Ingersley Court Residential Care Home

Ingersley Court Residential Care Home is registered to provide accommodation and personal care for up to 46 people. At the time of the inspection 28 people were using the service.

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

People living at Ingersley Court Residential Care Home told us they felt safe. Their comments included; “It [the home] has exceeded all my expectations for care, safety and maintaining dignity” and “Very nice, I enjoy living here, I feel safe.” Safeguarding systems, policies and procedures ensured people were safe and protected from abuse. Risks to people’s health safety and welfare were identified and managed safely with the involvement of the person or their representatives. Safe recruitment procedures were followed. Medicines were safely managed, and systems were in place for reporting accidents and incidents and learning from them.

People’s care, treatment and support achieved good outcomes and promoted a good quality of life. People told us they were involved in discussions about their care and their outcomes were good. Comments included: “The staff and the care are marvellous they do things the way I want them to be done” and “It [the home] is very good, all my needs met.”

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.

People were treated well, and their privacy, dignity and independence was promoted and respected. People and family members were given opportunities to openly express their views and opinions and they felt listened to. Their comments included: “Very good standard of care, very caring, smashing all round." “Yes, they are no problems, yes always treated with respect” and “Staff are marvellous never been kept waiting for anything”.

The atmosphere in the home was warm and welcoming. Staff had developed good relationships with people. Care plans were personalised and reflected people’s individual needs, their history and preferences. People told us staff knew them well and provided them with the right care and support.

The registered manager was clear about their role and responsibilities and they promoted a positive and person-centred culture. Staff worked well together as a team, and there was good partnership working with others to meet people's needs. Staff morale was good, and staff felt well supported. Effective systems were in place for checking on the quality and safety of the service and making improvements where needed. However, we found examples where two audits had not been completed effectively. No one was in any way harmed by this and managers acted effectively to make sure people were safe and protected from harm.

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

Rating at last inspection and update:

The last rating for this service was requires improvement (published 29 December 2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Ingersley Court 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 care home provides residential care to up to 46 people. During the inspection, there were 31 people living in the home, some of whom were living with dementia.

The previous registered manager had left the service and a new manager had been appointed and had been in post for seven weeks at the time 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. Feedback regarding the management of the service was positive and people told us they felt the service was improving.

The environment was not always safely maintained. Several safety issues were identified during the inspection, such as blocked fire exits which meant people would find it difficult to escape in the event of a fire and there were a number of items that people had access to that had the potential to cause them injury. We spoke with the manager about these issues and they were rectified during the inspection. Other safety issues could not be resolved on the day, such as risk of falls from a raised patio area that had insufficient security to prevent people from falling over them. However, following the inspection the manager confirmed these had been addressed.

People’s risks in the delivery of care had been assessed, but these assessments were not always accurate or reviewed regularly. This meant staff may not have accurate information about how to support people safely.

We looked at how medicines were managed within the home and found that safe medicine practices were not always adhered to. For example, the booking in and recording of medicines was not always accurate and the temperature at which medication was stored was not always monitored consistently to ensure medicines were stored at safe temperatures. Records showed that the manager had made some improvements to the management of medication within the home over the past few months and audits showed that less issues were being identified as a result of this.

We found that there were not always enough staff on duty to meet people’s needs in a timely way, especially at night. The provider acted on this straight away and increased the number of staff on duty at night and agreed to review the required number of staff during the day. Staff and people living in the home agreed that there were not always enough staff available.

Care plans were not always reviewed regularly and did not always reflect people’s current needs. This meant staff did not always have access to information on how best to support people.

Systems in place to monitor the quality and safety of the service were not always effective. The manager undertook a range of checks on the service but the checks undertaken had not picked up on all the concerns we identified during the inspection.

Records showed that safeguarding incidents had been referred to the local authority safeguarding team appropriately. However, CQC had not been notified of these issues. This meant the provider failed in their legal duty to keep CQC informed of issues that may have had an impact on the quality and safety of the care people received

Staff told us they always asked for people’s consent before providing care and when people were unable to provide consent, mental capacity assessments had been completed. These assessments were not always clear as to what decision needed to be made or who had been involved in best interest decisions. This meant people’s consent was not always clearly recorded. We have made a recommendation regarding this in the main body of the report.

People told us they felt safe living in Ingersley Court. Staff were knowledgeable about safeguarding and whistleblowing and knew how to raise any concerns they had in line with their organisational policy and procedures.

Most safe staff recruitment practices were evidenced within the staff records we viewed. However, not all staff files provided a full employment history and the manager agreed to review these records to ensure they contained the required information.

People were supported by the staff and external health and social care professionals to maintain their health and wellbeing. People and their relatives felt that health needs were being met and that action was taken in a timely way when people became unwell.

Staff were supported in their role through an induction and supervision sessions. Regular training was available and records showed that most staff had completed the training the provider considered necessary to meet people’s needs and provide good care.

Staff were familiar with people’s dietary needs and we saw that these were met. People told us they enjoyed the food available, had enough to eat and drink and always had a choice of meal.

People told us that staff were kind and caring and treated them with respect and their relatives agreed with this. We saw people’s dignity was protected by staff when they provided support and the people we spoke with confirmed this. People were able to be as independent as they wanted to be and had a choice regarding their daily routines and how they spent their time each day.

People’s friends and relatives visited during the inspection and they told us they could visit at any time and were always made welcome.

Care plans included information regarding people’s preferences, enabling staff to get to know people as individuals and provide support based on people’s preferences.

An activity coordinator was employed by the provider and a range of activities were planned each month for people to enjoy. People told us they enjoyed these activities available but said they would enjoy more opportunities to go out into the community.

People had access to a complaints procedure and told us they knew what to do if they had any concerns about the service or the care they received. The manager’s records showed that any complaints received had been investigated and responded to appropriately.

Regular staff and resident’s meetings took place to gather feedback from people regarding the service and we saw that the manager had taken action to improve the service based on the feedback received.

You can see what action we told the provider to take at the back of the full version of this report.