Reach Ivy Cottage

Updated 22 August 2019

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

This inspection was carried out by one inspector.

Service and service type

Reach Ivy Cottage 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 and professionals who work with the service. We used the information the provider sent us in the 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 read the report of a recent visit by Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service. We had discussions with the operations manager who line manages the service and the deputy manager.

We looked at a range of records. These included two people’s care plans, three staff recruitment and development files, the staff training matrix and staff meeting minutes. Medicines storage and administration records were looked at. We checked a sample of internal audits, audits by the provider, accident and incident forms. Other records included maintenance and upkeep of the premises, health and safety records.

After the inspection

The provider facilitated contact with people’s relatives or friends by seeking their permission for us to have their email addresses or telephone numbers, so we could ask them for feedback. We then contacted five relatives or friends.

We also asked the provider to pass the inspector’s email address to staff, to invite them to provide feedback.

The registered manager was on leave at the time of our visit. We contacted them by telephone on 6 August 2019, to speak with them about the service.

Updated 22 August 2019

About the service

Reach Ivy Cottage provides care for up to eight adults in one building, close to the town centre In Aylesbury. At the time of the inspection it was providing support to seven younger adults with a range of learning disabilities, autism spectrum disorder, physical disabilities and mental health problems.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures 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. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them. There were deliberately no identifying signs, intercom, cameras or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

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 service supported this practice.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People were relaxed around staff and said they received the support they needed. Relatives and friends spoke positively about the home. Comments included “The quality of his care is very good and his needs are well met at Ivy Cottage” and "The care offered at Ivy Cottage is exceptional; it totally fulfils (name of person)'s needs."

A community professional told us “The service is of a good standard and well organised in my experience…feedback requested from them has been very efficient and the staff manage some complex residents very well.”

There were enough staff to provide the support people needed. Staff were trained and supervised to make sure they met people’s needs effectively. They had been recruited using robust procedures.

People were supported to access healthcare services and their medicines were managed well. People were treated with dignity and respect. Their care plans were detailed and outlined the support they needed. These records were regularly reviewed to make sure they reflected changes to people’s circumstances. Written risk assessments were in place to identify and help reduce the likelihood of people experiencing injury or harm.

The service was managed well. Staff understood their responsibilities and worked together as a team. There were systems to monitor the quality of people’s care to make sure it was effective and safe.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the provider at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used positive behaviour support principles to support people in the least restrictive way. Some minor restrictive intervention practice was used as a last resort, in a person-centred way, in line with positive behaviour support principles.

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 Good (report published 25 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.