29 July 2020
During an inspection looking at part of 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.