 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 26 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. There is clear information about the service which can be accessed by prospective residents. there are good systems in place for assessing the needs of residents. Evidence: The statement of purpose and service users guide are in place and accessible to residents and relatives. The documentation is due for revision as some of the information about the staff and management needs to be updated to take account of recent changes in the management structure. The information available about Ivydene is clear and gives a good account of the service and service provision. Care plans are established from the information received through formal assessment of need and usually in conjunction with health care professionals involved in the placement. From the information submitted the management continue to review the processes in place for assessing the social and emotional and healthcare needs of the residents and to act on any recommendations that promotes the best outcomes for those living in the home. Residents are wholly involved in the care planning process and in decisions about their Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: lifestyle and the support they need. From the care files seen on the day and from the discussions with staff and residents the expectations of the people living in the home are clearly identified and met. Comments received from residents and relatives said that the information they received about the service was clear and made evident that the home could meet their needs. There are good procedures in place for assessing and monitoring the needs of residents and establishing support plans. Care Homes for Adults (18-65 years) Page 11 of 26 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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. Residents are involved in decisions about their lives and play an active role in planning the care and support they need. Evidence: From the information provided and from the discussions with the manager and the staff the residents have a varied and individual lifestyle given their mental health needs and recognised limitations. Good examples of support and care were provided throughout the day, and included residents involvement with the community, establishing and building on personal relationships and educational achievements. Residents said that they make their own decisions about what they would like to do and can rely on the staff for support. Risk assessments are in place and form part of the overall support plan. Reviews are carried out regularly and amended where change may indicate. Staff confirmed that they enable residents to focus on positive activities and interests that promotes both their social and personal lifestyle. Residents care plans reflected client involvement and the opportunity to make personal choices and decisions. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: Care Homes for Adults (18-65 years) Page 13 of 26 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are able to make choices about how they wish to live and are supported and enabled to develop their social and educational needs. The routines of the home are flexible and promote the independence and individuality of people using this service. Evidence: There is clear evidence to show that each resident is enabled to establish and develop the skills and contacts and interests of their choice that are unique to them. Good examples were given of people attending community services, personal appointments unaided, social activities and college courses. Residents support plans also provide details about specific projects to promote independence. Two people live in semi independent accommodation and good examples were given of ongoing support from staff to maintain their own way of life. Another resident spoke of their own growth and achievements whilst living at the home and can now access local facilities by Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: using public transport. All the residents make some contribution to the daily domestic routines in the home. Everyone can use the main kitchen to prepare snack foods and their own lunches as they wish. On the day of the inspection the refrigerator held a wide range of part prepared snacks that residents can easily access. The main meal of the day is usually in the evening but this is a flexible arrangement depending on group or individual activity. Residents spoke very positively about the menu and meal choices and said there are plenty of options to choose from, and they also have access to a hot drinks facility which is located in one of the sitting rooms. Care Homes for Adults (18-65 years) Page 15 of 26 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service provides excellent health care support to residents that is based on their individual and assessed needs. There are robust procedures in place for the management and administration of medication Evidence: From the information received and from the discussions on the day with both residents and staff it was confirmed that residents are well supported by the management and staff. Good examples of individual care were provided. Residents hold keys to their rooms and can rely on staff respecting their privacy and personal space. Records show that residents health care and well being is promoted and they are encouraged to make use of community facilities and health care screening including alternative therapies. There is a clear framework and risk assessment process for those residents who may wish to maintain their own medication. There is a clear and well managed medication system in place to ensure all medicines are issued as prescribed, stored safely and appropriately and reviewed and audited regularly. Staff seen on the day confirmed that they receive training in the management and administration of medication and also in end of life / palliative care to ensure staff can continue to Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: meet the gradually changing needs of older residents. Care Homes for Adults (18-65 years) Page 17 of 26 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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 using this service have access to an effective complaints procedure. Policies in place protect residents from abuse and self harm. Evidence: there are clear procedures in place for dealing with complaints or concerns. Residents seen on the day were very clear about what to do if they had any issues, and said without hesitation that any member of staff or management would happily take up matters on their behalf or deal with concerns they might have.Complaints or issues are logged and recorded and reviewed by the manager every month. Staff spoken to on the day were also confident about raising matters of concern or complaint. All the support staff have completed training on safeguarding adults which is underpinned by a sound adult protection procedure and whistle blowing policy. Care Homes for Adults (18-65 years) Page 18 of 26 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 using this service are provided with a homely and safe environment that offers a comfortable range of living space and facilities. Evidence: A brief tour of the premises was undertaken whilst meeting residents and staff. All areas were very clean and well maintained and the furnishings and fittings homely in style. Residents have a choice of communal rooms and access to the kitchen and laundry as they wish. The daily routines are flexible and fit in with residents activities each day. The kitchen and laundry areas are well laid out and maintained to a high standard. Everyone contributes to the general domestic chores where possible and this is agreed as part of the individual support plan, during the discussions it was said that the designated tasks are flexible and some people are assisted or discreetly supervised to complete them as may be needed. Care Homes for Adults (18-65 years) Page 19 of 26 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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. There are good recruitment and training procedures in place that ensure residents are supported by well trained and supervised staff. Evidence: From the information provided and from the discussions on the day good records relating to recruitment and selection of staff are in place and reflect a robust process for checking identity and criminal record details. All staff have a clear job description and terms and conditions of employment. The staffing structure is aimed at meeting the needs of the residents and delivering the best outcomes for them. Residents spoke highly of the consistent service and support they receive and some gave examples of how the staff have helped them to achieve things in their lives. Other health care professionals also spoke positively about the competent and confident way in which the staff work and the reliability of the service. Residents said that the staff and manager are wonderful and that Ivydene is the best place to live. There is a positive and proactive key worker system in place and staff interviewed were very clear about their roles and responsibilities to the service and the residents. From the information received eight of the staff hold an NVQ level 2 or higher Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: qualification and a further two staff are working towards their NVQ qualification this year, which will mean all the staff have achieved a relevant NVQ level 2 or higher in care. there are good training opportunities available to staff and training needs are reviewed every three months to ensure relevance and appropriateness to client group and changing needs. Staff members seen on the day confirmed that supervision sessions take place on a regular basis and that everyone is well supported by the management and also by their peer group. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home is well managed with clear direction and leadership. There are good policies and procedures in place to protect and promotes the health and safety of residents and staff. Evidence: Ivydene is family owned and the service is well managed and maintained by an appropriately qualified and very experienced manager and registered provider. Residents are afforded the benefits and consistent support of a well run and managed home. The views of the residents staff and other health care professionals are sought on a regular basis and the outcomes influence changes and movement within the service that strives to achieve the best standards and promote the quality of peoples lives. A number of the residents have lived in the home for ten years or more and are reassured by the stability and security the home provides for them. From the discussions with staff and residents it is clear that there is an open and inclusive Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: atmosphere within the home that residents are comfortable with and can respond to. There are good procedures in place that promote the health and safety and well being of both residents and staff. It was agreed during the discussions that the policies and procedures need to be reviewed and updated to take account of the changes in ownership and managerial responsibilities since October 2008. Care Homes for Adults (18-65 years) Page 23 of 26 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 Adults (18-65 years) Page 24 of 26 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 1 1 It is recommended that the registered provider updates all the documentation relating to the service to take account of the changes in the ownership and management of the home. It is recommended that the review and update of the policies and procedures is completed as soon as possible. 2 42 Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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. 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