Icknield Court

Updated 26 October 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by three inspectors, a specialist advisor in nutrition and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Icknield Court 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. This means that they 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 unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. Throughout the inspection we provided the service with opportunities to share information with us about improvements made.

We used all of this information to plan our inspection.

During the inspection

We spoke with 10 people during the inspection and one relative. We spoke with 16 members of staff including the registered manager, deputy manager, operations manager, care staff and ancillary staff. At the end of the day of the inspection we spoke with the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records whilst on site and requested some to be sent to us. This included 10 people's care records in full, two people’s nutrition records. We looked at 16 people's medicines records. We looked at four staff files in relation to recruitment, five agency staff profiles and seven staff development records. We looked at training records for the whole home. We looked at a range of records relating to the management of the home, these included, health and safety records related to fire checks and certificates for gas and electrical safety and incident reports. We looked at staffing allocations, handover records, complaints, compliments, staff meeting minutes, relatives’ and residents’ meeting minutes. We looked at the provider’s audits carried out by senior staff.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We contacted staff, relatives and community professionals to seek feedback from them.

Updated 26 October 2021

About the service

Icknield Court is a residential care home registered to provide personal care and support for up to 90 people aged 65 and over, some of whom are living with dementia. There were 37 people living at the home at the time of the inspection. People’s living accommodation is across two floors, each floor had separate areas called houses. There were six houses in total. Each house had seating areas, dining space and kitchen facilities. People had individual bedrooms with level access shower and toilet facilities. We observed people had free access to a large courtyard area. The home was bright and well- maintained.

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

People told us they felt safe living at the home. Comments included “Yes, I think I feel safe, very safe, living here, it is the right environment for me”, “I think we know that we are in a safe home and in safe hands”. Another person told us “I am 95 years old and I know that I could move and live here (permanently) … and I would be comfortable here, at the moment I wouldn’t change anything here and if something is wrong you only have to open your mouth and it is usually done”.

Records we viewed were not routinely consistent, accurate and complete. We found some further improvements were required to ensure people’s records reflected their needs and were updated in a timely manner.

People were not routinely supported by staff who ensured robust medicine management was in place or best practice guidance was followed. We found improvements were required in the records held about people’s prescribed medicines.

Each person had care plans in place for staff to follow, which describes their likes and choices. However, where people were staying short term at the home, these care plans were less comprehensive. We have made a recommendation about this in the report.

People were supported by staff who had been recruited safely and had been provided with training and support to ensure they had the right skills and attributes to work with them.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the home supported this practice.

People were supported by a management team who were keen to ensure they experienced a good level of well-being. The registered manager had supported staff to understand the expected level of quality of care to be provided to people. We received positive feedback about the management team.

The home management team worked well with external healthcare professionals. One GP commented “Understanding of residents’ needs and medical conditions has been excellent”.

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

Rating at last inspection and update

The last rating for this service was inadequate (published 23 September 2020) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.

At this inspection we found some improvements had been made, however we found enough improvement had not been sustained and the provider was still in breach of regulations.

This service has been in Special Measures since December 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 17, 18 and 19 September 2019. Breaches of legal requirements were found. We took enforcement action and issued warning notices for regulation 12 and 17. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, person-centred care, support for staff and good governance. We carried out a focused inspection on 29 and 30 July 2020 to check if the warning notices had been met. We found the provider was still in breach of regulations in the areas of safe care and treatment and good governance. Following the focused inspection, a decision was made not to escalate any enforcement. We took into account the impact of the COVID 19 pandemic.

We undertook this focused inspection to check what action had been made since the last inspection and to confirm the service’s compliance with legal requirements. This report only covers our findings in relation to the key questions Safe, Effective and Well-led.

The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the Safe and Well-led sections of this full report.

Enforcement

We have identified breaches in relation to medicine management and good record management at this inspection.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Icknield Court on our website at www.cqc.org.uk.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.