CQC report explained · a residential care home
What the CQC found at Ivy House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Some risks to people's health, safety and welfare were not thoroughly assessed or managed. Inspectors also found environmental risks, missing fire risk assessment arrangements and missing personal emergency evacuation plans where needed.
- Effective?
- Requires improvement
- Needs were not always fully assessed before people moved in, and care plans did not always give staff enough guidance. Mental capacity assessments and best-interest decisions were not always recorded correctly.
- Caring?
- Good
- This key question was not inspected during this visit. Its previous rating was carried forward to calculate the overall rating.
- Responsive?
- Good
- This key question was not inspected during this visit. Its previous rating was carried forward to calculate the overall rating.
- Well-led?
- Inadequate
- Quality checks and audits were not effective, and earlier problems had not been properly addressed. Inspectors said leadership shortfalls put people at continued risk of harm.
What inspectors found, May 2022
Ivy House is rated Requires Improvement overall; inspectors found unsafe risk management and inadequate leadership, although medicines, infection control and staff recruitment had improved.
This was a focused inspection on 24 March 2022. Inspectors checked Safe, Effective and Well-led, including care records, medicines, staff files, management records and feedback from people, relatives, staff and professionals.
They found continuing problems with risk assessments, care plans, consent records, staff induction and management checks. People were at increased risk because some risks in the home had not been identified or managed. The provider began addressing several concerns during and after the inspection.
Safe and Effective remained Requires Improvement. Well-led fell from Requires Improvement to Inadequate. Caring and Responsive were not inspected, so their previous ratings were used in the overall rating. The home had been rated Requires Improvement at the previous inspection and remained in breach of regulations.
People felt safe
People and relatives said they felt safe with the care and support. Staff had safeguarding training and understood how to report concerns.
“People felt safe with the care and support staff provided. Relatives told us, "From a safeguarding point of view I have no worries at all” from the report
Infection control
The provider had improved infection prevention and control enough that it was no longer in breach in this area. Inspectors were assured that COVID-19 measures and visiting guidance were being followed.
“We were assured the provider was preventing visitors from catching and spreading infections.” from the report
Accessible environment
The home had accessible facilities and equipment intended to support people's needs and independence.
“The service had been designed and adapted to help meet people's needs. There were accessible washing facilities, wide doorways and corridors, and a lift and lifting equipment installed throughout the service to improve accessibility.” from the report
Risks were not managed
seriousCare plans and risk assessments did not always explain people's risks or how staff should support them safely. Inspectors also found unsecured furniture, keys left in window restrictors and no fire risk assessment.
“People were at increased risk of harm, because risks had not been thoroughly assessed and managed.” from the report
Consent records
seriousThe home did not always follow the Mental Capacity Act. Records did not consistently show capacity assessments or best-interest decisions when people might not have been able to consent.
“People's ability to consent to their care and support had not always been thoroughly explored.” from the report
Weak management checks
seriousThe provider had not created effective regular audits to identify and fix problems. Inspectors said action was mainly taken after they raised concerns.
“Systems in place to monitor the quality and safety of the service remained ineffective.” from the report
Staff induction and supervision
needs fixingNew staff did not always receive a strong induction, and staff did not have regular supervision or yearly appraisals. Some training gaps remained.
“New staff had not received a robust induction to the service before they started work.” from the report
- 01How have you updated each person's risk assessment and care plan, including risks in the home environment?
- 02Can you show how fire risks and personal emergency evacuation plans are now assessed and kept up to date?
- 03How do you record mental capacity assessments and best-interest decisions for people who may not be able to consent?
- 04What regular audits are now in place to identify and fix care, safety and medicines problems before they cause harm?
- 05What induction, supervision and practical training will new and existing staff receive?
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 12 May 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, July 2021
Requires Improvement; inspectors found kind, personalised care but serious gaps in safety, consent, recruitment and management.
This was the home’s first inspection. Inspectors visited on 22 June 2021, spoke with a person living there, staff, relatives and a health professional, and checked care, medicine, staff and management records.
People were treated kindly and respectfully. Staff supported choice, independence, activities and community involvement. The home provided suitable food, and staff knew people’s needs and preferences well.
However, inspectors found important safety and management problems. Risk records were incomplete, safety checks had not been done reliably, infection control was not effective, medicines guidance was incomplete, and staff recruitment checks were missing.
The overall rating of Requires Improvement means the home was not consistently safe, effective or well-led. The provider was required to submit an action plan, and the CQC issued a warning notice about governance.
Kind and respectful care
People and relatives described staff as kind and caring. Inspectors saw staff offering reassurance and building positive relationships.
“Staff were kind and compassionate with people and we saw positive relationships with people.” from the report
Choice and independence
People were supported to choose how they spent their day and to take part in daily tasks and community activities.
“People were encouraged to participate in daily activities in the community and to undertake activities of daily living with support from staff when needed.” from the report
Personalised support
Staff knew people’s likes, dislikes and support needs. People helped develop and review their care plans.
“Staff knew the people they cared for well and used this knowledge to provide personalised care.” from the report
Food and activities
The home provided varied food based on people’s preferences and arranged activities linked to their interests.
“People were provided with a varied, nutritious and balanced diet based on their preferences.” from the report
Unmanaged safety risks
seriousImportant building and equipment checks were missing or overdue. This included fire alarm testing, fire extinguisher servicing, lift safety checks and gas safety evidence.
“There was no evidence of regular fire alarm testing. Fire extinguishers servicing had expired in January 2021.” from the report
Infection control
seriousVisitors were not screened properly for coronavirus symptoms, and the home did not take part in the expected staff and people testing regime.
“Visitors were not screened for coronavirus symptoms and their temperatures were not checked on arrival to the service.” from the report
Consent and restrictions
seriousRecords did not show that capacity assessments and best-interest decisions had always been completed. This included decisions about bedrails and COVID-19 testing.
“There was a lack of information in records to show mental capacity assessments and best interest meeting records had been completed.” from the report
Recruitment checks
seriousThe provider had not always obtained references from previous employers or explored gaps in employment histories before employing staff.
“Checks such as references from previous employers were not received.” from the report
Weak management oversight
seriousThere was no manager in post, staff lacked direction and supervision, and quality audits had long gaps. The provider’s systems had not found or fixed the problems identified by inspectors.
“There was ineffective leadership at the service. Processes and effective systems were not in place to test the quality of the service and respond to failures and concerns.” from the report
- 01What has been done to complete and regularly review risk assessments, especially for epilepsy and other health conditions?
- 02Have the fire alarm, fire extinguishers, passenger lift and gas safety checks all been brought up to date?
- 03How are visitors and staff now screened and tested for COVID-19, and how are infection risks for people with underlying health conditions assessed?
- 04How do you record mental capacity assessments, best-interest decisions and the legal authorisation for any restrictions?
- 05Who is currently managing the home, and how are audits, staff supervision and action plans checked by the provider?
This was a planned comprehensive first inspection covering all five key questions, including infection prevention and control and both the premises and care provided. This explanation was written from the published report of 29 July 2021 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 House
2 rated inspections over a year: the service has held its Requires improvement rating throughout.
- May 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Inadequate
- July 2021Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- September 2019
Registered with the Care Quality Commission on 19 September 2019.
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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