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Archived: Ifield Park Care Home Requires improvement

Reports


Inspection carried out on 21 November 2017

During a routine inspection

The inspection took place over two days, 21 and 24 November 2017 and was unannounced. Ifield Park Care Home provides accommodation for up to 94 people who need nursing or personal care. The home comprised four units, two providing nursing care, one providing residential care and one providing care for people who were living with dementia. The home is situated in a residential area on the outskirts of Crawley. Short stay or respite care is available in each unit. The provider is a charitable organisation.

The registered manager was in attendance on both days of the inspection. 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. At the last inspection on 5 May 2015, the home was rated Good overall. At this inspection we identified two breaches of the regulations and other areas of practice that needed to improve.

Staff were not consistently following the provider’s medicine policy and this meant people were at risk of not receiving their medicines safely. A medicine administration error had not been identified. Some people were receiving PRN (as required) medicines but clear guidance for staff was not consistently provided in all areas of the home. Storage of medicines was not consistently monitored.

Some management systems were not always effective in identifying shortfalls and omissions in the quality of the service. Some records were not complete. This had led to inconsistency in some areas of practice across the home.

One area of the home specialised in providing care and support for people who were living with dementia. This part of the home had been recently refurbished and provided a clean and bright environment. We made a recommendation that the provider seeks further information about best practice in the use of colour and design within the environment to help people with dementia to orientate themselves in time and place. Staff had received training in dementia but our observations were that people were not consistently supported with meaningful occupations that were stimulating for them. We made a recommendation that the provider finds out more about providing meaningful occupation, based upon current best practice in relation to the specialist needs of people living with dementia.

Whilst there were enough staff on duty to care for people safely, the deployment of staff in some areas of the home meant that people waited longer then they should expect for their needs to be met. People in some areas of the home said it took “too long” for their call bells to be answered. Our observations were that at some times of the day staff were not always available to support people. This was identified as an area of practice that needed to improve.

Staff had received training in the Mental Capacity Act 2005 (MCA) and demonstrated an understanding of the principles of the legislation. However records did not always contain mental capacity assessments that detailed how specific decisions had been made in people’s best interests. This was identified as an area of practice that needed to improve.

People told us they enjoyed the food provided at the home. Their comments included, “The food is lovely,” and “The food is really nice.” Risks associated with people’s nutritional and hydration needs were identified. However our observations were that some people did not always receive the help they needed to eat their food. This was identified as an area of practice that needed to improve.

People told us they felt safe living at the home, one person said, “Yes I feel safe, they look after things for me.” Risks to people were identified, assessed and care plans guided staff in how to manage specific risks. Environmental risks were assessed an

Inspection carried out on 5 and 12 May 2015

During a routine inspection

This inspection took place on 5 and 12 May 2015 and was unannounced.

Ifield Park providing nursing care, personal care and accommodation for up to 73 people. Care is delivered across three separate buildings, according to people’s individual needs. Nursing care is provided from Woodroffe Benton for up to 21 people. Penn Court provides a residential care for up to 26 people. Ellwood Place provides care for up to 21 people living with dementia..

During our inspection the registered manager was present. 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.

Staff knew each person’s individual needs, traits and personalities. Care plans were in place which provided detailed information for staff on how to deliver people’s care.

The home had good systems in place to keep people safe. People told us they felt safe. Staff were aware of their responsibilities in relation to safeguarding. The manager was clear about when to report concerns and the processes to be followed to inform the local authority and the Commission in order to keep people safe. Medicines were managed safely.

People were encouraged to make choices within their capacity. Risk assessments and support plans were in place which covered potential risks to people and ways to minimize these were recorded and acted upon. People were supported to access healthcare services and to maintain good health.

There were enough staff on duty to provide people with the care they needed. Appropriate recruitment checks were completed to ensure staff were safe to support people. Staff were sufficiently skilled and experienced to care and support people to have a good quality of life. Staff received training, supervision and appraisal that supported them to undertake their roles and to meet the needs of people.

Ifield Park met the requirements of the Deprivation of Liberty Safeguards (DoLS) and acted in accordance with the Mental Capacity Act 2005 principles. Staff were kind and caring and people were treated with respect. Staff knew what people could do for themselves and what support was needed. Staff were attentive to people and we saw high levels of engagement with them.

Staff and relatives told us that management of the home was good. Regular meetings were held with staff that encouraged open and transparent communication. Staff understood the vision and values of Ifield Park and the manager monitored that these were reflected in the support that people received.

The service had a formal procedure for receiving and handling concerns. Complaints could be made any staff member and then referred to the manager of the service. This meant people could raise their concerns with an appropriately senior person within the organisation.

Quality assurance audits were completed which helped ensure quality standards were maintained and legislation complied with. Accidents and incidents were acted upon and reviewed to prevent or minimise re-occurrence.

Inspection carried out on 11 February 2014

During a routine inspection

We spoke with ten people and nine visitors who told us that people were treated as individuals and that they were given information and choices in relation to their care. One person said �the girls will always ask me about my opinion and they seem to listen to me�. People, who could, told us that their dignity, independence and privacy was respected. This was confirmed by our review of people's records as well as our observations. A visitor told us �my husband is not able to make any decision but I have signed the consent form on his behalf and they are doing just what we agreed�.

We spoke with the registered manager and to ten members of staff who told us they felt confident in their role. They said that they had regular training and felt very supported by their unit manager�s and the registered manager. During our observation we saw that staff interacted well with people when they were supporting them. We saw that staff were knowledgeable about people's needs and preferences. We found staff were respectful and maintained people's dignity, privacy and independence.

We were shown examples of person centred care records which were well organised into separate sections. This provided clarity for staff. These had been developed for each individual and documented their wishes and preferences in relation to how their care was provided. A relative's assistance was sought with this where the person was unable to fully contribute themselves.

Reports under our old system of regulation (including those from before CQC was created)