The inspection of Ivy Lodge took place on 12 October 2017. We previously inspected the service on 10 March 2016. At that time we found the registered provider was not meeting the regulations relating to good governance and supporting staff. The registered provider sent us an action plan telling us what they were going to do to make sure they were meeting the regulations. On this visit we checked and found a number of improvements had been made.

Ivy Lodge is registered to provide accommodation and personal care for up to 10 people with learning disabilities and other complex health needs. The home is a two storey, purpose built building with separate garden areas. There are 10 private bedrooms with en-suite facilities, two communal lounges, one small quiet lounge and two communal kitchen/dining rooms. On the day of our inspection 10 people were living at the home.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they felt safe and this was supported by information from relatives.

Staff were safely recruited and there were sufficient numbers of staff to keep people safe. Staff received regular training, supervision and appraisal and told us they felt supported.

Behavioural risk assessments were in place to keep people and others around them safe.

Other potential risks to people had been assessed for example, financial management, alcohol consumption and self-administering of medicines to enable people to retain their independence.

Medicines were stored and administered safely. PRN (as required) protocols were in place. People were promoted to manage their own medicines where they had the capacity to do this, but improvement was required to ensure how this was determined and carried out in accordance with the registered provider’s policy and procedure for the safe management of medicines.

We recommend the registered manager review the Medications Management Policy and Procedure and where appropriate, ensure people’s capacity to self-administer their medicine is recorded within care plans.

Controlled drugs were stored safely but there was not a separate register to record the receipt and administration. Once highlighted to the registered manager this was organised this immediately.

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

Staff understood the requirements of the Mental Capacity Act 2005. Capacity was assumed and where people lacked capacity decision specific mental capacity assessments had been completed.

People were supported with their hydration and nutrition needs. The home had been awarded the highest food hygiene rating of five for good hygiene practice when handling food.

People enjoyed a wide range of activities and were encouraged to maintain life skills and have maximum control over their lives. Staff supported people to retain their independence.

Peoples’ personal records were stored confidentially in a locked room.

Care plans contained person centred information including a person’s likes and dislikes. Staff were aware of peoples’ preferences.

Regular audits took place within the home to help monitor and drive improvements.

There were well established links with the community such as, a gardening plot in the community allotment and people took part in a variety of charity fund raising events.

The inspection of Ivy Lodge took place on 12 October 2017. We previously inspected the service on 10 March 2016. At that time we found the registered provider was not meeting the regulations relating to good governance and supporting staff. The registered provider sent us an action plan telling us what they were going to do to make sure they were meeting the regulations. On this visit we checked and found a number of improvements had been made.

Ivy Lodge is registered to provide accommodation and personal care for up to 10 people with learning disabilities and other complex health needs. The home is a two storey, purpose built building with separate garden areas. There are 10 private bedrooms with en-suite facilities, two communal lounges, one small quiet lounge and two communal kitchen/dining rooms. On the day of our inspection 10 people were living at the home.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they felt safe and this was supported by information from relatives.

Staff were safely recruited and there were sufficient numbers of staff to keep people safe. Staff received regular training, supervision and appraisal and told us they felt supported.

Behavioural risk assessments were in place to keep people and others around them safe.

Other potential risks to people had been assessed for example, financial management, alcohol consumption and self-administering of medicines to enable people to retain their independence.

Medicines were stored and administered safely. PRN (as required) protocols were in place. People were promoted to manage their own medicines where they had the capacity to do this, but improvement was required to ensure how this was determined and carried out in accordance with the registered provider’s policy and procedure for the safe management of medicines.

We recommend the registered manager review the Medications Management Policy and Procedure and where appropriate, ensure people’s capacity to self-administer their medicine is recorded within care plans.

Controlled drugs were stored safely but there was not a separate register to record the receipt and administration. Once highlighted to the registered manager this was organised this immediately.

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

Staff understood the requirements of the Mental Capacity Act 2005. Capacity was assumed and where people lacked capacity decision specific mental capacity assessments had been completed.

People were supported with their hydration and nutrition needs. The home had been awarded the highest food hygiene rating of five for good hygiene practice when handling food.

People enjoyed a wide range of activities and were encouraged to maintain life skills and have maximum control over their lives. Staff supported people to retain their independence.

Peoples’ personal records were stored confidentially in a locked room.

Care plans contained person centred information including a person’s likes and dislikes. Staff were aware of peoples’ preferences.

Regular audits took place within the home to help monitor and drive improvements.

There were well established links with the community such as, a gardening plot in the community allotment and people took part in a variety of charity fund raising events.

People’s care and welfare needs had been met. People with learning disabilities are not always able to tell us about their experiences. We saw how staff members interacted positively with people in a friendly and supportive manner. We talked with five people who used the service. Some comments captured included, “It’s alright …nice, I like it here,” “I get support from staff when I need it,” and “I’m happy here.”

People were supported to have adequate nutrition and hydration.

During our inspection we conducted a tour of the premises and found it was clean and tidy. There were systems in place to reduce the risk and spread of infection.

We found people’s needs had been met by sufficient numbers of appropriate staff.

We found people were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records had been maintained.

We spoke with eight people about how they were involved in life at Ivy Lodge. One person told us, "I make all my own decisions about what I do. We have a meeting together where we plan what we want to do and the staff try to please everyone and make it fair, so that we all go out on activities, visit our family and go to any appointments we have.”

The majority of people that we spoke with told us that they were happy living in the home and that they were provided with good care and attention. People told us they liked the staff and could go to them if they had any worries or concerns. One person told us “The staff are brilliant. They show us the right way of doing things.” Two people told us they were not happy at the home. The registered manager was aware of this and was able to evidence to us the steps the service was taking to address this.

We saw that the home had appropriate systems in place to ensure that people received their medication safely. One person told us, “I haven’t got the confidence to look after my own tablets so the staff help me with them. I can stop worrying now because the staff make sure I get them at the right time.”

The provider had a satisfactory recruitment and selection procedure in place to ensure that staff were appropriately employed.

A complaints procedure was in place so that people could voice any concerns. People told us they knew how to complain and that staff always listened to them if they had any worries or concerns.

During our inspection visit conducted 17 January 2012 we talked to several people who reside at the home. Generally they told us that they liked the staff, liked their bedrooms and the various activities they were involved in. Two people told us they were not happy at the home and we passed on why to the home manager.

One person told us they liked the staff because “they’re fun…I always go and talk to them”. Another person told us they liked the staff to look after them and were helping them “move forward” to their aim of living in a flat. The parents of one person told us how happy and reassured they had been about their child living at the home. They explained the home was their child’s “new family” and “nothing was too much trouble”.