CQC report explained · a residential care home
What the CQC found at Ivers
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm. Risks, medicines, infection control, staffing and recruitment were managed appropriately, although agency staff were still used for annual leave and sickness cover.
- Effective?
- Good
- Care plans had been rewritten to reflect people's needs and choices. Staff training, mental capacity records and best interest decisions had improved, but the report noted two recent choking incidents involving unsafe food.
- Caring?
- Good
- This key question was not inspected during this focused visit. The previous rating was carried forward when calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. The previous rating was carried forward when calculating the overall rating.
- Well-led?
- Good
- Leadership was described as stronger and more stable after several management changes. Relatives and staff gave mostly positive feedback, and the home had systems for audits, meetings and reporting significant events.
What inspectors found, July 2023
Rated Good, up from Requires Improvement; inspectors found safer, more person-centred care, with some reliance on agency staff and recent choking incidents to consider.
This was an unannounced focused inspection. An inspector visited on 15, 18 and 30 May 2023. Inspectors spoke with or observed 9 people, contacted relatives, spoke with staff and reviewed care records, recruitment files and other documents.
The home was rated Good for Safe, Effective and Well-led. Staff knew people's needs, risks were assessed, medicines were managed safely and staffing levels met people's needs. Care plans had been rewritten and now gave clearer information about people's choices and support.
The home had improved from Requires Improvement at the previous inspection in April 2022. The earlier breaches about person-centred care and consent had been put right. The overall rating became Good, but Caring and Responsive were not assessed during this focused inspection and their previous ratings were used.
Clearer care plans
The care plans reviewed had been fully rewritten. They gave practical information about people's needs, preferences and how staff should support them.
“All had been fully replanned since we last inspected and now reflected people's needs and how they needed or wished their care to be delivered.” from the report
Choice and positive risk
People were supported to make choices and take part in activities such as horse riding and swimming. Risks were assessed so they could take part safely.
“People were encouraged to take positive risks which contributed to them having fulfilling lives.” from the report
Medicines management
The report found that medicines were given as prescribed. Records were complete and care plans included instructions for medicines needed occasionally.
“Medicines were safely managed. People received their medicines as prescribed.” from the report
Improved leadership
The management team was described as more stable. Staff and relatives reported that the home had improved and that leaders were approachable.
“Without exception, we received positive feedback about the management team from staff.” from the report
Support for people's lives
People had regular meetings with key workers about their goals and hopes. The home also provided activities, outdoor space and opportunities to be involved in the local community.
“People and their key workers met monthly and completed a 'wheel of engagement' meeting.” from the report
Recent choking incidents
seriousOne person had two recent choking incidents after getting food they could not safely manage. The home had responded by providing one-to-one staff support at mealtimes, but this is an important issue to discuss.
“There had been 2 recent incidents of choking due to the person having foods they could not manage.” from the report
Use of agency staff
minorReliance on agency staff had reduced after new staff were recruited, but agency workers were still being used for annual leave and sickness cover. Ask whether the home is now fully staffed as planned.
“Reliance on agency staff had significantly reduced however they were still needed for annual leave and sickness cover.” from the report
Specialist eating disorder support
needs fixingThe manager had found it difficult to obtain support for a specific eating disorder. They were still pursuing help from care managers and health professionals.
“The registered manager had struggled to get support for a specific eating disorder.” from the report
- 01Have you now reached the planned full staffing level, and how often are agency staff currently used?
- 02What happened after the two recent choking incidents, and what safeguards are now in place at mealtimes?
- 03What progress has been made in obtaining specialist support for the person's eating disorder?
- 04What are the current ratings for Caring and Responsive, which were not assessed during this inspection?
- 05How will you continue to check that the rewritten care plans accurately reflect each person's needs and choices?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 26 July 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, April 2022
Rated Requires Improvement; care was kind and more personalised, but care records, legal decisions and management still needed fixing.
This was an unannounced follow-up inspection on 15 and 16 March 2022. Inspectors spoke with people, relatives, staff and professionals. They reviewed care records, medicines records and recruitment information, and checked infection control.
The home had improved since the previous inspection, when it was rated Inadequate and placed in special measures. People were safer, medicines were better managed, communication support had improved, and care was more personalised. Inspectors rated caring and responsive care as Good.
Important problems remained. Risk assessments and care plans were not always accurate. Records about people's ability to make decisions and best-interest decisions were sometimes inconsistent or contradictory. There was no registered manager in post during the inspection, and the home still relied on agency staff.
The overall rating changed from Inadequate to Requires Improvement, and the home was no longer in special measures. The provider remained in breach of Regulations 9 and 11. CQC asked for an action plan and said it would continue to monitor progress.
Kind and respectful care
Inspectors saw staff treating people with patience, warmth and respect. People said they felt listened to and valued.
“People were treated with kindness, respect and compassion. People's privacy and dignity was respected.” from the report
Improved safety
The home had improved its safeguarding, incident reporting and infection control. It was no longer in breach of the earlier safe care regulations.
“The provider's systems, processes and practices generally protected people from avoidable harm.” from the report
Better personalised support
People were taking part in more chosen activities and were being supported to build everyday skills and independence.
“People were receiving more personalised care than when we last inspected.” from the report
Improved medicines management
Medicines were stored securely, staff had relevant training and checks, and the number of medicine errors appeared to be falling.
“There had been improvements in medicine administration since our previous inspection, and we found that people's medicines were well managed.” from the report
More positive management culture
Inspectors found a clearer improvement plan and managers who were more visible, open and willing to act on concerns.
“The current management team had worked very hard to develop a positive culture in which staff valued and promoted people's individuality, protected their rights and enabled them to develop.” from the report
Care records were not always accurate
needs fixingSome care plans did not describe people's current needs or the support staff were providing. The provider was reviewing them, but this work was incomplete.
“Care plans did not always accurately describe people's care needs or the care being delivered by staff.” from the report
Mental capacity records
seriousRecords did not always show that legal requirements had been followed when assessing people's ability to make decisions or making decisions in their best interests.
“Records of people's capacity to make decisions and best interest decisions were inconsistent and were sometimes contradictory.” from the report
Risk assessments
needs fixingSome risks were not properly assessed, or information in risk assessments conflicted with care plans. Managers accepted that further improvement was needed.
“Risks to people were not always properly assessed or sometimes conflicted with other information in people's care plans.” from the report
Agency staffing and cancelled activities
needs fixingThe home generally had enough staff, but it relied on agency workers and occasional shortages meant activities and trips were cancelled. Relatives were more confident with regular staff.
“There were occasional shortages due to staff sickness which could not be covered and this affected what people were able to do.” from the report
Family communication
needs fixingCommunication had improved but relatives and professionals still reported problems getting information from the home and messages being passed between staff.
“Feedback from families continues to highlight concern about being able to communicate with the site to find out how things are, as well there being evidence of poor communication between staff, such as messages not passed on or responded to.” from the report
No registered manager
needs fixingThere was no registered manager in post when inspectors visited. The provider said a new manager had been recruited and would start shortly.
“At the time of our inspection there was not a registered manager in post.” from the report
- 01Who is now the registered manager, and when did they start?
- 02How will you make sure my relative's care plan and risk assessments are accurate and updated when their needs change?
- 03How do you check that mental capacity assessments and best-interest decisions are legally correct and consistent?
- 04How often are agency staff used, and how do you make sure they know my relative's needs and communication methods?
- 05What is being done to prevent activities and trips being cancelled and to improve communication with families?
This was an unannounced follow-up inspection covering all five key questions and infection control, carried out after the previous Inadequate rating and action plan. This explanation was written from the published report of 27 April 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Ivers
6 rated inspections over 6 years: the service has held its Good rating throughout.
- July 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2022Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- September 2021Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- September 2020Requires improvementstayed Requires improvementSafe: Requires improvementCaring: Requires improvementWell-led: Requires improvement
- June 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2020
Registered with the Care Quality Commission on 21 September 2020.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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15 live-in carers within about an hour of Dorset
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,040 to £1,340 a week. 11 can care for a couple. 10 years' experience on average.
“Even when things get a bit chaotic (as they sometimes do!), you’ve handled it with patience and a sense of humour — which is gold.”
“Nina was patient, focussed on my aunt's physical well-being, and unfazed by what at the time was a new and uncertain situation”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.