Ivy Lodge Retirement Home

Ivy Lodge retirement home is a residential care home providing accommodation and personal care to up to 33 people. The service provides support to older adults. At the time of our inspection there were 28 people using the service.

People’s experience of using this service and what we found

The provider had systems in place to monitor the service. Some audits had not been completed in the time frame indicated and some did not have robust action plans. We have made a recommendation about monitoring systems.

People told us they felt safe. Staff understood their responsibilities to report any safeguarding concerns. People and relatives spoke positively about the caring nature of the staff team. People and staff had developed positive relationships resulting in staff knowing them well and supporting them in line with their preferences.

People’s medicines were administered as prescribed by trained staff. Risks to people had been assessed and action taken to mitigate any risks. Accident and incidents were monitored by the registered manager.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The provider worked in partnership with people, their relatives and professionals to obtain feedback about the service. We received positive feedback about the management team and the hands-on approach to supporting people and the staff.

For more details, please see the full report which is on the Care Quality Commission website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 7 November 2018)

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ivy Lodge Retirement Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice:

• The home was clean and staff wore appropriate personal protective equipment.

• The provider followed relevant guidance and sought advice from local infection prevention and control specialists when needed.

• There was a focus on promoting the emotional wellbeing of people who used the service during the pandemic. This had included organising ‘staycations’, where staff arranged activities and entertainment based on themes, such as a cruise and a safari.

• Staff felt very supported by the provider and management team, both emotionally and practically.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At our last inspection we found the service to be outstandingly caring. At this inspection, we found this continued to be the case. Staff were exceptionally compassionate and kind. We observed numerous caring interactions between staff and people who used the service. It was evident positive relationships had been formed and staff knew people extremely well. Staff used this knowledge to provide a personalised service and enhance people’s wellbeing. Throughout our inspection, we saw staff payed great attention to detail when supporting people, in order to ensure they felt valued and respected. We heard comments between staff and people which demonstrated the mutually high regard with which they held each other.

The service was safe and people were protected from harm. Care workers were knowledgeable about safeguarding adults from abuse and knew what to do if they had any concerns and how to report them. There were sufficient staff to meet the needs of the people who used the service and care workers demonstrated they had the relevant knowledge to support people with their care.

Recruitment practices were safe and records confirmed this.

Medicines were managed and administered safely.

Training was provided regularly and updated when required. Care workers demonstrated an understanding of the Mental Capacity Act (2005) and told us how they obtained consent before assisting with care. People were supported to maintain a balanced diet. People were offered choice of meals that were provided in line with their preferences.

Care plans were extremely person-centred and comprehensive. Since the last inspection the provider and registered manager had developed the social activities for people; this was evident in the records.

People were supported to access healthcare services and received ongoing support. Referrals to healthcare professionals were made appropriately.

People who used the service, staff and relatives all spoke very positively about the provider and the registered manager and all expressed the positive impact their involvement had.

Quality assurance audits were in place and actions taken promptly to address any issues identified.

Further information is in the detailed findings below.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no recent applications had needed to be submitted. All staff were due to receive training in this area and the manager confirmed that they understood when an application should be made, and how to submit one. This meant that people were safeguarded as required.

People received an assessment which helped to ensure that the home was able to meet their needs. We saw care plans and risk assessments were in place to help ensure people's safety and welfare. Information was reviewed regularly to ensure that it was up to date and reflected any changes.

The home had systems in place to make sure that managers and staff learnt from events such as accidents, incidents, complaints, concerns and whistleblowing. This helped to reduce the risks to people and helped the service to continually improve.

Is the service effective?

Individual choices and decisions were documented in the care plans we looked at and staff reviewed these decisions on a regular basis. However, people did not always sign their agreement to their records. This meant that it may be difficult for the provider to evidence who had input to people's care file development and that the decisions made about care were agreed by the person who used the service or their representative.

All of the people we spoke with said that they liked living at the home, said they felt listened to and would recommend the home to others.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. One relative told us that they visited the service regularly and were delighted with their parent's care.

Feedback from people who used the service, relatives and staff was obtained through the use of satisfaction questionnaires, meetings and one to one sessions. This information was usually analysed by the provider and where necessary action was taken to make changes or improvements to the service

Is the service responsive?

Since our last visit the service had reviewed their care records to ensure the care being delivered was appropriate for those who lived there. They had implemented a professional visitor sheet and updated the care plans.

We saw that the home had responded to suggestions made within questionnaires or within meetings and people were confident that the home would respond to any concerns if they were unhappy. They had improved the range of social activities available and carried out a programme of refurbishment and redecoration. Comments included "We have new furniture, including tables and chairs. There are a lot more activities taking place."

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. Meetings were held so that people could air their views. The relatives and those living at the home who we spoke with all confirmed that they felt able to air their views with the provider and manager and that these were responded to. One person told us "The service is under new management. It has improved. We can talk to the new owners and there is lots more going on."

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place which helped to ensure that medicines were well managed. People were supported to manage their own medicines where this was appropriate.

Records we looked at confirmed that staff received training in areas such as first aid, infection control and safeguarding. Staff we spoke with told us that they received 'good support from the manager' and that they received useful/appropriate training.

There were a range of effective quality management systems in place to assess and monitor the quality of service that people received. People's views and opinions were sought and their comments were acted upon.