Care Home: Ivy Lodge Retirement Home

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What the care home does well People receive good care from a staff group who know them well and understand what matters to them. People`s views are listened to and respected and staff are supported to attend training so they can recognise good care and how to provide it. One wrote. `The carers are kind and considerate and always go out of their way for both my relative and our family`. And a person living there commented. `This is an excellent home and I am very happy here`. People`s health care needs are well met so their wellbeing is promoted. Advice from health care professionals is requested promptly and this advice is followed. Survey responses and a discussion held with a health care professional suggest that the service is highly thought of. One professional commented `they provide excellent personalised care for residents`. People are able to maintain good links with families and friends which helps them to have varied and interesting lives. People are consulted about proposed changes at the home, so they can contribute to how the home runs. This helps them to feel included and valued. The home is warm, comfortable and well maintained, which enhances the experience of living there. One person living there told us `It`s a very clean place. The bed linen is always spotless`. What has improved since the last inspection? The home has met the requirement made following the last inspection of the home. People thinking of moving to the home are now consulted more in the pre-admission assessment process so that they can say what sorts of care and support are important to them. The home has employed an activities person (due to start working there in just a few weeks time) who will make people`s lives more interesting and stimulating. The owners have already purchased a lot of items to help with this. The home is now following recommended food hygiene guidelines and keeps records to demonstrate that food is being stored and prepared in a way that promotes people`s safety. There has been continued redecoration and refurbishment of the home with records kept to show when different areas were last redecorated. This helps to make sure the environment is maintained at a high standard. All the specialist plumbing equipment, used in the home to reduce the risk of hot taps delivering water that may be too hot and scalding an individual, have been replaced. Efficient and effective safety equipment helps to protect people from potential harm. What the care home could do better: The home could seek advice from a healthcare professional, who specialises in the prevention of falls, to see if there is anything more they could be doing to minimise the risk of people falling. This would help to promote their safety and wellbeing. The home could check with people as to whether they are happy to go to the dining room for morning coffee and afternoon tea. This would help to show that the service is providing a flexible service to meet people`s needs. Reminding people about the meals on offer that day could enable people to look forward to favourite meals. It could also give people the opportunity to say that they don`t want the meal on offer, so that an alternative can be agreed on. This could provide people with more choice and control of their lives. The staff team could be reminded of their responsibilities to report any allegation promptly, should they be told by an individual that they had been mistreated. This would contribute to keeping people safe. The home recognises well trained staff as being very important, and thus continues to support and encourage care staff to study for a National Vocational Qualification Level 2 in Care so that they can meet the standard whereby 50% of care staff have this qualification. This award helps staff to understand why they do what they do, when providing care. Key inspection report Care homes for older people Name: Address: Ivy Lodge Retirement Home Briergate Haxby York YO32 3YP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jean Dobbin     Date: 3 0 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Ivy Lodge Retirement Home Briergate Haxby York YO32 3YP 01904760629 01904760636 lindaporteus@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Ivy Lodge Care Limited care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 34 The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Ivy Lodge has been adapted and extended to provide good quality accommodation for older people who require support with their personal care. The building is situated in a residential area of Haxby, some four miles from the centre of York. The home provides accommodation on two floors for a maximum of thirty four people. The home has a garden area, and parking places are available for visitors. There is a choice of communal space, and a passenger lift to the first floor to make access easier. The registered manager told us that on 30th September 2009 the current weekly fees ranged from £420 to £588. However, the majority of rooms are offered at a rate of Care Homes for Older People Page 4 of 29 Over 65 34 0 Brief description of the care home £460-470. Services or items not included within the fees, and for which extra charges are made, include hairdressing, chiropody and personal newspapers and magazines. A brochure is offered to all people expressing an interest in moving to the home and the homes service user guide is available for people to read, and on admission. Recent reports written by our predecessor organisation, the Commission for Social Care Inspection are kept in the hallway of the home, for people to read. Care Homes for Older People Page 5 of 29 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: This is what was used to write this report. Information about the home kept by the Care Quality Commission. Information asked for, before the inspection, which the manager provides. This is called an Annual Quality Assurance Assessment or AQAA. Information from surveys, which were sent to people who live at Ivy Lodge, to staff and to other professional people who visit the home. 10 were sent to people at the home, and 7 were returned. 5 were sent to healthcare and social care professionals and 2 were completed and returned. 5 were sent to staff at the home and 4 were returned 10 were sent to the home for people to give to the visitor of their choice to complete. 4 were returned. Care Homes for Older People Page 6 of 29 A visit to the home by one inspector, which lasted about 9 hours. This visit included talking to people who live there, their visitors, staff and the manager about their work and training they had completed. A visiting health care professional was asked their views of the home. The visit also included checking some of the records, policies and procedures that the home has to keep. Some time was also spent watching the general activity to get an idea about what it is like to live at Ivy Lodge. Information about what was found during the inspection was given to the registered manager at the end of the visit. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: The home could seek advice from a healthcare professional, who specialises in the Care Homes for Older People Page 8 of 29 prevention of falls, to see if there is anything more they could be doing to minimise the risk of people falling. This would help to promote their safety and wellbeing. The home could check with people as to whether they are happy to go to the dining room for morning coffee and afternoon tea. This would help to show that the service is providing a flexible service to meet peoples needs. Reminding people about the meals on offer that day could enable people to look forward to favourite meals. It could also give people the opportunity to say that they dont want the meal on offer, so that an alternative can be agreed on. This could provide people with more choice and control of their lives. The staff team could be reminded of their responsibilities to report any allegation promptly, should they be told by an individual that they had been mistreated. This would contribute to keeping people safe. The home recognises well trained staff as being very important, and thus continues to support and encourage care staff to study for a National Vocational Qualification Level 2 in Care so that they can meet the standard whereby 50 of care staff have this qualification. This award helps staff to understand why they do what they do, when providing care. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed properly before they move to the home to check that their needs can be met if they choose to move there. Evidence: All the surveys received from people living at Ivy Lodge confirmed that they received enough information about the home to help them decide that it was the right place for them to move to. One visitor spoken with said that they had visited the home with their relative. They had looked around and talked to some of the people already living there. The manager had talked to them at this visit to find out about the kinds of help and support their relative would need. This reassured them that if they moved there, then they could be helped properly. The manager confirmed that she always assesses people before agreeing that they can move to the home. This can be done in hospital, at their home, or like in this case, when they visit to look around Ivy Lodge. Information in the form of a brochure Care Homes for Older People Page 11 of 29 Evidence: is given or sent to people interested in moving there. Care records looked at showed evidence of an assessment completed before the person is admitted. An assessment completed by the persons care manager was also seen. This information is important as it helps care staff to understand a little about the individual before they arrive. One person was admitted to Ivy Lodge on the day of the visit. Fresh flowers had been placed in their room, as well as an information pack, or service user guide, giving information about the services and facilities provided by the home. The manager should consider providing this information in different formats, so that people, for example, with poor eyesight or difficulty understanding words can still find out about the home, without having to rely on others to help them. Ivy Lodge does not provide intermediate care. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and health care needs are generally well met, but the underpinning record keeping does not always evidence this well. Evidence: People at Ivy Lodge looked well cared for. Peoples clothes looked well maintained and a number of the ladies were wearing make-up and nail varnish. People told us they were well looked after. Comments include the carers are very kind and helpful and I think we are very well catered for. We observed care staff speaking with people in a kindly and respectful manner and listening to their their responses and views. We saw one area of poor practise though, which meant one person could be identified as having a health need. This was discussed with the manager who was very aware of this issue and explained the circumstances, however this continued practise does not respect the individuals dignity. Three care plans were looked at. These describe the care and support people need in order to stay in charge of their lives as much as possible. This care was not always Care Homes for Older People Page 13 of 29 Evidence: written down in enough detail, so people may get a different level of support depending on who was providing it. Care staff may also help people when they can manage the task themselves. Detailed records help to ensure people receive consistent care, regardless of who is providing it. These records need reviewing regularly to make sure they are up to date and appropriate. For example one persons records, written earlier this year, said they required help with washing and dressing, and help through the night, when needing the toilet, until they were confident. The records though did not describe what sort of help they needed, nor whether they were now confident. If people need any assistance to move around the home then the way this is to be done needs to be clearly recorded to help ensure the safety of the individual and the carer providing that help. Another persons admission record stated that they liked a cup of coffee with sugar at 10pm and they would like it every night. This sort of information needs to be included in their care plan as it identifies what makes one person different to another and is good person-centred care. Whilst each person has daily records these are not filled in each day. it would be good practise to do this as these records help to show the care people receive on a day by day basis. A health care professional commented in their survey that in their view Ivy Lodge was an excellent place. They said that the senior staff communicated well with them to ensure peoples health care needs were met in a timely way. And a visiting health care professional agreed broadly with these comments saying that staff seek help appropriately and follow the advice given. There was evidence in peoples care records of visits from the optician and chiropodist. One visitor said they were taking their relative to the hospital the following day to see a specialist. Whilst the care records looked at contain an assessment of risk of harm to the individual from, for example, falling or developing a pressure sore then those people assessed as at risk need a detailed plan of care describing what staff at the home are doing to manage this risk. And this care plan needs to be reviewed regularly to check that there is nothing else needed to be done. Records need to show that this review took place. The home has reported to us a number of incidents in the past year where people at the home have fallen. Some people have required hospital admission as a result. The manager should consider seeking advice from a specialist healthcare professional to Care Homes for Older People Page 14 of 29 Evidence: check whether the home is doing all it could be doing to minimise the risk of people falling. Medication systems at the home were looked at. Care staff who dispense medicines have received extra training and have been assessed as competent in this task. The manager told us that people can look after their medicines if they are assessed as safe to do so, but that currently nobody living there does this. Medication record sheets were seen to be completed appropriately and accurately, but following the inspection the manager made some small changes to make it easier to check that medicines are being given correctly, according to their prescription. Care Homes for Older People Page 15 of 29 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 can make decisions about how they spend their time and with whom, and this helps to promote their well being and independence. Evidence: People spoken with told us that staff help them to stay in charge of their own lives as much as possible. Many of the people living there are from the local area, and there was a steady stream of visitors throughout the day. People were seen going out with their visitors or pottering around in the grounds on their own. One person said they regularly go out for Sunday lunch and another said they go to the local shops with their visitors. The home provides four daily newspapers and three monthly magazines for communal use. A hairdresser visits regularly although one person said they chose to have their private hairdresser visit. Communion is provided on a needs basis whilst Christian Fellowship meetings take place fortnightly. One person commented how much they like these meetings. The home currently does not have an activities person, with carers providing that support when their care duties allow, or coming in extra to their care hours to provide Care Homes for Older People Page 16 of 29 Evidence: specific activites such as keep fit sessions and discussion groups. However a part time activities person is due to start working at the home within a few weeks and this person, currently employed as a carer, confirmed this. She has lots of ideas and has been supported by the management of the home in purchasing items that will be useful in this role. On the day of the visit some people did some craft work and this work was later displayed. The survey responses tell us that activities are regularly provided. Residents meetings are held four times a year and the manager conducts her own survey each year so that people can say what they like, or dont like about living at Ivy Lodge. One person said that they now get offered more fruit on the menu, because people said this was what they wanted. The meals follow a two week cycle, which is changed with the seasons. The menu is displayed in the hall in two different areas but despite this people told us they often didnt know what the meal was until they sat down at the table. There is no choice of meal either, though the manager said that people would be offered an alternative if they dont like whats being served. One person said you never go hungry, the food is very good. However they added. You have whats put in front of you. If you dont like it theyll find a sandwich for you. The manager explained that she thought this comment referred to the evening meal, where sandwiches are always offered as an alternative to the hot meal. All the survey responses comment always or usually to whether they like the meals provided, though one person asked for more foods that were softer to eat. This comment was discussed with the manager. The meals observed looked very appetising and staff were seen assisting people in a relaxed and unhurried manner, which promoted the meal as a social event. Whilst people get offered hot drinks during the day, they generally have to go to the dining room for them. They told us that if they choose not go there then they get offered a cold drink only. The manager explained that hot drinks are regularly provided in the lounge and to people in their rooms. However she needs to be satisfied that the home is providing a service according to what people want. Care Homes for Older People Page 17 of 29 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 that complaints would be looked into properly and staff are alert to the need to keep people safe. Evidence: The complaints policy is displayed in the hall and is included in information given to people when they move to the home. All except one survey completed by people living there said they knew how to make a formal complaint and all said there was someone they could speak with if they were unhappy about something. People spoken with said that they would speak with Linda (the manager) if they were unhappy. One said they felt very safe here, but could go to Linda anytime and talk with her. Another added. I would say something if someone was horrid to me. It would be a major issue if something like that happened here. Neither the home nor the commission have had to respond to any complaints in the past year. All staff working at the home attend annual refresher training in safeguarding adults. One carer spoken with was clear about her responsibilities should she suspect that someone has been harmed. She was less clear though about what to do should an individual tell her, in confidence, that they had been mistreated by someone else. The manager needs to continue to remind staff about the homes whistle blowing policy so that they would be very clear about what they needed to do should this situation arise. Care Homes for Older People Page 18 of 29 Evidence: When new staff start work then the manager discusses with them the need to protect vulnerable people from abuse and how peoples safety can be protected. They then attend the formal training which is provided in the autumn. Care Homes for Older People Page 19 of 29 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 excellent 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 well maintained and attractive home, which has been adapted to meet their needs. Evidence: Ivy Lodge is sited in a residential area of Haxby, north of York. It is a traditional detached house that has been extended and adapted for its present use. It was noted to be clean, warm, and well maintained, with no unpleasant smells. There is unrestricted access to the home during the day, and people and visitors were seen coming and going throughout the day. The home has well maintained gardens and there are a number of outside seating areas so that people can enjoy these. There is a dining room and two lounges, where the chairs are positioned in smaller groups to encourage a more homely environment. Most of the bedrooms are on the ground floor, though a vertical passenger lift provides access to rooms on the first floor. Almost all the private rooms have en-suite facilities and those rooms looked at contained personal items to make the rooms seem more like home. The manager explained though that whilst people could bring in small items of furniture the home did not have the storage space to allow people to bring in larger items. People spoken with said that the home was well maintained and kept clean. One Care Homes for Older People Page 20 of 29 Evidence: person commented its a very clean place. The bed linen is always spotless. There is a planned programme of redecoration and refurbishment. There could be some consideration though in decorating different areas in different colours, as this may help people with memory problems to find their way round better. This would help to promote their independence. The fire safety officer and environmental health officer have both visited the home earlier this year. The fire officer required that some minor remedial work needed to be completed. The second officer said that catering staff must complete food hygiene training and records relating to food safety management must be properly completed. The manager has addressed these requirements and catering staff are currently enrolled in distance learning training on food hygiene. Staff spoken with understood the importance of good hygiene measures to reduce the risk of a spread of infection. The manager makes sure that appropriate aids are available and used to make sure that people living in the home are protected against infection. Care Homes for Older People Page 21 of 29 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. The home employs enough appropriately trained and recruited staff to meet the needs of the people living there. Evidence: On the day of the visit there were four care staff working until early evening , three through the evening and two through the night. This is for thirty three people living there. The rotas confirmed that this was the norm. Agency staff are not used as the home has its own bank of relief staff to draw on. There are also catering and domestic staff employed. Care staff are responsible for laundering peoples clothes whilst the washing of bed linen is managed by an outside contractor. People spoken with said that they thought there were generally enough staff and that they knew what they were doing. All the surveys except one responded always or usually to questions like are the staff available when you need them? and do the staff listen to you and act on what you say? One person however responded sometimes to the availability of staff and their comments were discussed with the manager. Comments from speaking to people include all the staff are friendly and really helpful. And its very nice here. The carers are very kind and very helpful. One person said I like the way the staff dress in their own clothes. It creates a homely and relaxed atmosphere. Care Homes for Older People Page 22 of 29 Evidence: Although the home supports staff to undertake extra training, less than half the care staff have achieved a National Vocational Level 2 Qualification in Care. The manager however explained that some carers have alternative social care qualifications. The service continues to encourage the care staff working there to undertake this qualification as it is a recognised award that helps staff to understand good care and how it is to be delivered. The files of two members of staff who had recently started working at the home were looked at. These confirmed that staff are recruited properly, before being deployed. New staff do not start working at the home until a police check has been completed to confirm that they are suitable to work in the care industry. New staff complete an induction process and records of this were seen in one file. A planned induction ensures that new staff learn in a consistent manner about the policies and procedures they are expected to follow. Refresher training is provided each autumn for all staff who work at Ivy Lodge. This covers areas like first aid, lifting and handling and safeguarding adults. The manager is a member of a dementia care support learning group and supports staff to improve their knowledge about dementia care. One care worker spoken with said that in the last year they had attended training in first aid, health and safety, safeguarding and fire safety. They were going to complete a dementia awareness course to improve their understanding of the needs of people with dementia. Staff told us in their survey responses that they enjoyed working at Ivy Lodge. One person said I feel very fortunate to work here. I love my job. Care Homes for Older People Page 23 of 29 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. A competent and well thought of manager ensures the home is generally run in the best interests of people living there. Evidence: People tell us they are happy living at Ivy Lodge. Comments include this is an excellent home and I am happy here. And this is a very well run home. Linda is the manageress. Shes a very nice lady. You can go to her anytime and talk to her. The registered manager, (who is known as the manageress), is a qualified nurse who also hold a professional management qualification. She has worked at the home for a number of years and is using her experience in a Dementia Care group she attends, to develop the care provision for people living at Ivy Lodge who may have developed dementia since moving there. People spoken with knew who she was and said she was seen regularly throughout the home. One visitor spoken with said they would feel comfortable going straight to Linda if they needed to, as she was very approachable. Care Homes for Older People Page 24 of 29 Evidence: The manager carries out her own surveys each year to get peoples views about how the service runs. She also asks peoples visitors and professional visitors about their perspective of the home. These results are looked at and an action plan written if necessary. The results are available in the hall for all to see. A recent survey with the people living there identified that they wanted more fresh fruit and less gateaux for desserts, and these changes have been made. Routine checks and audits on the environment and written records are carried out and the manager meets with the owner each week to discuss the running of the home. The manager tells us that she doesnt always keep a written record of these spot checks. It would be good practise to record this information as a way of showing that the check has been done. People have a secure place in their private rooms so that personal items and money can be safely stored. One person commented that they can have a key to their bedroom, but they choose not as they dont think its necessary. The home can keep peoples monies on their behalf if requested to. The manager tells us financial records are maintained and people have access to these records so they can see where it is being spent, and on what. There are a range of health and safety policies and procedures in place. The home has made proper provision to ensure that there are safe working practises by providing staff training in first aid, fire, food hygiene, infection control and safe lifting and handling techniques. The manager meets with all new staff and discusses safe care practises and fire safety as part of their induction process. Hazardous products are stored appropriately and random safety certificates looked at were in date. Monitoring arrangements are in place to ensure the delivery of safe hot water and minimise the risk of Legionella. The home employs a part time health and safety officer and a maintenance man who carry out regular checks so as to maintain the safety of the premises. There are good fire safety systems at the home with regular checks and fire drills. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 29 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 1 8 13 Where risk of harm to an individual is identified there needs to be more detailed records stating what care staff are doing to minimise that risk. This plan of care needs reviewing regularly to check that the management of that risk is still appropriate. This will help to keep people safe. 30/11/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 8 Consideration should be given to asking a falls specialist nurse for guidance as to whether changes in care practise or in the environment could help to reduce the incidence of falls that happen to people living there. This would help to promote peoples safety and wellbeing. People should be reminded where the menus are displayed, should they wish to check what the meal is, so that they can plan and look forward. This would also help tthem to Page 27 of 29 2 15 Care Homes for Older People 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 decide whether they want the proposed meal, so that alternatives can be decided on in advance. 3 15 The home should determine if people are happy with the present arrangement of generally having to go to the dining room if they want a hot drink at coffeetime and midafternoon. This would ensure that peoples choices and preferences are being met. The manager should remind staff of their responsibilities should they be told of an incident where an individual may have been mistreated by another person. This will help to ensure any such incidents are promptly reported as good systems contribute towards keeping people safe. The manager should continue to support and encourage care staff to achieve a Level 2 National Vocational Qualification in Care as this helps staff to understand good care and how to provide it. 4 18 5 28 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. 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