Inspection on 12/10/05 for Ivydene Nursing Home

This inspection was carried out on 12th October 2005.

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

The inspector 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 Nursing Home 10/12/08

Ivydene Nursing Home 12/12/06

Ivydene Nursing Home 24/05/06

Ivydene Nursing Home 17/01/06

Ivydene Nursing Home 09/02/05

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Ivydene Care Home Staniforth Drive Ivybridge Plymouth Devon PL21 0UJ Lead Inspector Fiona Cartlidge Unannounced Inspection 12th October 2005 10:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ivydene Care Home DS0000061638.V257769.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ivydene Care Home DS0000061638.V257769.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ivydene Care Home Address Staniforth Drive Ivybridge Plymouth Devon PL21 0UJ 01752 894888 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Sanctuary Care Limited Mrs Veronica J Stewart Care Home 57 Category(ies) of Old age, not falling within any other category registration, with number (20), Physical disability over 65 years of age of places (57), Terminally ill over 65 years of age (5) Ivydene Care Home DS0000061638.V257769.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Physical Disability over 65 years of age (PD(e)) 37 Both Terminally Ill over 65 years of age (TI(e)) 5 Both Old age not falling within any other category (OP) 20 Both One Service User under the age of 65 years (named elsewhere) Date of last inspection 09/02/05 Brief Description of the Service: Ivydene is a purpose built care home, situated in the town of Ivybridge, providing nursing and personal care for up to 57 persons over the age of 65 years of age of either gender. The home is designed to care for persons suffering with varying degrees pf physical disability/frailty or illness. The accommodation is located on 2 floors with a passenger lift providing access to the 1st floor. All the bedrooms have the benefit of en-suite WC and wash hand basin. 7 bedrooms are dedicated to persons receiving short term nursing care funded by the NHS. Ivydene has large communal areas including dining room and large lounge and 2 smaller lounges. There is a pleasant patio area with flower- beds; the town centre is a short distance away. Ivydene was first registered in 1994. Ivydene Care Home DS0000061638.V257769.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 6hours and 30 minutes and was unannounced. A partial tour of the home took place when some bedrooms and all communal living rooms were viewed. Personal records of care of 5 residents and personnel records of 5 members of staff were inspected. The inspector spoke with 20 residents, 6 visitors, 2 staff members the registered manager, deputy manager and administrator. Written feedback was received from 2 residents and 2 visitors/relatives before the inspection. The registered manager had also submitted answers to a pre-inspection questionnaire. What the service does well: The admission process is safe it ensures that adequate information is obtained about prospective residents. Social activities are well organised and varied and provide stimulation and interest for residents. People feel safe living in this home and know who to speak to if they are dissatisfied. The home is adequately decorated and furnished and clean, pleasant and hygienic. The procedures for the recruitment of staff are robust and offer protection to people living in the home. The deployment and number of staff on duty during the inspection met the needs of the residents. The home is being managed properly and there is evidence of clear leadership, guidance and direction to staff. Systems for holding money in the home on behalf of service users are safe. Quotes received from residents include ‘ I have nothing but praise for the staff’ This is a good place to be’ Visitors said they were pleased with the care and if they made complaints or mentioned concerns they had been dealt with efficiently. Ivydene Care Home DS0000061638.V257769.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ivydene Care Home DS0000061638.V257769.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ivydene Care Home DS0000061638.V257769.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,5,6 The admission process is safe it ensures that adequate information is obtained about prospective residents; this allows senior staff in the home to make a decision about if/how those peoples needs will be met. EVIDENCE: Ivydene Care Home DS0000061638.V257769.R01.S.doc Version 5.0 Page 9 The inspector examined personal documentation held on behalf of 5 recently admitted residents; all included pre-admission information supplied from care management or hospital settings. The Manager confirmed that either her deputy or herself make every effort to perform the homes own pre- admission assessments on all prospective service users except those admitted via emergency or the early hospital discharge scheme where time does not allow, in these cases the home obtains detailed relevant information to enable them to make a clear decision about the homes ability to meet the needs of individuals. The assessment tool has been provided by the registered company and is inclusive and encourages a consistent and comprehensive approach to assessing needs. The inspector spoke to a number of residents about how they had made the decision to be admitted to the home, the inspector was told that some had been given a list of homes by the placing authority and had visited several before deciding that Ivydene was the one for them, others had heard about the home through word of mouth, all told the inspector that they (or their representatives) had been able to visit the home before making a decision. This home has 8 beds, which are allocated to people admitted via GP’s to prevent hospital admission with a plan for them to return home. These patients do not have separate communal facilities, but when spoken to said they were happy to spend time in their bedrooms resting and recuperating most of those spoken to where aware that they had been admitted for a short stay only. Health and rehabilitative care is provided by professionals employed by the community primary care trust with nursing and personal care being provided by staff employed at the home. Ivydene Care Home DS0000061638.V257769.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,10 On admission the arrangements for planning care in this home are good, ensuring that health, personal and social care needs of people are recognised. More regular review of the documented plans of care would ensure changes in need are formally identified to ensure they are consistently and fully met. EVIDENCE: The documented assessments seen provided information about skin integrity, moving and handling, safety - including risk of falls, nutritional screening and social needs. The information generates the plans of care, which provide the basis for the care to be delivered. The inspector viewed 5 care plans; these had not been reviewed as recommended on a monthly basis and two lacked detail about the social history and the record of social therapies to provide a plan to meet social needs. There was some documentary evidence that residents and or their representatives had been involved in the planning process, one residents who’s care the inspector case tracked confirmed they had been involved in the plan to meet their needs. The records showed that residents have their vital signs and weights assessed and recorded on a monthly basis the inspector observed that 2 of the 5 records indicated that the residents had hypotension and one Ivydene Care Home DS0000061638.V257769.R01.S.doc Version 5.0 Page 11 had recently fallen for no apparent reason there was no documentary evidence that either resident was being investigated or treated for causes of their hypotension. The need for further review was discussed with the manager at the time of the inspection. Records are maintained for all visits to the home by social or health care professionals, all residents are registered with a GP. Records provided evidence that as well as visits from General Practitioners, district and specialist nurses, chiropodist and dentists visit. Records of outpatient appointments show that visits to community and hospital health resources are enabled. Residents told the inspector that the staff respect their privacy and dignity, the inspector observed that when personal care was being provided this was done behind closed doors, the staff spoke to residents in a polite manner and knocked on the doors to private accommodation before entering. Written feedback was received by the commission before the inspection from 2 residents 1 indicated that their privacy is respected the other commented that it is ‘usually but not always’. Both residents written feedback indicated that they feel well cared for and written feedback from 2 visitors/relatives indicates they are satisfied with the overall care provided. Ivydene Care Home DS0000061638.V257769.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Social activities are well organised, creative and provide stimulation and interest for people living in the home. The arrangements for visiting are flexible the food served in the home meets the needs and preferences of most residents. EVIDENCE: The home employs an activities co-ordinator who is responsible for planning social events. Minutes of residents meetings provided evidence that their views on what social activities they would like, influences those things that are offered. Plans have already been put in place to ensure that festive social arrangements will be in place at Christmas to include a pantomime and buffet. A monthly newsletter, which includes the organised activities available is published and provided to each resident. The activities listed in the September calendar included board and card games, fashion shop, chairoebics ‘remember that, hairdressing, pets corner, bingo, coffee morning with a slide show, bookworm club congregational service, sing-along, ‘tranquil moments’ fairground frolics, communion and a session entitled ‘ down memory lane’. Two residents who provided written feedback and those spoken to said the home provides suitable activities. A group of residents were enjoying a game of carpet bowls and others were seen to be receiving visitors or spending time in their own rooms enjoying their own leisure activities. Ivydene Care Home DS0000061638.V257769.R01.S.doc Version 5.0 Page 13 The feedback about food served in the home was mixed, some saying they enjoyed the meals others saying they felt the menu lacked imagination particularly the tea- time meals. A few residents were unaware of the availability of snacks in the evening and one said it was a long time to wait between tea time and breakfast the following morning because they were only offered a warm drink and a biscuit in that time. Information obtained from minutes of residents meetings indicated that a resident had asked for the porridge at breakfast to be made with milk instead of water and another request for thick bread instead of medium for toast had been responded to by the cook saying neither would be cost effective. Written feedback from 2 residents indicated that they like the food ‘sometimes’ and one commented ‘ often inadequate choice and do not keep to the printed menus’. The visitors and residents spoken to confirm they are satisfied with the visiting arrangements and could visit socially in the lounges or privately in the resident’s bedroom accommodation. The written feedback received from 2 relatives/visitors indicates that they feel welcomed into the home by the staff at any time. Ivydene Care Home DS0000061638.V257769.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 People are safe living in this home and know who to speak to if they are dissatisfied. EVIDENCE: The home has a complaints procedure, which is included in the contract/information pack and was also seen displayed on a notice board in the entrance hall. There have been 3 complaints recorded in this inspection year, the documentation showed that the complaints had been acknowledged in a timely fashion and investigated and responded to appropriately with actions taken where necessary. A recent complaint passed by the commission to the provider for investigation has not been responded to as requested by the commission it is however noted that the complaint was being investigated and responded to by a member of the company not employed specifically at this home. The home has an ‘Abuse of Vulnerable Adults’ policy. The policy has been updated to includes locality specific detail about who to contact and how, if an allegation or suspicion of abuse or neglect occurs and who and in what instance would lead the investigation. Policies and procedures for the protection of residents and staff are in place and they include information about dealing with challenging behaviour. All of the residents spoken to confirmed they feel safe living in the home as did the two residents who provided written feedback to the commission. Ivydene Care Home DS0000061638.V257769.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,26 The home is adequately decorated and furnished and clean, pleasant and hygienic and provides safe and comfortable surroundings in which to live. EVIDENCE: A tour of the home provided evidence that the providers maintain an attractively presented environment for residents and staff that is well maintained. Resident’s rooms contained personal items of furniture and ornaments and pictures. All of those spoken to said they liked their rooms, some particularly commented positively about the fact they have there own en suite WC. The home appeared well equipped to meet the needs of those residents identified with moving and handling risks and disabilities that affect their capability to bathe. The gardens are safe and accessible and the manager confirmed that further landscaping is planned to provide an even better seating area for residents next summer. A redecoration and refurbishment programme is in place and when the inspector indicated there was a damaged carpet in one bedroom, she was told Ivydene Care Home DS0000061638.V257769.R01.S.doc Version 5.0 Page 16 this room was a priority in the programme. The inspector noted that their were a considerable number of notices instructing staff on personal care matters displayed in residents rooms, there use was discussed as being institutional and a possible invasion of residents rights and privacy. Specialist mattresses were seen in place for those residents requiring them, as were height adjustable beds. The communal areas of the home were fresh and clean in their appearance; Hand washing facilities are available throughout the home as were protective gloves. Since the last inspection the home has had 2 new washing machines, 2 new dryers, 2 new sluice machines, new fire panel, suction machine, 6 profiling beds, 2 hoists new entry system and call bell system. Ivydene Care Home DS0000061638.V257769.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The procedures for the recruitment of staff are robust and offer protection to people living in the home. The deployment and number of staff on duty during the inspection met the needs of the residents. EVIDENCE: Information provided by the manager to the commission prior to this inspection indicates there has been a low turnover of staff in this inspection year. The staff files of 5 staff members employed since that time showed that all necessary recruitment checks had been undertaken to ensure the protection of residents. Residents spoken to said that the staff at the home are ‘kind and caring’ and that they received assistance when needed/requested. One resident said that sometimes it was late morning before their bed was made and added it depends who is on duty and if any staff have gone sick. Both residents who provided written feedback indicated that the staff treat them well. Written feedback was received from 2 visitors/ relatives, one indicated that in their opinion there was ‘sometimes’ sufficient numbers of staff on duty with the other stating there is ‘not always’ sufficient numbers on duty. At least one Registered nurse is on duty at all times supported by a team of Care Assistants 60 of these have obtained a National Vocational Qualification in care. Training records indicate that all staff receive regular training on health Ivydene Care Home DS0000061638.V257769.R01.S.doc Version 5.0 Page 18 and safety issues, first aid and protection of vulnerable adults. A good standard of induction training is provided to new members of the team. A good level of formal and informal communication was observed between staff. Regular staff meetings are held and recorded and staff meet to discuss care issues and work related issues at the beginning and end of each shift. Ivydene Care Home DS0000061638.V257769.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,37,38 The home is being managed properly and there is evidence of clear leadership, guidance and direction to staff. Systems for holding money in the home on behalf of service users are safe. EVIDENCE: The registered manager is a 1st level registered nurse who consistently updates her knowledge and skills. The manager is well supported by departmental heads and a deputy manager. Formal and informal systems of communication are in place. The manager provides direct supervision to the senior team (Outlined above) and each departmental head has responsibility for delegating supervision arrangements for their staff teams. The inspector examined the records and storage of personal money held in the home on behalf of residents. The actual balances were checked against the documentation and found to be correct. Best practise systems are in place for the protection of both residents and staff. Ivydene Care Home DS0000061638.V257769.R01.S.doc Version 5.0 Page 20 Internal auditing processes are in place, An external company manager visits the home on a monthly basis and performs a systems audit as well as feedback from residents and staff the results of which are reported to the manager to ensure a plan is made to address any short falls. The registered provider stated in the information provided in writing to the commission before the inspection that: New contracts have been set up with electrical and gas installation services, to service and repair all equipment in the home. The maintenance person has undertaken training and is now able to perform testing on portable electrical appliances. Fire equipment is checked regularly and fire drills and training in fire safety have been provided for staff. Water temperature checks are performed and recorded on a weekly basis. A new emergency call system has been fitted which records all calls made. Ivydene Care Home DS0000061638.V257769.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Ivydene Care Home DS0000061638.V257769.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement Service user plans must be reviewed and updated regularly to provide clear guidance to staff on the actions to be taken to meet their health and welfare needs. Where a risk to the health of a service user is identified action must be taken to assess and reduce the risk. Timescale for action 01/11/05 1 OP8 12 01/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP15 Good Practice Recommendations The wishes and requests of service users should be considered when planning menus and their suggestions for improvements should be acknowledged and where possible followed. Snacks should be available at all times and residents should be aware of this to ensure the interval between having food is no greater than 12 hours. Ivydene Care Home DS0000061638.V257769.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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