Archived: Ilsom House Care Home

Ilsome House provides nursing, residential, and respite care for up to 38 people. At the time of our inspection 27 people were living there. There was a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. There were no legal breaches of legal requirements at the last inspection in August 2013.

Medicine administration records were not maintained correctly to ensure safe practice and audits had not identified this. Not all storage was safe. Regular checks were made to monitor staff practice. People’s medicines were not consistently managed safely. This required improvement.

There was sufficient staff to meet people’s needs. Staff had completed regular training updates to ensure they had sufficient knowledge to carry out their roles. Staff had regular supervision meetings to identify staff training needs and monitor their progress.

People were kept safe by staff trained to recognise signs of potential abuse and they knew what to do to safeguard people. People and relatives we spoke with felt the home was safe and the service provided was safe. The recruitment procedures followed ensured people were cared for by staff who had appropriate checks completed before they started work and their practice was monitored.

People had access to health and social care professionals and were assisted by staff as required when they had appointments in the community. Visiting healthcare professional told us people were well looked after and staff responded quickly when required.

The staff were aware of people's dietary needs and preferences which were recorded in their care plans. The menus were based on the four seasons. The cook visited people in their bedroom or the communal areas to talk to them about their food preferences. Meal times were calm and unhurried and people at risk from malnutrition were monitored and supported to eat their meals. People told us about the food, “Food is marvellous and there is always a choice”, “Food is very good” and “I know I can have what food I want”.

Staff knew people well and were concerned for their wellbeing and responded to them in a caring way. People’s dignity was respected by staff and care plans described what people could achieve alone and when they needed assistance, this helped staff to promote their independence.

People had a range of activities they could be involved in. In addition to group activities people were able to maintain hobbies and interests. The activity programme was based on individual choices.

The service had robust quality assurance procedures which included the opinions of people and their relatives and action was taken to address improvements identified. Staff meetings were held and staff were able to influence any changes. Systems were regularly audited to improve the service.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

People living at the home told us "I have a fry up every morning to start the day' and 'The food is really nice, we always have a choice' and 'I like to have traditional food and always tend to pick the hot choice'.

The registered manager told us the home had been renovated last year. This included installing a new fire sprinkler system, new bathrooms, wet rooms, toilets, carpets and new furniture and fittings. The home worked with an interior designer to ensure the historic features of the home were maintained.

We spoke with five people they told us they felt safe living at the home. People told us 'I feel safe living here' and 'The staff are caring and look after me well'. We observed and heard staff talk to people in a manner that showed empathy and respect. People told us that staff treated them very well and showed them respect.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We looked at the records of three people who lived at the home in order to see how they were supported with their care, health and emotional needs.

We looked at processes in place to ensure that people were able to give informed consent to their care, and where they lacked capacity, that staff complied with the Mental Capacity Act 2005. We found that people's preferences were understood and discussions were documented but formal consent had not been obtained for the use of bed rails.

Care plans and associated risk assessments were mostly up to date and provided clear guidance to staff about how to support each individual in their care. Records did not always reflect that care had been provided as prescribed, although we saw no indication that people's needs were not being met.

We observed that the home was clean and tidy and largely well maintained. We observed staff taking appropriate steps to minimise the risk and spread of infection.

The home was adequately staffed and staffing levels were regularly reviewed and adjusted according to the number of people in the home and their dependency.

The home had an effective complaints system which was well publicised. There was evidence that they took complaints seriously and investigated and responded appropriately to concerns.