Ivy House Residential Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

Whilst care plans contained personalised information on people’s lives, they had not always recorded discussions held with people about their care and choices. Sometimes these recorded discussions had been held with their relatives rather than with the person themselves. This meant the provider could not always demonstrate people had been involved in important decision making.

We found some care plans did not always reflect what actions staff should take when caring for people. For example, records showed staff provided a towel for a person to hold when providing them with personal care as they could attempt to grab onto staff. However, this detail was not reflected in the person’s care plans or risk assessments. For another person, staff completed checks when they were in their room as they were not able to use the call bell however, these checks were not included in their care plan. Care plans contained contradictory information on whether people had capacity to consent to their care, and one person’s nutrition and hydration care plan was unclear as to what guidance was current for the person and whether there was a choking risk or not. We made a safeguarding to the local authority safeguarding team so this person’s needs could be considered.

The provider did not always plan and deliver people’s care and treatment with them. They did not always follow legislation and current evidence-based good practice and standards.

We found areas of practice at Ivy House Residential Care Home that had not always followed good practice. For example, in the areas of the MCA and in seeking timely medical advice.

People were happy with their meals and drinks. One person told us, “Roast dinners here are to die for. Such care is taken and the Yorkshire puddings are fantastic.” While another person told us how they were always given alternative meal choices. They said, “So, if the roast is lamb, staff cook me different meat. They’re brilliant with all these little things. It makes such a difference.”

However, we found not all food safety procedures were documented or followed. For example, the serving temperatures of meals had not always been recorded, and we found bags of sugar and potatoes had been stored directly on the floor rather than on a raised shelf. This meant there was a lack of assurance that food was always stored and served in line with good practice guidance.

The provider did not always work well across teams and services to support people.

The home had not always worked with other healthcare services in a timely manner. For example, medical advice had not always been obtained at the time of an incident.

However, staff told us they worked well together. There were ‘hand-over’ meetings between staff finishing their shift and the new staff starting. This helped staff to communicate how people had been and whether there were any changes to their care needs.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control.

People had access to a visiting GP, and records showed what health needs had been reviewed and whether this had resulted in any changes, for example, to their medicines or whether any referrals to other services were recommended.

However, we found that for one incident, advice from the out-of-hours healthcare services had not been obtained in a timely manner. Whilst people had access to other healthcare services, staff had not always arranged this in a timely manner.

The provider did not always act on the routine monitoring of people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive andconsistent, or that they met both clinical expectations and the expectations of people themselves.

People’s health indicators were monitored however, decisions regarding what actions to take had not always been recorded. For example, one person had shown a weight loss trend over the last year. The registered manager told us other professionals had advised them that a referral to the dietician was not required however, they were unable to provide evidence of this advice. We made a safeguarding referral for this person so their needs could be considered.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

We observed staff checked that people consented to their day-to-day care, such as checking whether they could enter their bedroom, where they wanted to sit and how they wanted to spend their time. Staff we spoke with provided examples of how they checked with people whether they were happy for them to have help with their care before providing it.

However, we found no discussions had been recorded with a person over the risks associated with their care choices. Instead, discussions had been recorded with their relatives. This showed that people had not always been involved in providing informed consent over their care choices.