CQC report explained · a residential care home
What the CQC found at Ivy Mead
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Medicines, staffing, risk assessments and infection control were generally managed safely, but records for some topical creams were not detailed enough.
- Effective?
- Good
- People's needs and choices were recorded and reviewed. Staff had training and support, people were helped to eat and drink healthily, and health professionals were contacted when needed.
- Caring?
- Good
- This question was not assessed during this focused inspection.
- Responsive?
- Good
- This question was not assessed during this focused inspection.
- Well-led?
- Good
- The home had clear leadership, governance systems and a person-centred vision. People, relatives and staff were involved through meetings and surveys.
What inspectors found, December 2020
Ivy Mead is rated Good; inspectors found safe, effective and well-led care, with improved systems since the previous inspection.
The inspection took place on 11 November 2020. It was an unannounced comprehensive inspection originally, followed by this focused inspection to check whether the home had completed its improvement plan. One inspector spoke with people, relatives and staff, and reviewed care, medicines, staff and management records.
The home was rated Good overall. Safe, Effective and Well-led were rated Good. Inspectors found that people received their medicines as prescribed, risks were assessed, staffing was sufficient, infection control measures were in place, and staff were trained and supported.
There was one recommendation about records for topical creams given when needed. These records did not always say clearly when and where the creams should be applied, although staff knew this information.
The previous rating was Requires Improvement, published on 5 August 2019. Inspectors found improvements had been made and said the home was no longer in breach of regulations. Caring and Responsive were not assessed during this focused inspection.
Safe medicines administration
Staff who gave medicines were trained and assessed as competent. Medicine records contained the information needed for safe administration.
“People received their medicines safely.” from the report
Risk management
Risks were assessed, reviewed and managed with the least restrictive approach where possible. Staff shared relevant information with people and relatives.
“Risks to people's safety were assessed and action taken to mitigate those risks.” from the report
Personalised support
Care plans included detailed information about people's needs and choices. People were involved in their support and in decisions about their environment.
“Support plans contained detailed information about people's care and support needs, and people had been involved in these.” from the report
Leadership and oversight
The home had a clear vision, regular audits and systems for tracking improvements. People, relatives and staff were asked for their views.
“There was a clear governance framework. Surveys and meetings involved people, relatives and staff in how the service was managed.” from the report
Topical cream instructions
needs fixingRecords for some creams prescribed for use when needed did not clearly explain when and where they should be applied. Inspectors made a recommendation to improve this information, although staff knew what to do.
“Records for people who had been prescribed topical creams on an 'as and when basis' did not contain enough information about when and where they should be applied, although staff were very knowledgeable about these.” from the report
Delayed refresher training
minorSome refresher training had not taken place during the COVID-19 pandemic. The home made alternative arrangements and later provided an update showing that training had been completed.
“During the Covid-19 pandemic some of the refresher training had not taken place, however management had made alternative arrangements to ensure staff remained competent.” from the report
- 01How do you now record when and where each topical cream should be applied?
- 02What checks make sure staff follow the updated topical cream instructions?
- 03Has all refresher training remained up to date since the inspection?
- 04How will you continue to review risks and learn from accidents and incidents?
- 05How do you involve people and relatives in decisions about the home and their support?
This was a focused inspection of Safe, Effective and Well-led, including infection prevention and control; Caring and Responsive were not assessed and the previous ratings for those areas were carried over. This explanation was written from the published report of 11 December 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.
What inspectors found, August 2019
Rated Requires Improvement; inspectors found kind, person-centred care but gaps in medicines checks and risk management.
The inspection was unannounced and took place on 22 March 2019. The inspector spoke with people living in the home, staff, managers and relatives. They observed care, reviewed care records and checked the home's records and audits.
People were treated kindly and supported to make choices, build independence and take part in activities. The home had enough staff, followed safeguarding procedures and provided suitable training. People said they felt safe and were happy with the care.
The inspectors found important weaknesses. Medicine stock records did not always match the tablets held. Some risk assessments, including one about unsafe food, did not give staff clear enough instructions. Records about mental capacity and best-interest decisions also needed improvement.
The overall rating fell from Good at the previous inspection in July 2016 to Requires Improvement. Safe and Effective were rated Requires Improvement. Caring, Responsive and Well-led were rated Good. The provider was required to send an action plan after one breach of Regulation 12.
Kind and respectful staff
People were treated with dignity and staff had developed good relationships with them. Inspectors saw a pleasant atmosphere and positive interactions.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Support for independence
People were supported to build confidence, access the community and take positive risks. Some people developed work and volunteering opportunities.
“The service supported people to become as independent as possible.” from the report
Activities and community life
People had a good range of activities and social opportunities. Staff supported people to go out during the day and to take holidays if they wished.
“We saw people had a good range of activities and social opportunities.” from the report
Staffing and training
Inspectors found enough staff with suitable skills. Recruitment checks were completed, and training was kept up to date.
“We found there were enough staff with the rights skills to care for people.” from the report
Medicine records did not always match stock
seriousOn three occasions, the number of tablets held did not match the records. A recorded discrepancy had not been investigated, so the home could not always account properly for medicines.
“we identified three occasions when the number of tablets in stock did not match with what records stated should have been present.” from the report
Food safety risk was not clearly managed
seriousOne person's food risk assessment and care plan did not clearly tell staff which foods were safe. The report records that a high-risk food was eaten, and this contributed to the Regulation 12 breach.
“These did not adequately take into consideration the risk related to the person's everyday meals and what it was safe to consume, considered alongside their capacity and understanding.” from the report
Some risk assessments lacked clear guidance
needs fixingTwo people's road-safety assessments did not explain clearly enough how staff should reduce the risks. The home was also not using some screening tools to establish risks such as choking or poor nutrition.
“two people's risk assessments referenced risks associated with road safety but did not provide adequate instruction to staff on how to reduce those risks.” from the report
Capacity records needed improvement
needs fixingSome records did not clearly show that the correct process had been followed when people might lack capacity to make particular decisions. The home had started reviewing these records.
“Some improvements were needed to the quality of capacity assessments and best interest documentation to demonstrate the correct procedures had been consistently followed.” from the report
The building did not fully support the guidance
minorThe layout and shared accommodation did not fully meet the guidance about helping people with learning disabilities live full, independent lives. Some furniture and decoration were damaged or worn.
“The design of the building meant the service did not fully comply with the Registering the Right Support guidance.” from the report
- 01What changes have been made to medicine stock checks, and how are discrepancies now investigated and recorded?
- 02How do staff identify and manage choking, nutrition and food risks for each person?
- 03How have mental capacity assessments and best-interest records been reviewed since the inspection?
- 04What improvements have been made to the shared areas, furniture and decoration?
- 05How does the home make sure safeguarding incidents are reported to the CQC promptly?
This was an unannounced planned inspection of the overall service and all five CQC questions, following the previous inspection in July 2016. This explanation was written from the published report of 8 August 2019 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 Mead
3 rated inspections over 4 years: the service has held its Good rating throughout.
- December 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Good
- October 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 14 January 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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