CQC report explained · a residential care home
What the CQC found at Ivy Bank Residential Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Good
- People were protected from avoidable harm. There were enough staff, recruitment checks were completed, medicines were generally managed safely, and infection prevention measures were in place.
- Effective?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
- Well-led?
- Requires improvement
- Management and leadership were inconsistent. Written guidance and care records were incomplete in some areas, and audits did not reliably identify problems.
What inspectors found, December 2022
Ivy Bank Residential Care Home is rated Requires Improvement; inspectors found safe care but weaknesses in guidance, records and quality checks.
This was an unannounced, focused inspection on 25 October 2022. Inspectors reviewed Safe and Well-led, following concerns about restrictions on visiting. They spoke with people, relatives and staff, and checked care, medicines, recruitment and management records.
The home was rated Good for Safe. People and relatives said they felt safe and comfortable. There were enough staff, risks were usually managed, medicines were generally given safely, and infection control and building safety checks were in place.
The home was rated Requires Improvement for Well-led. Staff did not always have enough written guidance about how to support people, including with hoists, choking and end-of-life wishes. Management checks had also failed to find some medicines record errors and gaps in care plans. The overall rating was Requires Improvement, partly because the other key question ratings were carried forward from the previous inspection.
People felt safe
People and relatives told inspectors they felt safe and comfortable. Staff knew how to recognise and report abuse.
“People and their relatives told us people were safe living at Ivy Bank Residential Care Home.” from the report
Enough trained staff
Inspectors found enough staff to meet people's needs. Recruitment checks had been completed and staff had relevant skills, including moving and handling.
“There were enough staff on duty to offer people the care they needed.” from the report
Positive staff culture
Staff felt supported and appreciated. Relatives described the care and dedication of staff positively.
“The staff are platinum. I can't fault the care and devotion of the staff” from the report
Infection control
The home had measures in place to reduce infection risks. Inspectors were assured that personal protective equipment and hygiene arrangements were being used safely.
“We were assured that the provider was using PPE effectively and safely.” from the report
Incomplete care guidance
seriousStaff did not have detailed guidance for all areas of people's care. This included how to use hoists, what to do if someone choked, and some people's end-of-life wishes.
“Staff knew how to meet people's needs but detailed guidance was not in place for them to follow for all areas of people's care.” from the report
Weak management checks
seriousAudits did not identify inaccurate medicines stock records or gaps in care plans. The report says the provider's systems were not effective enough to monitor and improve quality and safety.
“The provider and registered manager had failed to operate effective systems to assess, monitor and improve the quality and safety of the service.” from the report
Some confusion about visits
needs fixingVisiting restrictions had been removed, but some relatives did not know they could visit people's bedrooms.
“However, some relatives were not aware they were able to visit their loved one's bedroom.” from the report
- 01What written guidance is now in place for staff about hoist equipment and techniques?
- 02What instructions do staff have about what to do if a person chokes?
- 03Have all residents' end-of-life wishes, including preferred place, visitors and spiritual or cultural needs, been recorded?
- 04How are medicines stock balances now checked so that errors are found promptly?
- 05Can relatives visit their loved one's bedroom, and how is this information explained to families?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried forward from the previous inspection. This explanation was written from the published report of 16 December 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.
What inspectors found, January 2020
Ivy Bank Residential Care Home rated Good; inspectors found safe, kind care, with some improvements still being completed.
Inspectors visited on 12 and 19 November 2019. The first day was unannounced and the second day was arranged. They spoke with people, relatives and staff, observed care, and checked care plans, medicines, recruitment, training and quality records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines systems, personalised care, kind staff and regular checks on the quality of the service.
The home had improved since the previous inspection. Earlier problems with risk assessments, care plans, audits and activities had been addressed, so the home was no longer breaching regulations.
Some work was still under way. Training updates were overdue, end of life wishes had not yet all been added to care plans, and minor complaints were not being recorded consistently.
Safer risk planning
The home had improved its assessment and management of risks such as falls, choking, diabetes and epilepsy. Staff had clear guidance about the support people needed.
“Individual risk assessments and plans of care had been developed for epilepsy, diabetes, choking and falls.” from the report
Kind and respectful staff
Inspectors saw staff showing patience, compassion and kindness. People were supported with privacy, personal care and independence.
“All staff including housekeeping and kitchen staff were observed to demonstrate compassionate attitudes towards people with spontaneous expressions and acts of kindness” from the report
Personalised activities
The home had introduced a programme of activities, including group sessions and individual time. Relatives were positive about the improvements.
“An activities co-ordinator had since been employed. A programme of activities was displayed with pictorial prompts to help people understand.” from the report
Improved leadership
The new manager had introduced clearer lines of responsibility and regular checks on care, medicines and health and safety.
“At this inspection we saw improvements in all these areas. The new manager demonstrated drive and determination to improve overall compliance.” from the report
Overdue training
needs fixingSome staff training updates had not happened while the home was without a manager. Courses had been booked, but inspectors said they would check progress at the next inspection.
“The absence of a manager however, had meant training updates had not happened and were overdue.” from the report
End of life information
needs fixingPeople and relatives had discussed end of life wishes, but these had not yet all been added to care plans. The manager agreed to take action.
“The manager was still to add peoples end of life preferences to the care plan to ensure their wishes were respected.” from the report
Minor concerns not recorded
minorPeople and relatives felt able to raise concerns and said issues were resolved quickly. However, minor concerns were not recorded, making it harder to monitor them.
“However, no record was kept of the minor concerns raised so these could be monitored.” from the report
Areas needing upgrading
minorThe home was generally clean, but an odour was found in two small areas. The laundry was described as tired and in need of upgrading.
“The laundry was well equipped, but the environment was tired and in need of upgrading, which was planned.” from the report
- 01Have all overdue staff training updates now been completed, and how do you check staff remain competent?
- 02How will my relative's end of life wishes be recorded in their care plan and kept up to date?
- 03How do you record, investigate and monitor minor concerns raised by people or relatives?
- 04What improvements have been made to the tired laundry and the areas where inspectors found an odour?
- 05How do you make sure staff understand when an incident between people may need to be treated as a safeguarding concern?
This was a planned inspection covering all five CQC questions, including both the care provided and the premises; the previous Requires improvement ratings were reassessed. This explanation was written from the published report of 21 January 2020 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 Ivy Bank Residential Care Home
6 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- December 2022Requires improvementcurrent ratingdown from GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Ivy Bank Residential Care Home →
- January 2020Goodup from Requires improvementSafe: GoodWell-led: Good
Read what inspectors found at Ivy Bank Residential Care Home →
- December 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- April 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- April 2011
Registered with the Care Quality Commission on 6 April 2011.
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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