Inspection on 11/11/08 for Ivydene Care Home

This inspection was carried out on 11th November 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

Ivydene Care Home 14/12/06

Ivydene Care Home 30/11/05

Ivydene Care Home 31/08/05

Ivydene Care Home 02/02/05

Ivydene Care Home 27/07/04

Ivydene Care Home 17/03/04

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: Ivydene Care Home Ivydene Close Earl Shilton Leicester LE9 7NR     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: Rajshree Mistry     Date: 1 1 1 1 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 38 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 38 Information about the care home Name of care home: Address: Ivydene Care Home Ivydene Close Earl Shilton Leicester LE9 7NR 01455843001 01455843001 chrisquarmby@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Susan Victoria Beardmore Type of registration: Number of places registered: Ivydene Care Home Ltd care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: NO ADDITIONAL CONDITIONS OF REGISTRATION APPLY Date of last inspection Brief description of the care home Ivydene Care Home is registered to provide care for twenty-three older people with dementia and/or mental disorder. The home is situated in a quiet and secluded cul-desac, close to the centre of Earl Shilton, Leicestershire. The home is close to local shops and amenities. There is car parking spaces at the front of the home. There are eleven single bedrooms and six shared bedrooms, on the ground and first floor. The first floor is accessible via the stairs or the passenger lift located at the centre of the home. All the bedrooms are close to the bathrooms and toilets. People have a choice of two lounges and a dining room. There is a large garden to the side and rear of the home, which has mature shrubs and trees. The registered manager provided us with the range of fees: from £334.00 to £455.00 per week. There are additional charges made Care Homes for Older People Page 4 of 38 Over 65 23 23 0 0 Brief description of the care home for hairdressing, private chiropodist, personal toiletries and newspapers. People considering using Ivydene Care Home are encouraged to contact the home directly. The full details of the home and any specific requirments can be obtained from the home in the form of the Statement of Purpose and the Service User Guide. The latest inspection report from the Commission for Social Care Inspection is available at the home. Care Homes for Older People Page 5 of 38 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 star. This means the people who use this service experience good quality outcomes. We as it appears throughout this Inspection Report refers to The Commission for Social Care Inspection. This key inspection consisted of preparation by reviewing the last inspection report dated 14th December 2006 and the review of the annual service review dated 3rd March 2008. We looked at the information we about the management of Ivydene Care Home and the events that affected the wellbeing of the people living at the home. The registered manager sent to us the completed annual quality assurance assessment Care Homes for Older People Page 6 of 38 document, which reflected the homes own assessment of the standards within the home. We sent out twenty-three surveys to the people living Ivydene Care Home, of which forty percent were returned, completed by their relatives. All the responses and the comments received indicated people were satisfied with the standard and the quality of the care, the staff and the meals provided. We sent out twenty surveys to staff, of which twenty percent were returned. The responses and comments received indicated there is a stable staff team, that work as a team, have good communication. There are good management systems and staff have access to regular training, updates and supervision. We received some comments in relation to how the home could be improved, which were shared with the registered manager during the site visit. All the comments received in the surveys and during our site visit have been included in the relevant sections of this inspection report. We visited Ivydene Care Home on 11th November 2008, starting at 09:30hrs and finishing at 17:00hrs. The registered manager assisted us during the site visit. The main method of inspecting we used was case tracking. This means looking at the range of care people receive that ensures their needs are met whilst their rights, independence and choices are respected and promoted. This was done by selecting four people who have difference care needs ranging from being independent with some assistance to being diagnosed with dementia and having a physical disability. We also case tracked one of the newest people living at the home. We read the care files containing information about peoples care needs,, lifestyles and how these were respected. We made observations of people, how they were treated and interacted with the staff. We spoke with the visiting relatives to gather their views about the quality of the care they had observed and experienced for their relative living at the home. We looked at the accommodation from the communal areas, bathrooms, individual bedrooms and looked at the environmental improvements made. We read the information people receive about Ivydene Care Home. The policies and procedures and specific records viewed that demonstrated the day-to-day management of the home. The Commission for Social Care Inspection had a focus on Equality and Diversity and issues relating to these are included throughout the main body of this inspection report. What the care home does well: Ivydene Care Home is a well established care home registered to care for people with dementia and mental health diagnosis. There is a welcoming and homely atmosphere in the home. The lounges are set out so that people are encouraged to converse and interact. People are involved in the planning of their care, with the support of their relatives and information gathered from the health and social care professionals. People have their health care needs met through the local health care professionals. The care people receive is personalised to support peoples individual routines and preferences to promote their wellbeing. The home has good working relationships with the health and social care professionals, which benefits and improves the quality of life people have at the home. People are supported to attend regular health check appointments. People are encouraged to have visitors at any time and continue to follow their social and leisure interests. The home ensures people are supported to continue to observe and practice their religion and spirituality. There is a stable staff team, recruited and trained to competently meet the needs of the people living at the home. Staff work with individual people known as key working and take time to know the person and their lifestyle. Staff have information and training to work with people that have some level of dementia or mental health diagnosis. This has improved the care people receive as staff have a better understanding of peoples experiences. The comments we received during the site visit and in the surveys included: The staff are very caring and supportive to my mother All the residents at Ivydene have mental related illness i.e. dementia and need a high level of care. I feel the staff show enormous levels of patience and understanding. They show affection to the residents and make them feel safe and secure My mother is taken care of by a wonderful group of carers who pull together Gives a really pleasant and homely feeling to patients and relatives and are really helpful if we need to ask any questions. Manageress is always willing to talk with you if we have a problem about anything. She is very understanding and caring person. Ivydene is full of love and laughter. All the carers (we have met) are supportive of the relatives as well as the residents. They are more like our friends we look forward to seeing them when we go. They always cheer mum up if she is down and I believe mum is happy there. She always looks clean and tidy and can move freely about the place if she wishes to I feel the care and wellbeing of the residents are the main priority and they get first Care Homes for Older People Page 8 of 38 class care always and each individual is treated as an individual with their needs and likes and dislikes of food. I have 100 faith in them, which as I go in everyday, I know how genuine the care is. The annual quality assurance assessment completed by the registered manager and the responsible individual (owner) which we received before the site visit was comprehensive. This demonstrated that the home recognises the quality of the service it provides in relation to the standards and regulations. The home also identified areas that they need to improve in to ensure they improve the quality of life people experience during their stay at Ivydene Care Home. What has improved since the last inspection? What they could do better: This was a positive inspection of Ivydene Care Home. There was good evidence of the improvements made in response to the last inspection report and to support the information we received from the home before the site visit. Care Homes for Older People Page 9 of 38 We shared the comments received in the relatives and staff surveys with the registered manager. They have given us the assurance that improvements would be made to ensure people have their own laundry returned and will continue to improve the decor in the home. The home should ensure we receive a copy of the updated statement of purpose, the service user guide and the findings from the quality assurance survey conducted. 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 10 of 38 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 11 of 38 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 receive good information about the service, are involved in the assessment process to make sure their needs are met. Evidence: Ivydene Care Home provides information to people when they are looking for a care home, known as the service user guide, which contains the statement of purpose. The information is set out clearly and in an easy read style detailing the aims and objectives of the service, range of facilities, the skills mix of staff to meet the complex and challenging needs of people with dementia or mental health related illness and the management of the home. People are informed of the complaints procedures and the opportunities people have to comments and influence the quality of the service provided. The contact details for the Commission for Social Care Inspection and the local social services are included. Care Homes for Older People Page 12 of 38 Evidence: The information we received from the registered manager before the site visit identified areas for development and improvement. We discussed this in relation to the information provided to people: service user guide and the statement of purpose and resulting is further work being undertaken to ensure the information is beneficial to prospective residents, relatives and professionals. We spoke to two people we were case tracking and two relatives that were visiting the home. Whilst one said they were involved and agreed to move to the home, the other person said my son and the social worker arranged for me to come here. Relatives told us they had heard about Ivydene Care Home, had visited the home and were able to ask the manager questions. We received comprehensive information from the registered manager and the responsible individual before the site visit, which stated always seen in person normally by the manager, always encouraged to visit the home as often as they like before a placement begins, the home offers trial visits such as for a meal or for an afternoon visit and introduced a website to allow prospective residents and both close and more distant relatives to obtain more information about the home at their convenience on line. The comments we received directly from the relatives and the responses received from the relatives surveys, supported the information we had. The comments included: Id heard about Ivydene and their reputation, they have met my expectations, they are very good, kind and sensitive I didnt need to look around, Sue answered all my questions Its local to me and I come to visit my wife everyday My mother has been in Ivydene for 8 months now and settled down very well, she is happy When my mother moved into Ivydene in ....., she was like a caged animal. She was distressed and prone to shouting and assaulting other residents. She has also has a spell of not eating. Throughout all this she has received top quality care and understanding. She is now calmer and settled. I believe it is due to the care she receives. The difference in a year is amazing We read the care files for the four people we case tracked, all having individual care needs and included a new person living at the home. The care files had copies of the Care Homes for Older People Page 13 of 38 Evidence: assessments of needs carried out by the registered manager, which had information about the individual ranging from their personal details, family, general practitioner to their mental health, medical history, physical and sensory impairment, preferences and dietary needs, routines, medication medical history and any known complex or challenging needs due to their illness. There was information gathered from family members, hospital and health care professionals such as general practitioners and psychiatrists. There are number of internal documents used to ensure all the relevant information is gathered. This demonstrated the assessments of needs is thorough and the checklists ensures the maximum information is gathered before the person moves in. Ivydene Care Home accommodates people that are privately funded and are financially supported by social services. Where people are financially supported by the social services, a copy of the assessment of care needs completed by the social worker was found on file and an individual placement agreement. Everyone living at the home are provided with a contract, with the terms and conditions of stay. We spoke with the senior carers and carers on duty. Two senior carers told us they have been out with the registered manager to assess people, as part of their development. They told us that in the absence of the manager carried out assessments along with the responsible individual, as records showed for one person we case tracked. This showed the staff are encouraged to develop their skills and knowledge. Staff told us they have benefited from attending training and learning about dementia and mental health, which has given them a better insight into peoples experiences. Staff said they receive information about the new person, their care needs, routines that are already known, to help them provide the care and support needed. We were told that carers would key work with a new person from the point of them moving into the home, to get to know them and help in gathering information to ensure the care they receive can be personalised. The registered manager told us emergency admissions are only considered providing she has information about the person and has an opportunity to meet and assess their need before a decision is made. This showed that Ivydene Care Home follows the admission procedures to ensure the home is able to meet the persons needs and the support is put in place. This demonstrated consideration is made to ensure the placement is appropriate and the new person will compliment the people already living in the home. Ivydene Care Home does not provide intermediate care services. Care Homes for Older People Page 14 of 38 Care Homes for Older People Page 15 of 38 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. People are treated with respect, having their individual health and personal care needs met by trained staff that promote wellbeing and independence. Evidence: We received survey responses from relatives of the people living at the home. The responses indicated people were happy with the standard of care provided to their relatives by staff that possess the right skills and experience, providing health and personal care including medication and were kept informed of their wellbeing. The comments we received included: All the residents at Ivydene have mental related illnesses i.e. dementia and need a high level of care. I feel the staff show enormous levels of patience and understanding, They show affection to the residents and make them feel safe and secure When my mother moved into Ivydene in ....., she was like a caged animal. She was distressed and prone to shouting and assaulting other residents. She has also has a Care Homes for Older People Page 16 of 38 Evidence: spell of not eating. Throughout all this she has received top quality care and understanding. She is now calmer and settled. I believe it is due to the care she receives. The difference in a year us amazing My mother has been in Ivydene for 8 months now and settled down very well, she is happy They always take great care of her, I am please with the care We spoke with two people that we case tracked about the level of support they receive. They told us that whilst they are helped by staff, they are always encouraged to do as much for themselves as possible. This showed that staff were encouraging people to maintain some level of independence. The type of support that they described to us was consistent with the care plans that we read. The care plans were individual, holistic and focused in the individual knowing their preferences, likes and routines. The care plans reflected the safety measures identified from the assessments of risks, such as falls, nutrition, behaviours, use of hip protectors and continence management. There were clear guidance and instructions for staff to follow, which respected the individual persons rights regardless of the level of dementia. There was evidence of care plans being reviewed monthly or more frequently if peoples care needs changed. This showed that people were treated as individuals and the care was reflective of peoples current needs. The staff we spoke with demonstrated a good understanding the level of support individual people required. There is a system of key working, where a member of staff is a key worker to a person living at the home. The key worker we spoke with described her responsibilities to make sure the persons care needs and lifestyle needs were met and their bedroom was tidy. We read the care file for a person we case tracked with the key worker. The key worker described the purpose of the information in the care files, reasons for care needs being reviewed and how new information was gathered about the person. The senior carers told us the carers inform them of changes in peoples care needs.When necessary risk assessments are completed and the safety measures are reflected in the new care plan. This demonstrated staff were aware of their responsibilities, showed the care was holistic and meaningful to ensure peoples needs were met. We observed good moving and handling practices, staff encouraging and guiding individuals to ensure they were steady and safe. Staff addressed people by their preferred names, as stated in the care files and spoke in a gentle and encouraging tone of voice, which people responded to. One person who liked to walk, came and Care Homes for Older People Page 17 of 38 Evidence: held our hand, smiling. Staff told us that they were saying hello by smiling and gently holding our hand, which is a form of communication that person uses. Staff training records showed staff had attended training to raise their awareness of dementia and mental health diagnosis. Staff demonstrated the learning and knowledge they had gained from attending the dementia awareness courses, had been put into practice to improve the quality of life people had. We saw another member of staff calm a person by speaking them and gently stroked a persons face. This showed staff knew the people living at the home and how best to respond to help the person be relaxed and settled. We observed staff responding to people when they wanted to go to the toilet, closing the toilet door, which was left ajar, to ensure their privacy and dignity was respected, staff were seen supporting people by walking with them and talking with them; drawing the curtains to stop the sun shining on people and comforting people when the two minutes silence was observed for remembrance day. These were examples we saw of how staff respected people. We looked at the staff training records. The records showed staff are kept up to date with current best practice and have specialist training specific for their roles and to meet the needs of the people living at the home. Training completed by staff included moving and handling, safe administration of medication, health and safety to specialist training, such as risk assessing, dementia awareness and food and nutrition course for the cook. Several staff said they are keen to learn about palliative care, recognising the value of end of life care, having worked with the district nurses and the specialist nurses. The senior carers we spoke with said whilst more people are registered with the local General Practitioner (GP) surgery, some choose to remain with their own GP. One person said they preferred to stay with their own GP as the surgery was local to the home. The care files we read showed people had visits from health professionals such as the general practitioners, district nurses, chiropodist, dentist, optician and the consultant psychiatrist. This supported the comments received directly from the visiting relatives and the surveys received, which included: If shes needed to see a doctor, its organised, she looks clean and seems happy This year alone my mother has needed a trip to the dentist, a chest x-ray and a visit to a foot specialist. The home has organised these things and accompanied me when necessary. I am always kept up to date with health matters. Care Homes for Older People Page 18 of 38 Care Homes for Older People Page 19 of 38 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 encouraged to take part in activities, interests, contact with family and offered nutritious meals that promote their wellbeing. Evidence: During the site visit we saw people were sitting in one of the two lounges and the dining room, watching the remembrance service on the television. The seating is arranged in small clusters in the large lounge at the front of the home, which encourages people to converse and creates a homely, family atmosphere. In the lounge/dinner to the rear of the home, people were watching television, whilst others preferred to move from one lounge to the other. We saw a person sitting in the small seating area with the reading books near the lounge and dining room, listening to the radio. Staff said they preferred to listen to the radio. We spoke with one person sitting in the lounge, reading the newspaper, who said they enjoy reading the daily newspaper, if they are not knitting or watching the television and said I do enjoy knitting but I dont like to keep asking for a pair of scissors to cut the wool. They also told us about their relatives that were in the war pointing to the newspaper articles. At 11am, people living at the home, visitors and staff all observed Care Homes for Older People Page 20 of 38 Evidence: the two minutes silence in memory of those people that lost their lives in the wars. Several people were emotional and we saw staff comforting people by holding their hands, sitting and listening to them speak. One person told us that their son and family visits them regularly. Throughout the day we saw people were receiving visitors. The visitors told us that they visit daily at different times and have always found their relative happy and well. They told us that staff are polite, helpful and caring. We saw the weekly programme of activities on the notice board and photographs from the Easter Bonnet and the carnival parade. We saw a member of staff playing dominoes with one person, whilst two other people preferred to watch the game. Staff we spoke with said they try to find out what interests people had or still have from talking with people and their relatives. Staff gave examples of how talking about an activity or subject of interest helps when a person becomes agitated or upset. Staff described how they encourage people to make choices and benefit from the information gained from family about the persons interests. We read the care plans, which showed peoples interests such as sports and practicing their faith. This was consistent and reflective of the information we had received from the registered manager before the site visit stating the home continues to promote group activities such as ball games, jumbo bingo, outside entertainers to special events throughout the year to include easter and Christmas parties, carnival parade, cream teas and fish and chips nights. The relatives survey responses and comments received included: Ivydene is full of love and laughter. All the carers (we have met) are supportive of the relatives as well as the residents. They are more like our friends, we look forward to seeing them when we go. They always cheer mum up if she is down and I believe mum is happy there. She always looks clean and tidy and can move freely about the place if she wishes to As a Christian family, we appreciate the times when my mother and other Christian residents are read to from the Bible regularly. Also for the little service on a Sunday when we havent been able to bring mum out to the Church with us. Feeling independent is a great help to the elderly - they should be encouraged to help themselves if possible With my husbands condition, he hasnt got the ability to always choose what he wants to do, but Im pleased to say he nearly always seems happy and content with the way his life is handled and the time spent with him. Care Homes for Older People Page 21 of 38 Evidence: The information we received from the registered manager before the site visit stated the home has adopted the safer food better business procedures in the kitchen, following the discussion with the Environmental Health Officer. In addition, the cook is trained in food and hygiene and is on an 16-week distance course on food and nutrition. The cook finds out what dietary needs people have when they first move to the home to make sure these are catered for. The registered manager and the cook have developed nutritional needs assessments to support the care plans to ensure people have a healthy and nutritious diet. The cook said they prepare a choice of menus from knowing peoples preferences and meet dietary needs such as vegetarian meals and diabetic meals. The meals are served individually at the laid dining table. Staff said that whilst most people do sit down for lunch together, if someone prefers to have their meal later, it is kept warm for them. Staff we seen helping to preserve peoples dignity, handing a tissue to wipe the side of their mouth. People said they enjoyed the meal, pointing to the clean plate. This showed people enjoyed the choice of meals provided. We read the daily diaries completed by the staff. The contents were reflective of the wellbeing of the person, from meeting health and personal care needs to recording what activity they did, visitors and general wellbeing. The comments we received from staff showed people were valued, respected and tried to ensure their enjoy life in the home: We treat them as individual people they are all difference and lovely people You know and understand why they do certain things or cant remember what they said You learn to be patient The residents benefit from having familiarity, stable staff team even if they cant remember and it helps their relatives who also need to be supported. Care Homes for Older People Page 22 of 38 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 confident to complain and protected by staff recruitment processes and training to ensure people are safe from harm and abuse. Evidence: We read the complaints procedure, which is included in the information people receive about Ivydene Care Home. The complaints procedure is also displayed at the entrance to the home, for ease of access for the people living at the home; visiting relatives and health care professionals. The complaints procedure clearly sets out the process of how to complain and has the contact details for the Commission for Social Care Inspection. The information we received from the registered manager before the site visit stated they received one complaints about the service, which was resolved within the set timescale. We read the complaints log that showed the nature of complaint, the investigation and resolved. The Commission for Social Care Inspection has not received any complaints or expressions of concern about Ivydene Care Home. We spoke with some people living at the home who said they were confident to tell the staff or the manager if there was a problem. Visiting relatives said they were confident to raise concerns with members of staff or the manager. The information we received from the registered manager before the site visit stated the home welcomes Care Homes for Older People Page 23 of 38 Evidence: comments and concerns both positive and negative from staff, residents, relatives and visiting professionals. The comments we received directly from people living at the home, visiting relatives were consistent with the responses in the surveys from relatives, which included: I have no problems. I see the manageress and talk about it - no complaints up to now If something is a miss, it is taken care of as soon as possible Id complain to the manager, I wouldnt stand for it Staff demonstrated how the knowledges gained from attending dementia awareness courses and key working, had changed their practice. Staff gave examples of how some people living at the home that have a level of dementia or mental health communicate, using touch and facial expressions. This demonstrated staff recognised the different communication methods, putting their learning into practice, which ensured peoples concerns were addressed promptly. Ivydene Care Home has received a number of compliments in the form of letters of thanks and cards. We read some of the letters and cards received, all thanking the manager and the staff for the care their relatives received. There was a commendation from a social services review officer, which demonstrated recognition of the standard of care provided at Ivydene Care Home. Two people we case tracked, of which one was a new person, said they felt safe and comfortable with the staff around them. A visiting relative said they had always observed staff to be gentle and kind to people, including me and Im a visitor. From our own observations throughout the day, we saw staff were responsive, sensitive to peoples needs and showed respect when talking to them. The care plans we read identified peoples vulnerability such as falls, nutrition and self neglect and the guidance for staff to ensure they are safe and the risks are minimised or removed. The care plans are reviewed monthly and updated when changes occur, which shows people are protected with regular monitoring. Staff we spoke with demonstrated a good understanding of safeguarding issues, which means promoting the wellbeing of people using the service from harm, risk and abuse. Staff were aware of the types of abuse that could occur. The staff gave examples of how people with dementia or mental health diagnosis would be adversely affected, such as neglect, kept untidy, laughing at residents directly, talking down to people, to the physical and emotional abuse. Staff told us they are informed of specific Care Homes for Older People Page 24 of 38 Evidence: challenging and complex needs of people and ways to support them, with guidance from the consultant psychiatrist. This showed measures were identified to prevent people from being at risk from themselves and others. Staff said they were confident to report poor, bad or inappropriate conduct of colleagues to the manager. This showed staff were confident to whistle-blow, using the procedures that are in place. Staff said they had received information through the induction and as part of their national vocational qualification, training in the issues of protection and abuse. The staff training records showed some had received information and training in abuse and safeguarding procedures. The registered manager confirmed she had recently attended the safeguarding, alerters and referrers training and the updates would be shared with the staff team. This supported the information we received from the registered manager before the site visit and the comment all staff undertaking NVQ level 2 and level 3 in care are fully aware of the particular issues with regard to abuse and protection for service users with advanced dementia or mental health diagnosis. The staff we spoke with confirmed they started work after checks were carried out. The four staff files we looked at contained evidence of the pre-employment checks such as two satisfactory references, criminal records bureau checks and the newest staff having the protection of vulnerable adults checks carried out. This demonstrated staff recruitment procedures are followed to ensure people are safe. The registered manager described the system in place to manage peoples money that is held in safekeeping. The individual financial records are kept in the care files. We saw records were double signed, clear and auditable. The registered manager and senior carers have delegated responsibility to ensure peoples money is held securely. Care Homes for Older People Page 25 of 38 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. People live in a homely, clean and tidy that promotes their wellbeing. Evidence: We received surveys responses from the relatives of people living at the home and staff surveys. Whilst people were happy with the standard of care and staffing there were a number of comments relating to improvements to be made to the home environment and laundry arrangements. These included: The home is looking a little tired, could do with brightening up in lounges and bedrooms Patients should be sure of getting their own clothing, after all they all have their names in them and at present they seem to have the wrong ones on The home needs some repairs to the entrance, conservatory to stop it raining in and the odd bit of re-decorating. But regards to staff, I dont think it can be improved The one thing could be better is the decor, carpets and furnishing in particular my ... room. Care Homes for Older People Page 26 of 38 Evidence: We shared these comments with the registered manager, who said she was aware of the issues that had been raised. We were shown the bedroom where the carpet has been replaced in relation to the survey comments. The registered manager told us senior staff are more vigilant and are doing random checks to make sure people have their own laundry. The registered manager said they have created a no name box has been created for unnamed clothing. Relatives are encouraged to check the no name box to reclaim clothing that belongs to their relatives and to ensure it is named. A senior carer told us they can now identify the member of staff responsible for the laundry to make sure mistakes do not happen. The laundry room is close to the kitchen but is not used by staff. We saw staff taking the laundry to the laundry room using another door. This showed good and safe practices were followed to ensure peoples health and safety. The information we received from the registered manager before the site visit stated the improvements made in the last 12 months. The list included the use of a maintenance book and a formal maintenance programmed to monitor and maintain the fabric of the building both internally and externally; replacement of old singleglazed windows with new uPVC double glazed units in most bedrooms and communal rooms; redecorated many bedrooms and several bedrooms have been re-carpeted. During the site visit we saw evidence of the improvements made in the home. One person told said, its much warmer sitting by the bay window, its not draughty anymore. Ivydene Care Home has a warm and welcoming atmosphere. People were seen sitting in the large lounge at the front of the home in small clusters, the lounge/dining room and the dining room. Two people were sat in the large reception area at the centre of the home, listening to the radio, where there is a selection of books and a pay phone. Some people were seen talking with visiting relatives or staff. Corridors were well lit and bright, which encouraged people to move around freely, albeit using a walking aid or the grab rails. This showed people were not restricted and seating arrangements allowed people to converse by choice and created a homely and relaxed feeling. With permission we looked a number of bedrooms with the registered manager. All the bedrooms were individual, spacious, clean and personalised with photographs, pictures and ornaments. A number of bedrooms are shared, all having privacy screens. We saw the new profile beds, in some bedrooms and other specialist equipment such as sensor mats and hoists. This demonstrated the home has access to specialist equipment to ensure peoples health and safety. All areas of the home were clean, tidy and homely. Care Homes for Older People Page 27 of 38 Evidence: The bathrooms and toilets are close to the lounges for people to use. We saw staff put on protective gloves and aprons when preparing to assist people with personal care such as taking them to the toilet. We heard staff guiding people to promote their independence and ensure their safety. Staff demonstrated a good understanding of the current safe practice in relation to infection control measures, having anti-bacterial gels in the home. The training records showed staff had received training, having over 50 of staff that had attained the national vocational qualification level 2 in care and the cook trained food hygiene. The evidence we found during the site visit and the staff discussions supported the information we received from the registered manager before the site visit. The registered manager confirmed the responsible individual is at the home on a daily basis and will look to replace or repair things that need fixing in the home. There is now a maintenance programme in place, which showed the issue identified at the last inspection was addressed. We were told that the home is considering the value of converting one of the bathroom into a wet shower room to benefit people that have a physical disability. The registered manager said that any development decision would be made in consultation with the people living at the home and/or their relatives. People we spoke with and the visiting relatives said the home was clean and their relatives were always clean. The staff survey responses indicated people were cared for and lived in a clean home. The comments received included: We provide a very homely warm caring place to live for our service users and their families to visit. The staff always make time for any questions or concerns. Our manager Sue is very hands on and takes a very big interest in all the service users and their families and sets a very good standard to work by. Care Homes for Older People Page 28 of 38 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. People are protected by good staff recruitment process, stable staff team who receive regular training that ensures care needs are met; independence and wellbeing is promoted. Evidence: The people we spoke with said they liked the staff working at the home, they felt safe, happy and comfortable. We observed how staff interacted with the people living at the home, which further showed staff respected the people living at the home. Visitors told us they felt confident to approach the staff if they needed some information or wanted to discuss the care their relative was receiving. Relatives said the staff are very good, you can ask them anything from how is .... to asking them when can they have their hair done and staff are like family and I trust them to look after .... The relatives survey responses received indicated the staff have the right skills and experience to look after people. The individual comments received in the surveys included: My mother is taken care of by a wonderful group of carers who pull together I find the carers friendly and easy to get along with and very hard working Care Homes for Older People Page 29 of 38 Evidence: My mother seems always happy when I visit, she says they are lovely girls Ivydene is full of love and laughter. All the carers (we have met) are supportive of the relatives as well as the residents. they are more like our friends, we look forward to seeing when we go. They always cheer mum up if she is down and I believe mum is happy there. She always looks clean and tidy and can move freely about the place if she wishes to I feel the care and wellbeing of the residents are the main priority and they get first class care always and each individual is treated as an individual, with their needs and likes and dislikes of food. I have 100 faith in them, which as I go in everyday, I know how genuine the care is. We received staff surveys, all of which indicated the staff recruitment was done fairly, the employer carried out pre-employment checks and were trained for their role. Some of the comments received in the staff surveys included: My manager is always available at any point to speak to and is very approachable We provide a very homely warm caring place to live for our service users and their families to visit. The staff always make time for any questions or concerns. Our manager Sue is very hands on and takes a very big interest in all the service users and their families and sets a very good standard to work by We are assessed regularly with the management and they will talk to us about our work. The registered manager told us there is a stable team of staff and has recruited two new carers recently. We spoke with the staff on duty the majority had been working at Ivydene Care Home from 7 years to 17 years, which supported the information we received from the registered manager before the site visit. Whilst the staff we spoke with were recruited some time ago, they were aware that new staff must have police checks known as criminal records bureau checks and are inducted before they can work alongside the staff team. We looked at the staff rota, which was reflective of the staff on duty. The staff said they were happy with the staffing levels and would cover staff sickness if required as the home does not use agency staff. This showed staff recognised the staff worked as a team, focusing on the needs of the people living at the home. We looked at four staff recruitment and training files, both senior carers and carers on Care Homes for Older People Page 30 of 38 Evidence: duty who we had spoken with. All the staff files contained evidence of satisfactory criminal records bureau checks and two written references. This supported the information we received from the registered manager before the site visit. Staff we spoke with said they attend training and have regular updates. Staff were able to describe how after attending training in dementia awareness they had changed their own practice, having a better understanding of people diagnosed with dementia. Staff spoke about the 14 week distance learning course on person centred dementia care attended. Staff gave examples of changes in their own practice such as being patient, talking with people and allowing people to express themselves, even if it meant the carer returning a short while later offering them a cup of tea. This demonstrated the training was valuable and practice changed to benefit the people living at the home. We saw the staff training certificates, which demonstrated staff had attend training specific to their roles and to keep them up to date with current best practice. The training records showed staff had received information on the homes policies and procedures and attended training in health and safety, infection control, moving and handling, mental health, fire, safe guarding adults procedures, first aid, dementia awareness, stroke awareness, foot care, hazardous substances (COSHHE) and specific training for senior carers included medication training and assessments. The cook has completed the food and hygiene training and is at present completing a 16 week distance learning course in food and nutrition. The registered manager confirmed there were over 50 of staff that had attained the national vocational qualification level 2 or above in care and is herself a qualified assessor. This supported the discussions with the staff and the information provided by the registered manager. We saw staff communicating with each other promptly when changes in peoples wellbeing was noticed. Staff responded quickly and without affecting other people living in the home. Staff said they share information when new staff come on duty. This supported the staff survey responses, where all responded that there is a good system of sharing information between staff about the wellbeing of people living at the home. Care Homes for Older People Page 31 of 38 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. People benefit from a well managed home, have their interests protected and their health, safety and wellbeing promoted. Evidence: The registered manager has over 25 years experience managing Ivydene Care Home. She has attained the national vocational qualification level 4, registered managers award and continues her professional development through attending regular training and updates. The registered manager described the management structure of the home, benefiting from having a stable staff team and having recently appointed two new carers. The registered manager said she is supported by the owner, otherwise known as the responsible individual who visits daily and is actively involvement in overseeing the management and the development of Ivydene Care Home. People living at the home and visiting relatives were seen approaching the registered manager and the Care Homes for Older People Page 32 of 38 Evidence: responsible individual on first name terms. A relative said they found the manager and the staff were able to answer questions they had and found the whole experience very positive. The registered manager said she welcomes comments both positive and negative to help improve the standard within the home. This was evident as we shared some of the comments received in the relatives and staff surveys, specifically relating to the peoples clothing and the improving the decor and the home environment. The registered manager was aware of the issues relating to the laundry and had already taken steps to ensure people had their own clothes and the new UPVC windows in the home. The responsible individual told us about the developments and environmental improvements made within the home, which was evident during the site visit. The responsible individual is an active member for the care homes trade association and keeps up to date with developments and changes in legislation, which is then practiced within the home. We observed there working relationship of both the registered manager and the responsible individual. The responsible individual continues to monitor the standard and quality of the service on a daily basis and resolving any environmental issues as they arise. The staff we spoke with said they had clarity in their roles and responsibilities and people benefited from having a stable and caring staff team. The staff survey responses stated the system from sharing information about individual people was good, which supported the comments made by the staff during the site visit. Staff told us they felt supported, confident to raise concerns and valued the continuous development and responsibility they had to ensure people were well cared for. The comments we received from the relatives and staff surveys included: As long as the high levels of care continue I cant see any reasons for improvements Gives a really pleasant and homely feeling to patients and relatives and are really helpful of we need to ask any questions. Manageress is always willing to talk with you if we have a problem about anything. She is a very understanding and caring person The registered manager showed us the quality assurance questionnaire that was sent to the people using living at the home, their relatives and the health and social care professionals. The responses are being collated by the responsible individual. The registered manager plans to share the report of the findings with the people that have contributed and a copy would be made available to the Commission for Social Care Inspection. The registered manager told us people living at the home and their Care Homes for Older People Page 33 of 38 Evidence: relatives have the opportunity to share their views or concerns individually, at the review meetings or through the social worker, as some people are unable to express themselves and rely on their relatives to act on their behalf. We saw the number of cards and letters of thanks received by the home from relatives. The comments made in the cards and letters indicated the standard and quality of care provided was good. Other specific comments included: ... write yo you so you can place this on record my sincere thanks for the care that you gave mum during her time with you our appreciation of the manner in which .... was cared for and loved in her stay over 2 years with you There was also a commendation received from a social services review officer: commending the home for providing support, sensitivity and flexibility for ... We saw the recent audit carried out on the environment, using the quality audit tool provided by the care homes association. The registered manager showed us that quarterly are carried out. This demonstrated the home has system of conducting regular internal quality checks to ensure the home complies with the regulations. The majority of people are supported to manage their own money either by their relatives or have money held in safe keeping. The registered manager described the system of managing peoples money and showed us the records of transactions for people. This was consistent with the arrangement described by a visiting relative who leaves money with the manager to pay the hairdresser on behalf of his wife. This demonstrated there is a safe system in place to safely manage peoples money. The staff survey responses received stated staff have time with their manager to discuss work issues and training needs. The staff told us they receive regular supervision and appraisals and staff records contained records of these meetings. The comments received in the staff surveys supported the comments we received from the staff, which included: My manager is always available at any point to speak to and is very approachable We are assessed regularly with the management and they will talk to us about our work We have regular supervision and Sue is around if you need to speak with her Care Homes for Older People Page 34 of 38 Evidence: We have access to the care plans all the time and full support of the seniors and the management. We saw the assessments of risk carried out for individual people as part of the assessment and admission process or when peoples needs change. The assessments of risk ranged from falls, moving and handling, safe use of hip protectors and nutritional needs assessment. The care plans reflected the measures to be used to ensure peoples wellbeing and gave clear instructions for staff to follow, whilst peoples choices and rights were respected. The staff training records showed staff had received training in assessing risks, health, safety, manual handling and attaining the national vocational qualification in care, which demonstrated staff were aware of the current best practice. The records relating to the people living at the home, staff and the management of the service are kept secure, in good order and in accordance with data protection. Staff training records demonstrated staff received training for their roles and to ensure they follow guidance in relation to health and safety. We saw staff had received training in moving and handling to specialist training in dementia awareness to be able to support the people living at the home. The information was organised and easily accessible and supported the information we received from the registered manager before the site visit. We saw that there is now an accident report folder containing details of reported incidents and accidents that occurred. The registered manager showed us the maintenance book, which is now in place. This demonstrated there are systems in place to ensure events affecting the wellbeing of people living at the home is reported and a system of monitoring the maintenance of the home. The information we received from the registered manager before the site visit detailed the programme of maintenance, servicing and testing of equipment and checks in place. This was evident during the site visit and the responsible individual oversees the maintenance of the home. From the observations made of the home during the site visit, it was evident the home was clean and safe for the people living there and there are ongoing plans for improving the home. Care Homes for Older People Page 35 of 38 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 36 of 38 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 37 of 38 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 © (2008) 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 38 of 38 - 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!