Archived: Ivers

Updated 8 September 2020

This was a targeted inspection to check on specific concerns we had about medicine administration, infection control, staffing levels, people’s compatibility, communication with families and quality assurance processes.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Ivers 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 service had a manager registered with the Care Quality Commission. A registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. We announced the inspection the day before we visited to discuss the safety of people, staff and inspectors in relation to COVID 19.

What we did before the inspection

We reviewed all of the information we had received about the service since the last inspection. We sought feedback from the local authority and from other professionals who work with the service. We had not requested the provider send us a provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We were able to gather this information, where relevant, during our inspection.

During the inspection

We spoke with three people who lived at the home about their experience of the care provided. We spoke with two assistant managers, three care staff, the registered manager and the regional manager.

We reviewed a range of records. This included people's care records and medication records.

After the inspection visit.

Between 31 July and 12 August 2020, we received feedback from one person who lived at the home and from six relatives about the quality of the service. The registered manager provided us with copies of specific care records and a range of records relating to the management of the service including staffing rotas, staff training records, audits, policies and procedures. They also sent us copies of recent compliments they had received from both people who lived at the home and from their relatives.

Updated 8 September 2020

About the service

Ivers is a care home for up to 25 people who have a learning disability or autism. The service had previously been a learning disability college but no longer operated as such. It would be unlikely that we would register this model of service now when considering applications for services for people with a learning disability and/or autism.

This is because there were several properties on one site. ‘The House’ could accommodate nine people; there were also four bungalows, Tyneham, Crantock, Kenley and Trafalgar, that could each accommodate four people. There were 19 people living at the home when we visited; four more people were staying with their families on the day of our inspection.

The provider had changed the way the service operated so that the main house and the four bungalows were each managed by a deputy manager and had separate staff teams. This was with the aim to personalise the services and to better reflect the Registering the Right Support Guidance.

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

The service was going through a period of significant change and restructuring, in an effort to create five very distinct ‘homes’ at Ivers. Each would cater for a small group of people with similar needs. This had been delayed due to the significant impact of COVID 19 both within the service itself and in the wider health and social care sector. We acknowledged the real pressures this had placed upon the service, upon people and the staff team.

Medicines were not always managed in a safe and consistent way. Infection control practice was not always in line with current guidance or best practice. Both of these issues were addressed immediately by the registered manager.

The provider and manager's oversight and monitoring of the service had improved. There was an action plan in place to address a number of improvements identified by the provider's monitoring in July 2020. This meant the service was not always providing consistent, high quality care to people.

Staff were very kind and caring and respected people's individuality and diverse needs. However, improvements were needed to ensure people living together were compatible, to make sure the service suited all people living there and to ensure staff teams had the right training and skills to provide specialist areas of support.

There were enough staff on duty to care for people, although some people’s staffing levels were being reviewed as their needs had changed. The provider had been very successful in recruiting new staff and reduce the use of agency staff. This means people were provided with more consistent staff support.

Relatives had mixed views about the quality of care, communication and their involvement in the service.

People who lived at the home told us they were happy at Ivers, well cared for and liked the staff who supported them.

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

Rating at last inspection

The last rating for this service was Requires Improvement. Our report was published in June 2019.

Why we inspected

We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns we had about medicine administration, infection control, staffing levels, people’s compatibility, communication with families and quality assurance processes. A decision was made for us to inspect and examine those risks.

CQC have introduced targeted inspections to follow up on a Warning Notice or other specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about.

Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.