About the service: Ivy Mead is a care home for up to 20 people of various ages. Most people have a learning disability and/or mental health needs. It is split into two separate houses. At the time of the inspection 19 people were living in the service.

People’s experience of using this service:

The service did not consistently apply the principles and values of Registering the Right Support and other best practice guidance. This guidance helps ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice and independence. The service promoted independence and provided person-centred support within the constraints of a environment where a large number of people shared communal facilities and head office staff were based close to bedrooms. People were encouraged to access the community and undertake person centred activities. The provider had plans to improve the layout of the home and the environment which would help ensure the principals and values were consistently applied.

People said they felt safe living in the home. Safeguarding procedures were in place and we saw evidence they were followed to help keep people safe.

We saw some good examples of suitable risk management plans. However, some risk management processes needed improving to ensure there was clear guidance available to support staff in keeping people safe. Some checks on the medicine management system needed to be more robust to ensure all medicines were accounted for.

We found there were enough staff with the rights skills to care for people. Safe recruitment procedures were in place which involved people who used the service. Staff received a range of training and support relevant to their role.

Appropriate DoLS assessments had been carried out by the service. Care was delivered in the least restrictive way possible. Some improvements were needed to mental capacity assessments and related care plans to clearly demonstrate correct procedures had been followed. This had been identified by the service and was in the process of being addressed.

People received person centred care and support. Staff were kind and compassionate and treated people well.

Some systems needed to be made more robust to ensure the service provided a consistent high-quality service. However, we felt assured by the management team who were committed to continuous improvement of the service.

Rating at last inspection: The service was rated Good at the last inspection in July 2016.

Why we inspected: This was a planned inspection based on the date of the last inspection.

Enforcement: We found one breach of regulation and issued a requirement action. Please see the end of the full report for details of the concern.

Follow up: We have asked the provider to send us an action plan detailing how they will make the required improvements to the service.

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

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.”

This inspection took place on 27 June 2016 and was unannounced. The inspection was undertaken by an adult social care inspector. The home was previously inspected on January 24 2014 and was compliant.

Ivy Mead is a care home registered to provide accommodation and personal care for up to 19 people with learning disabilities. Ivy Mead consists of two separate houses one with ten bedrooms and the other with nine bedrooms, which is for females. The home is situated in the residential area of Lundwood close to the town of Barnsley.

The service had a registered manager in post at the time of the inspection. 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 we spoke with told us the service provided good care and support. They told us they felt safe, the staff were caring, kind and respected their choices and decisions.

Medicines were stored safely and procedures were in place to ensure medicines were administered safely, although some minor concerns had been identified around the recording of medication.

We found the service to be meeting the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The staff we spoke with had a good understanding and knowledge of this.

People were involved in menu planning and meal preparation. We saw people were able to choose what they wanted to eat. There was plenty of choice.

Staff respected people’s privacy and dignity and spoke to people with understanding, warmth and respect.

People’s needs had been identified, and from talking to people and observing staff supporting people, we found people’s needs were met by staff who knew them well.

Care records we saw detailed people’s needs and how best to support people in making decisions. People had been involved in their care planning.

There was a robust recruitment system and all staff had completed an induction. Staff had received formal supervision and annual appraisals of their work performance.

There were systems in place for monitoring quality, which were effective. Where improvements were needed, these were addressed and followed up to ensure continuous improvement.

The service had received only one complaint since our last inspection, and the registered manager had responded appropriately to the complaint. Information on how to report complaints was clearly displayed in the service

Staff and people who used the service who we spoke with told us that the managers were approachable and the service was well led.

We found there were effective processes in place to ensure people’s consent to treatment and capacity to make decisions had been adequately managed.

We found people’s care and welfare needs had been met. We talked with five people who used the service. People told us they were happy at the service and felt well supported by staff. Some comments captured included, “Yes it’s nice here,” “[Staff] look after us well,” “Okay living here,” “Happy [here],” “They’re nice [staff] I like everybody,” and “It’s alright here.”

We found there were effective recruitment and retention processes in place.

We found there was a complaints process in place.

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

People told us that the staff were nice and listened to them. They said that they could do what they wanted, including “Going out for a walk”. They said “I can go to bed and get up when I want and I can choose what to have for my meals”. People told us they felt their needs were met in the home. When asked people confirmed that staff gave them the right support to live their lives.

People told us they felt there were enough staff working in the home. When we asked people told us they felt safe and that they were able to raise any concerns. They said, “I know what to do I’ve got a copy of the policy and I would speak to Kerry ( the manager) if she couldn’t help she would get advice for me” and “I would tell Kerry and she would sort it out for me.”

We saw that people had been supported with living their lives by the use of advocacy and that they were provided with information about living in the home prior to moving in. We observed that interactions between people who lived in the home and staff were positive and helpful, with staff providing information to people to help with decision making.

People were supported to live their lives through a care planning approach that identified their needs and which was reviewed on a monthly basis. Systems were in place to help protect people from harm with staff having received training on the safeguarding of vulnerable adults. Staff were aware of how to handle any complaints raised in the home.

During our inspection visit 10 January 2012 we talked to several people who reside in both houses at the home. People made clear through various form of communication that they were happy at the home, liked all the staff, liked their bedrooms and the various activities they were involved in. One person explained how they were “happy with everything” and felt “attached to it [the home]” because they had been happy living there the last eight years.