Archived: James Dixon Court

Updated 3 June 2017

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 25 and 26 April 2017 and was unannounced. The inspection team included an adult social care inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before our inspection we reviewed the information we held about the service. This included the statutory notifications sent to us by the provider about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send to us by law. We also contacted the commissioners of the service.

The provider had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make.

We used all of this information to plan how the inspection should be conducted.

During the inspection we spoke with four members of the care team, seven people living in the home, three relatives, the chef and a registered manager from one of the provider’s other locations. The registered manager was not in work during the days of the inspection and we were supported by the senior care staff and a registered manager from another home within the organisation throughout the inspection.

We looked at the care files of five people receiving support from the service, three staff recruitment files, medicine administration charts and other records relevant to the quality monitoring of the service. We also observed the delivery of care at various points during the inspection.

Updated 3 June 2017

This inspection took place on 25 and 26 April 2017 and was unannounced.

James Dixon Court is a residential care home for 30 people. It is a purpose built, single storey building, situated in a residential area of Netherton, close to local facilities and transport links.

During the inspection there were 17 people living in the home.

A registered manager was in post but was not in work during 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. Feedback regarding the management of the service was positive.

We found that the safety of the environment was not always maintained within the home. A fire risk assessment of the building was in place and people who lived at the home had a PEEP (personal emergency evacuation plan) to ensure their safe evacuation in the event of a fire. External contracts were in place and internal checks were also completed to help maintain the safety of the building and its equipment. We found however, that chemicals were not always stored securely and fire regulations were not always adhered to as a fire door was wedged open.

People knew how to raise any concerns and felt confident that they would be listened to. There was however no complaints log available to evidence how complaints had been investigated and whether they had been resolved.

The registered manager completed a variety of audits, as well as a monthly care home checklist, which looked at the safety of the home. A member of the provider’s quality team also visited the home regularly to complete an operational compliance audit; however there was no evidence that all identified actions had been addressed. We found that although audits were completed, they did not identify all of the issues highlighted during the inspection. This meant that systems in place to monitor the quality and safety of the service were not always effective.

When there were concerns regarding people’s capacity to consent to care or make decisions, mental capacity assessments were completed. We found however, that they did not always follow the principles of the MCA. We found that necessary assessments and agreements were not evident for a person who received their medicines covertly (hidden in food or drink.)

Some staff had commenced an induction when they commenced in post, but no staff had completed this. Care staff had not received an annual appraisal and not all staff had regular supervisions to support them in their role.

We looked at how medicines were managed within the home. A medicine policy was available for staff to refer to and records we viewed confirmed that staff had completed training in relation to safe medicine administration and had their competency assessed. Medicines were stored safely, all administrations were recorded and stock balance checks were accurate.

People told us they felt safe living in James Dixon Court and their relatives agreed.

Staff were knowledgeable about adult safeguarding and how to report concerns.

Safe recruitment processes were followed when new staff were employed and staff only commenced in post once checks had been completed. People living in the home, their relatives and staff told us that there were sufficient numbers of staff on duty to meet people’s needs in a timely way.

There were no concerns raised regarding the cleanliness of the home. A recent infection control audit had been completed by Liverpool Community Health and the service had scored 99.68%.

We found that Deprivation of Liberty Safeguards applications had been made appropriately.

Regular training was provided to staff to help ensure they had the knowledge required to meet people’s needs safely.

People were supported by care staff and external health care professionals to help maintain their health and wellbeing. People told us staff arranged for a doctor in a timely way if they were unwell.

We received mostly positive feedback regarding the meals available in the home. One person we spoke with had a specific dietary requirement. They told us the chef sourced special ingredients to make their meals and that they were very happy with the food they received. Staff we spoke with were aware of people’s dietary needs.

People told us that staff were kind and caring and treated them well. We observed people’s dignity and privacy being respected by staff during the inspection and interactions between staff and people living in the home were warm and genuine.

We saw that care files containing people’s private information were stored securely in order to maintain people’s confidentiality.

Care plans were written in such a way as to promote people’s independence and people told us independence was encouraged. People told us they had choice regarding the care and treatment they received and could choose how they spent their day. Staff we spoke to knew the people they were caring for well and told us they were kept up to date about any change in people’s needs.

We observed relatives visiting throughout both days of the inspection and everybody agreed they could visit whenever they wanted to and could visit in private if they wished to.

Staff told us that if people had no family or friends to represent them, they would support them to access a local advocacy service.

Feedback regarding activities was mixed. Activities available were advertised within the home and external entertainers also visited the home on occasion. Most people we spoke with told us they spent a lot of time in their rooms watching television and some people told us they would like more activities. A staff member told us there was not enough resources available for activities and that the staff tried hard to ensure there were activities available for people that they enjoyed.

Plans of care contained person centred information, which showed that people had been consulted regarding their care. Relatives we spoke with were aware of the plans and told us they were involved in their family member’s care. Care plans were reviewed regularly and reflected people’s preferences.

Records showed that meetings took place and questionnaires were distributed in order to gather views from people living in the home and their relatives.

Staff meetings took place every few months. Staff we spoke with described these as ‘flash meetings’ and told us that they were not always planned or advertised. Not all staff had the opportunity to attend these meetings and a staff member told us planned staff meetings would be beneficial.

Staff were aware of the home’s whistle blowing policy and told us they would not hesitate to raise any issue they had.

The Care Quality Commission (CQC) had been notified of events and incidents that occurred in the home in accordance with our statutory notifications. Ratings from the last inspection were displayed within the home as required.

You can see the action we told the provider to take at the back of the full version of this report.