St. Ives Country House Care

St Ives Country House Care is a residential care home providing personal care to up to 60 people. The service provides support to older people, people who have physical disabilities or sensory impairments and people living with dementia. At the time of our inspection there were 55 people using the service.

People’s experience of the service and what we found:

People were safely cared for by well trained staff who understood their responsibilities about safeguarding. Risks were assessed however people were not restricted and lead fulfilling lives.

A robust recruitment system ensured only staff suitable for caring roles were recruited and use of a regular care agency ensured continuity of care.

The premises were very well maintained and extremely clean and all necessary infection prevention and control measures were in place.

The service was very well-led, and we only received positive feedback about the management team and staff. There was an open culture and people, staff and relatives could easily communicate with the management team due to an open-door approach.

Auditing and planning ensured both good oversight and continual improvement of the service delivery.

Staff were supported to develop in their care careers and most feedback from staff indicated pride in working at St Ives Country House Care.

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.

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

Rating at last inspection

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

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key question 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 St Ives Country House Care 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.

People told us they happy and felt safe living at St Ives Country House Care. The registered manager, deputy manager and all the staff at the home had worked hard to keep them safe. Robust policies and procedures together with regular audits and checks meant that the home worked in line with good practice and government guidance.

There were safe practices in place for welcoming visitors to the home. These included rapid COVID-19 testing, temperature checks. personal protective equipment (PPE) and hand hygiene. Vaccination status was checked for all visiting professionals. Records of mandatory staff vaccinations were maintained. Staff testing for COVID-19 was at the frequency in line with government guidance. All necessary consent was in place which included capacity assessments where appropriate.

Supplies of PPE were in good supply, stock checks maintained, and we observed staff wearing this correctly. Staff had training in infection prevention and control and were shown how to put on and take off PPE correctly. The home was a good standard of cleanliness, paying attention to high use touch points such as door handles and handrails. Emergency contingency plans in place meant that the home could work safely during an outbreak by supporting people to maintain distance where possible. Each person’s bedroom was well equipped and had an en-suite shower room in order to make periods of isolation easier.

People were supported to maintain vital contact with their loved ones during the COVID-19 pandemic. As restrictions changed the home adapted its policies and practice and this was communicated to people and those important to them verbally and by telephone or email. Risk assessments were completed for all aspects of care and support including additional risks related to COVID-19. These included having visitors or going out of the home.

The home had a registered manager who had been in post four months at the time of our 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.

St Ives Country House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is registered to provide care for up to 60 people. The service had been registered for providing nursing care in the care home and personal care to people living in their own homes but had not commenced these activities so were not included in our inspection. At the time of our inspection there were 31 people in the home some of whom were living with a dementia. The home provides accommodation over two floors. Rooms have en suite shower facilities. Communal facilities include specialist bathrooms, lounges, dining rooms, quiet social areas and an accessible garden.

People and their families described the care as safe. Staff understood how to recognise signs of abuse and the actions needed if abuse was suspected. Staff had completed equality and diversity training and respected people’s individuality. People had their risks assessed and actions put in place to minimise avoidable harm whilst respecting people’s rights to freedom and choice.

Medicines were ordered, stored, administered and recorded safely. Protocols were in place for medicines prescribed for as and when needed but required more detail to meet best practice guidance. Staff understood the actions needed to protect people from avoidable infections.

People were supported by enough staff that had been recruited safely including checks to ensure they were suitable to work with vulnerable adults. Accidents and incidents were reviewed and where necessary actions taken to reduce further risk. Processes were in place to ensure lessons are learnt when things go wrong both in the home and across the wider organisation.

People were supported by staff that had completed an induction and on going training that gave them the skills to carry out their roles effectively. Pre-assessments had been completed with people and their families which provided information about peoples care needs and life histories.

Care and support plans detailed how people liked to be supported and recognised their individuality. Working relationships with other professionals such as district nurses provided effective outcomes for people. Staff understood their roles in supporting people whilst respecting a person’s right to privacy, dignity, independence and life style choices. People and their families were involved in end of life plans which included cultural requirements.

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

Staff were described by people and their families as caring, kind and patient. Relationships between staff and people were warm and positive and demonstrated that staff were knowledgeable about people, their likes, dislikes and things that were important to them. People’s communication needs were understood which meant people could be involved in decisions about their day to day lives. A complaints process was in place which people and their families felt if they used they would be listened to and actions taken.

People had opportunities to join in with group activities and one to one time with staff. Links with the community included trips out to local places of interest, social, health and spiritual groups and local schools. The environment provided opportunities for people to access communal areas, private areas to meet with family and friends and accessible outside space.

The service had visible leadership and staff described morale and teamwork as good. Processes were in place to enable effective communication with people, their families and the staff team including regular meetings. Quality assurance processes captured the effectiveness of service delivery and where improvements were identified actions were successful in improving standards.

Innovative use of technology and equipment supported people’s safety and independence.