Ivy Grove

Ivy Grove is a care home for 46 older people, some of whom may be living with dementia. The home is spread over 3 floors and each floor is accessible by a lift. At the time of this inspection there were 36 people using the service.

The care home is run by 2 companies; Care UK Community Partnership and Bayfield Court Operations Limited. These 2 companies have dual registration and are jointly responsible for the services at the home. Care UK has replaced Gracewell Healthcare Limited since the last comprehensive inspection and the care home was known as Gracewell of Chingford.

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

People were kept safe from the risk of harm or abuse. People using the service felt safe with staff at the service and relatives confirmed this was the case. Staff knew how to report concerns of abuse. People had risk assessments in place.

There were enough staff at the service to meet people’s needs and nobody had to wait long for support. Staff were recruited safely. Medicines were managed safely, and people were protected from risks associated with the spread of infection. Accidents and incidents were recorded, and lessons learnt from these shared with staff.

People had assessments before they began to use the service. Staff were supported with appropriate training and supervision. People had a choice of nutritious food and drink and their healthcare needs were met. The building was designed to meet people’s needs and people were involved in decisions about the environment. 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.

Staff were knowledgeable about people and their care needs. People and relatives thought staff were kind and caring. Staff understood how to treat people fairly and equally. The provider involved people and relatives in decision-making around the care people received. People’s privacy and dignity was promoted, and staff understood how to maintain people’s independence.

Care plans were person-centred and staff understood how to deliver personalised care. People’s communication needs were met. There were a variety of activities offered to people inside and outside the service. People and their relatives knew how to make a complaint. Care records documented end of life care wishes so this type of care could be provided when needed.

People, relatives and staff spoke positively about the leadership in the service. Managers and staff understood their role and responsibilities. The provider involved people, relatives and staff in developing the service. People, relatives and staff had regular meetings so they could be updated on changes within the service. The provider had quality assurance systems in place and carried out quality surveys to identify areas for improvement. The provider worked jointly with other agencies to improve outcomes for people.

Rating at last inspection

The last rating for this service under the previous joint providers (Bayfield Court Operations Limited and Gracewell Healthcare Limited) was good published on 31 January 2019.

Why we inspected

This inspection was prompted by a review of the information we held about this service. There had been a change in the joint providers where Care UK replaced Gracewell Healthcare Limited. This change in registration took place on 10 December 2021 alongside a change in location name.

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.

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.

Safe arrangements were in place for visitors to the service. Staff ensured visitors had taken a lateral flow test and tested negative for COVID-19.

Visitors were provided with suitable personal protective equipment (PPE) to wear such as a face mask. Hand sanitizer was available throughout the home.

Visiting professionals were asked to provide evidence of their COVID-19 vaccination status prior to entering the home. All staff coming on shift were required to take a lateral flow test and provide the management team with the result before starting work. Only staff that had a negative test result were permitted to work.

The service was adequately staffed. The provider ensured they were able to cover for staff absences due to COVID-19, and continue to meet people's needs. Isolation procedures were in place to control the spread of infection. People self-isolated in their rooms when necessary.

A regular programme of testing for COVID-19 was in place for people and staff. Policies, procedures and risk assessments related to COVID-19 were up to date which supported staff to keep people safe. The provider kept up to date with government and local guidance on vaccinations, self-isolation, visiting and outbreaks to ensure they were following it correctly.

All staff had completed relevant training in infection control and PPE. We saw staff using PPE correctly and safely. Handwashing guidance was displayed throughout the home and additional PPE was available for staff and visitors. The premises was kept clean at all times to maintain hygiene and help prevent the spread of infections.

This care home is run by two companies: Gracewell Healthcare Limited and Bayfield Court Operations Limited. These two companies have dual registration and are jointly responsible for the services at the home.

This inspection took place on 17, 21 and 24 December 2018. The inspection was unannounced. At the last inspection in October 2016, the service was rated Good. This inspection was prompted by an increase in incidents being reported. At this inspection we found the service had met all relevant fundamental standards and remained Good.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 were knowledgeable about reporting abuse and whistleblowing. There were enough staff on duty to meet people’s needs. The provider had safe recruitment procedures in place. Risk assessments were carried out to mitigate the risks of harm people may face. Building and equipment safety checks were carried out. Medicines were managed safely. People were protected from the risks associated with the spread of infection. Accidents and incidents were recorded, and lessons learnt from these.

People had their care needs assessed before they began to use the service. Staff were supported to carry out their role effectively through supervisions, appraisals and training. People were offered choices of nutritious food and drink and staff were knowledgeable about people's dietary requirements. Staff assisted people to maintain their health. The provider had systems in place for the staff team to share information about people’s well-being. The building was tastefully decorated. However, the décor of the building meant some people could have difficulty finding their bedroom. The provider was in the process of refurbishing the building. Care was provided in line with the requirements of the Mental Capacity Act (2005). Staff understood the need to obtain consent before delivering care.

People and relatives thought staff were kind and caring. Staff explained how they got to know people and their care needs. People and their relatives were involved in decisions about the care. Each person had a named care worker who had overall responsibility for their care. Staff knew how to provide an equitable service. People’s privacy, dignity and independence were promoted.

Staff understood how to provide a personalised care service. Care plans were personalised, contained people’s preferences and were reviewed monthly. People were offered a variety of activities to meet their social needs. Care plans included people’s communication needs. The provider kept a record of complaints and these were used to make improvements to the service. People had their wishes documented for end of life care.

People, relatives and staff gave positive feedback about the leadership in the service. The provider had a system in place to receive feedback about the service from people using the service, relatives and staff so they could use these to make improvements to the service. People, relatives and staff had regular meetings, so they could be updated and give their views about the development of the service. The provider had quality audit systems in place to identify areas for improvement. The service worked in partnership with other agencies to make improvements to the service.

We have made one recommendation about the refurbishment of the building.

Further information is in the detailed findings below.

The manager in post at the time of our inspection was in the process of applying to be registered with the Care Quality Commission. 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 how to report concerns or abuse. There were enough staff on duty to meet people's needs who were employed through safe recruitment processes. Risk assessments were carried out and management plans put in place to enable people to receive safe care. There were effective and up to date systems to check and maintain the safety of the premises. Medicines were administered and managed safely.

Staff received support through supervisions and training opportunities. Appropriate applications for Deprivation of Liberty Safeguards had been applied for and authorised. Staff obtained consent when carrying out care tasks. People were offered a varied and nutritious food menu and staff were knowledgeable about their dietary requirements. Healthcare professionals gave positive feedback about their joint working with the service. Records showed people had access to healthcare professionals as required to meet their day-to-day health needs.

People thought staff were caring and staff knew how to build positive relationships with people who used the service. Each person had a named carer who oversaw the care they received. Staff ensured people’s privacy and dignity was respected and their level of independence was maintained. There was a calm and happy atmosphere throughout the home.

Care plans were written in a personalised way. Staff knew the people they were supporting including their preferences which helped ensure a personalised service was provided. A variety of activities were offered including visiting entertainers, a bistro service onsite and trips out to events in the community. The service dealt with complaints in accordance with their policy and timescales.

The provider was trying out holding separate meetings for people who used the service and for relatives but was considering returning to the previous system of holding them jointly. People and their representatives were given the opportunity to complete feedback surveys. The provider had quality assurance systems in place to identify areas for improvement.