Archived: Irene House

Irene House is registered to provide nursing care and accommodation for up to 40 people with a range of needs, including people living with dementia. At the time of our inspection, 39 people were living at the home. Irene House is a large, older-style detached property with the addition of annexed accommodation surrounding an enclosed garden/courtyard area. Communal areas include a large dining room, sitting room and conservatory. Some rooms have en-suite facilities and all are of single occupancy. Irene House is situated close to Worthing town centre and seafront.

A registered manager was in post. 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.

Not all staff had received regular supervision meetings or annual appraisals to assist them to carry out their role effectively. This had been already been identified as an area for improvement by the provider. Following the inspection, the registered manager had put a plan in place to ensure that outstanding staff supervisions were organised and completed in line with the provider’s policy.

The home was uniformly decorated throughout and had not been specifically adapted to meet the needs of people living with dementia. This was discussed with the registered manager as an area for improvement.

Staff had completed all essential training and staff meetings were organised, although these were not always well attended by staff. New staff completed an induction programme and studied for the Care Certificate, a universally recognised qualification. Staff understood the requirements relating to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and put this into practice.

People had sufficient to eat and drink and were supported to maintain a balanced diet. They had access to a range of healthcare professionals and services.

People told us they felt safe living at Irene House. Staff had been trained to recognise the signs of potential abuse and knew what action to take. People’s risks were identified, assessed and managed appropriately by staff. Accidents and incidents were reported and prompt action taken to prevent the risk of reoccurrence. Weekly checks were undertaken of equipment used to support people. Staffing levels were sufficient and robust recruitment systems were in place. Medicines were managed safely. Staff had a good understanding of their role in the prevention and control of infection.

People were looked after by kind and caring staff who knew them well. They were supported to express their views and to be involved in all aspects of their care. People were treated with dignity and respect. At the end of their lives, people were supported to have a private, comfortable, dignified and pain-free death by staff who were sensitive to their needs. Records relating to people’s end of life care had been completed appropriately.

People received personalised care that was responsive to their needs. Care plans included detailed, comprehensive information about people’s care needs, their likes, dislikes and preferences. A range of activities was organised for people. Complaints were managed promptly in line with the provider’s policy.

People were involved in developing the service and they were encouraged to be involved in meetings with their relatives to feedback their views about the service. The provider sent out annual surveys to people and their relatives. Staff felt supported by the management team at Irene House and that any concerns they had would be listened to. People and staff said the home was well managed and well led. A system of audits monitored the quality of the service overall and identified areas for improvement.

We found one breach of regulation of the Health and Social Care Act (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the end of this report.

We gathered evidence that helped answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with six people using the service, four visiting relatives, five staff supporting them and from looking at a selection of records.

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

Is the service safe?

There were enough staff on duty, including nursing staff, to meet the needs of the people living at the home.

The home was clean throughout and this was maintained by domestic staff, who were well-led by a supervisor.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. On the day of our inspection we were advised no DoLS applications had been made. Relevant staff had been trained to understand when an application should be made to deprive someone of their liberty.

Medicines were administered by appropriately trained staff. The provider had made suitable arrangements in relation to the obtaining, storing and disposing of medicines.

There were systems in place to make sure that the manager and staff learned from events such as falls, accidents and incidents. This reduced the risk of harm to people and helped prevent such incidents in the future.

Is the service effective?

From our observations people were happy with the care that had been delivered and their needs had been met.

One person told us, "The care here is excellent. Nothing is too much trouble.'

From speaking with staff and our own observations we found that there was a good understanding of people's care and support needs. Staff we spoke with were clear about how best to support people while maintaining their independence and dignity.

Care plans we examined included assessments and reviews of people's health and care needs. Care plans included detailed information to ensure staff delivered care consistently to meet people's needs.

All care and nursing staff we observed demonstrated they understood the care needs of people and how best to support them.

Is the service caring?

People were supported by sympathetic and patient staff who displayed patience and gave encouragement when supporting people.

Lunch was sociable and people told us they enjoyed the food served. One person told us, 'The food is good, he's a good chef and there's always a choice of two mains.' People were given time and supported to enjoy their meal.

Is the service responsive?

Relatives of people living at the home were updated monthly by nursing staff with a review of their care plan. The home held residents' meetings and published a residents' newsletter. The home had a transparent complaints policy and responded to concerns promptly. People we spoke with told us the manager was approachable and they would feel comfortable raising any concerns with her.

Is the service well-led?

The manager held regular staff meetings and used them to communicate issues related to the day to day running of the home.

Staff we spoke with were clear about their roles and responsibilities and confirmed that they had the opportunity to attend regular staff meetings. They said they felt supported by the manager.

There were systems in place to ensure training was kept up to date for all staff. The provider offered funding and support for staff to undertake further courses in areas such as diabetes care, dementia and end of life care.

Staff we spoke with understood the values of the home. One told us, 'The best thing about working here is the residents; caring for them, loving them, involving them and giving them a sense of worth.'

We found that consent was obtained prior to people receiving care and support. People were offered the opportunity to make choices and be involved in their care. Best interest decisions made had taken into consideration people's preferences, wishes and capacity.

We found that people's care was planned and delivered in line with their needs and preferences. People's care needs were regularly reviewed and updated to reflect their most up to date needs.

People were protected against the risks of unsafe or unsuitable premises. The building was accessible to people who had difficulties with mobility. Maintenance issues were addressed swiftly and there were routine checks of environmental risks.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. Staff were given appropriate training, supervision and support fulfil their roles.

The home had systems in place to monitor the quality of service provision. There was an on-going commitment to improve the quality of the service they provided.