About the serviceJames Hirons is a care home, which provides accommodation and personal care for up to 23 older people, some of whom are living with dementia. The home has two floors, with numerous communal lounges, conservatories and a dining area on the ground floor. People had their own bedrooms, and most were en-suite. There is a large communal garden area. At the time of our inspection there were 22 people living at James Hirons.
People’s experience of using this service and what we found
People told us they were happy living at James Hirons and described the home as having a happy atmosphere with things to do. Most staff had a kind and caring approach toward people and gave support when needed, however, this was not consistent. Improvements were required to ensure staff consistently showed a caring attitude and responsive approach to people.
Staff did not always have detailed information available to tell them to keep people safe. Whilst some risks had been identified, risk management plans were not robust.
The provider and registered manager had not ensured staff always had the skills or knowledge to safely provide care and support to people. Competency assessments on staff’s moving and handling skills had not always been undertaken and unsafe practices were seen during our visit.
People had their prescribed medicines available to them, but staff did not always follow manufacturer’s guidance in how medicines should be given.
The home was well-maintained and good cleanliness reduced risks of cross infection.
Staff understood the importance of giving people choices. 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.
People’s needs were assessed, and information was used to form plans of care. However, plans of care were basic and did not always contain all the information staff needed to deliver personalised care.
There were enough staff on shift to meet people’s needs and the provider had a system to ensure staff were suitable to work at the home. There were some gaps in staff’s employment history which had not been addressed.
Agency staff were used to cover shifts when needed, but agency staff profiles had not always been checked to ensure their training had been updated when required.
There were systems were in place for people and relatives to give their feedback on the service, although some people felt their comments were not always acted on. The provider’s complaints policy was displayed so people had the information they needed.
There were processes to audit the quality and safety of the service. Some issues had been identified as requiring improvements and were acted on. However, some audits, checks and falls analysis were not robust and had not identified where improvements were needed.
Following our inspection feedback, the registered manager took some immediate actions to make improvements. This included scheduling refresher training for staff’s moving and handling and taking action to ensure hazardous products were safety stored.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at the last inspection
The last rating for this service was Good (published 23 May 2017). During this inspection visit, we found the safety and quality of the service had deteriorated and some people’s care outcomes were not of a good standard: the service is now rated Requires Improvement. We identified breaches of the Health and Social Care Act 2014 (Regulated Activities):
Regulation 12 Safe care and treatment
Regulation 17 Good governance
Why we inspected
This was a planned inspection based on the rating of the last inspection.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.