Archived: James Hirons Care Home

The service was last inspected on 15 April 2014 when we found the provider was compliant with the essential standards described in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

James Hirons provides accommodation for people in a residential setting and is registered to provide care for up to 23 people. There were 20 people living at the home when we inspected the service. People were cared for over two floors. On the ground floor there were a number of communal areas where people could choose to spend their time. There was one dining room split over two different levels, two conservatory areas, a large garden area, and two separate lounge areas at the home.

A requirement of the provider’s registration is that they have a registered manager. 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 and associated Regulations about how the service is run. There was an experienced registered manager in post at the time of our inspection who had been at the service for several years. We refer to the registered manager as the manager in the body of this report.

The provider had recently changed their company status which came into effect from the 1 April 2016. The provider planned to register the new provider's information and company status with the CQC within three months of our inspection visit.

Staff received training in safeguarding adults and understood the correct procedure to follow if they had concerns. All necessary checks had been completed before new staff started work at the home to make sure, as far as possible, they were safe to work with the people who lived there. The manager and staff identified risks to people who used the service and took action to manage identified risks and keep people safe.

There were enough staff employed at the service to care for people safely and effectively. New staff completed an induction programme when they started work, to ensure they had the skills they needed to support people effectively. Staff received training and had regular meetings with their manager in which their performance and development was discussed.

People’s needs and their wishes were placed at the heart of the service. People planned their own care, with the support of their relatives and staff. This ensured their care plans matched their individual needs, abilities and preferences, from their personal perspective. People who used the service and their relatives, were encouraged to share their views about how the service was run.

Care staff treated people with respect and dignity, and supported people to maintain their privacy and independence. People were encouraged to maintain relationships with people who were important to them. The manager and staff understood their responsibilities under the Mental Capacity Act (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure people were looked after in a way that did not unnecessarily restrict their freedom.

People were supported with their health needs and had access to a range of healthcare professionals where a need had been identified. There were systems in place to ensure that medicines were administered safely. People were encouraged to eat a balanced diet that took account of their preferences and, where necessary their nutritional needs.

People were supported in a range of activities, both inside and outside the home. Staff were caring and encouraged people to be involved in decisions about their life and their support needs. People made decisions about their environment and chose how their bedroom was decorated which made it personal to them.

The provider was proactive in developing and maintaining the home to increase people’s enjoyment in their surroundings and the quality of their lives. Quality assurance procedures were in place which included regular checks of people’s care plans, medicines administration and staff practice. Accidents, incidents and falls were investigated and actions taken to minimise the risks of a re-occurrence. There was a culture within the home to learn from feedback, audits, and incidents to continuously improve the service provided.

Below is a summary of what we found. If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Care plans were well organised and the information was clear.Staff recorded what the person could do for themselves and identified areas where the person required support. The care plans had sufficient detail to ensure that staff were able to provide care consistently.

There were risk assessments in place which identified the risks for the individual and how these could be reduced or managed. We saw risk assessments relating to such matters as mobility and tissue viability. Discussions with care staff demonstrated they understood the importance of carrying out risk assessments to ensure the people who used the service were protected from harm.

The service had a process in place to maintain accurate information and share it with other providers, in a timely way when it was required. This meant that people could be confident that important information about them would be shared with other providers who required it, in order to provide them with safe and appropriate care and treatment.

Is the service effective?

People told us the care they received met their needs. People told us they had been involved in planning the care they received.

Staff we spoke with were clear about the needs of the people they supported and what they told us was reflected in people's care plans.

We spoke with staff who told us they felt well supported by the manager who ensured access to regular training and development.

We saw that medicines were handled appropriately by staff who had been adequately trained and who had access to regular updates. We found the documentation associated with the giving of medicines showed people received medication they needed when they needed it.

Is the service caring?

We spoke with three people who used the service. People told us the service felt like their home and that the staff were helpful and supportive. One person told us, "I like it here and it's my home." Another person told us, "My room is beautiful and I have furnished it with my own things."

People were supported by kind and attentive staff.

We saw care workers were patient and gave encouragement when supporting people. People told us they were never rushed.

Is the service responsive?

We found people were asked for their views about their care and these were acted on. We saw the provider's latest customer quality survey results. Comments received in the latest survey included 'I am very pleased with the way I am kept informed', 'The home and gardens are beautifully maintained' and 'I could not be happier with the care my mother receives and if I had any concerns I know who to contact'.This showed people were happy with the way the service was run and knew who to talk to if they had any concerns.

We found when people required care and treatment from another provider, such as a doctor or a hospital, the provider obtained these services in a timely way. One person who used the service told us,"They are very good at getting a doctor quickly if you are unwell."

Is the service well led?

We found the service had an effective quality assurance system in place and any identified actions had led to improvements in the service people received.

Discussion with staff and the manager showed us there was a commitment to provide a quality service that took account of people's views. Some of the people who lived in the home were not able to be directly involved in decision making processes about how the home was run. Management processes ensured that their views were represented through relatives' meetings and individual consultation with families and others involved in their care.

Staff told us they were clear about their roles and responsibilities. Staff told us the leadership at the service was inclusive and that their views were taken into consideration.

During our visit we saw people enjoyed a variety of activities. Some people were supported by care staff to have a manicure. Several people joined in a word search in the conservatory and talked with staff about 'What the papers say' in the afternoon. We observed people having their lunch in the dining room. We saw that people were appropriately supported by staff and enjoyed their meal.

We saw that people's care was planned according to their needs. We found that staff understood people's needs and followed people's care plans when they supported them.

We found that people or their relatives had agreed to the care and treatment they received.

We looked at the cleanliness of the home and found that everywhere was clean and tidy. Staff we spoke with explained what steps they took to minimise the risk of infection within the home.

Staff were supported to care for people through a programme of training and regular one to one meetings with the manager. Staff told us the manager was very supportive. One member of care staff told us, 'I can go to the manager any time, his door is always open.'

We found that the records kept by the home were fit for purpose and stored appropriately.

One person who lived in the home told us, 'I like the staff enormously' and 'Everyone is very helpful.'

We saw that the home was clean, well maintained and that people were happy with their bedrooms. One person who lived at the home told us that they were happy with it and there was "a friendly atmosphere".

We spoke with a relative who told us they were "delighted" with the home, that the staff were "great" and the "food is very good".

We saw that the staff were friendly with people living at the home and knew how they needed to be supported. We saw people take part in a quiz in the conservatory on the day of our visit and they enjoyed the activity.

We saw in the entrance hall, that there was a lot of accessible information for people who lived at the home and for visitors. We saw that people were able to move around the home freely and there were different areas for them to occupy. We observed that at lunch time people had the choice of where they would like to have lunch, some people ate in their rooms, however most people ate in the dining room.