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CQC report explained · a residential care home, run by Achieve Together

Ivers

Hains Lane, Marnhull, Sturminster Newton, DT10 1JU

Goodpublished 26 July 2023, 3 years ago

Rated Good: inspectors found the service performing well and meeting their expectations.

The five questions inspectors ask
Safe?
Good
People were protected from avoidable harm. Risks, medicines, infection control, staffing and recruitment were managed appropriately, although agency staff were still used for annual leave and sickness cover.
Effective?
Good
Care plans had been rewritten to reflect people's needs and choices. Staff training, mental capacity records and best interest decisions had improved, but the report noted two recent choking incidents involving unsafe food.
Caring?
Good
This key question was not inspected during this focused visit. The previous rating was carried forward when calculating the overall rating.
Responsive?
Good
This key question was not inspected during this focused visit. The previous rating was carried forward when calculating the overall rating.
Well-led?
Good
Leadership was described as stronger and more stable after several management changes. Relatives and staff gave mostly positive feedback, and the home had systems for audits, meetings and reporting significant events.
The latest report, explained

What inspectors found, July 2023

Rated Good, up from Requires Improvement; inspectors found safer, more person-centred care, with some reliance on agency staff and recent choking incidents to consider.

This was an unannounced focused inspection. An inspector visited on 15, 18 and 30 May 2023. Inspectors spoke with or observed 9 people, contacted relatives, spoke with staff and reviewed care records, recruitment files and other documents.

The home was rated Good for Safe, Effective and Well-led. Staff knew people's needs, risks were assessed, medicines were managed safely and staffing levels met people's needs. Care plans had been rewritten and now gave clearer information about people's choices and support.

The home had improved from Requires Improvement at the previous inspection in April 2022. The earlier breaches about person-centred care and consent had been put right. The overall rating became Good, but Caring and Responsive were not assessed during this focused inspection and their previous ratings were used.

What inspectors praised

  • Clearer care plans

    The care plans reviewed had been fully rewritten. They gave practical information about people's needs, preferences and how staff should support them.

    “All had been fully replanned since we last inspected and now reflected people's needs and how they needed or wished their care to be delivered.” from the report

  • Choice and positive risk

    People were supported to make choices and take part in activities such as horse riding and swimming. Risks were assessed so they could take part safely.

    “People were encouraged to take positive risks which contributed to them having fulfilling lives.” from the report

  • Medicines management

    The report found that medicines were given as prescribed. Records were complete and care plans included instructions for medicines needed occasionally.

    “Medicines were safely managed. People received their medicines as prescribed.” from the report

  • Improved leadership

    The management team was described as more stable. Staff and relatives reported that the home had improved and that leaders were approachable.

    “Without exception, we received positive feedback about the management team from staff.” from the report

  • Support for people's lives

    People had regular meetings with key workers about their goals and hopes. The home also provided activities, outdoor space and opportunities to be involved in the local community.

    “People and their key workers met monthly and completed a 'wheel of engagement' meeting.” from the report
What inspectors were concerned about

  • Recent choking incidents

    serious

    One person had two recent choking incidents after getting food they could not safely manage. The home had responded by providing one-to-one staff support at mealtimes, but this is an important issue to discuss.

    “There had been 2 recent incidents of choking due to the person having foods they could not manage.” from the report

  • Use of agency staff

    minor

    Reliance on agency staff had reduced after new staff were recruited, but agency workers were still being used for annual leave and sickness cover. Ask whether the home is now fully staffed as planned.

    “Reliance on agency staff had significantly reduced however they were still needed for annual leave and sickness cover.” from the report

  • Specialist eating disorder support

    needs fixing

    The manager had found it difficult to obtain support for a specific eating disorder. They were still pursuing help from care managers and health professionals.

    “The registered manager had struggled to get support for a specific eating disorder.” from the report
Questions to ask them, based on this report
  1. 01Have you now reached the planned full staffing level, and how often are agency staff currently used?
  2. 02What happened after the two recent choking incidents, and what safeguards are now in place at mealtimes?
  3. 03What progress has been made in obtaining specialist support for the person's eating disorder?
  4. 04What are the current ratings for Caring and Responsive, which were not assessed during this inspection?
  5. 05How will you continue to check that the rewritten care plans accurately reflect each person's needs and choices?

This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 26 July 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.

The story over the years

Every inspection of Ivers

6 rated inspections over 6 years: the service has held its Good rating throughout.

  1. July 2023Goodcurrent ratingup from Requires improvement
    Safe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good

    Read what inspectors found at Ivers →

  2. April 2022Requires improvementup from Inadequate
    Safe: Requires improvementEffective: Requires improvementWell-led: Requires improvement

    We are reading this report · the original is on cqc.org.uk

  3. September 2021Inadequatedown from Requires improvement
    Safe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate

    Read this report on cqc.org.uk

  4. September 2020Requires improvementstayed Requires improvement
    Safe: Requires improvementCaring: Requires improvementWell-led: Requires improvement
  5. June 2019Requires improvementdown from Good
    Safe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
  6. May 2017Good
    Safe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
  7. September 2020

    Registered with the Care Quality Commission on 21 September 2020.

Ratings and report dates from the Care Quality Commission. A service can also be visited without a new rating being published, so the timeline shows published inspections, not every contact the CQC has had with the service.

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