CQC report explained · a residential care home
What the CQC found at James Court Residential Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, December 2017
Rated Good overall; inspectors found safe, kind and personalised care, but the home was not always well-led.
This was an unannounced inspection on 28 September 2017. One inspector reviewed records, spoke with people using the home, staff and managers, and observed care. The home supported nine people with learning disabilities and could provide care for up to 12 people.
The inspectors found Good care in four areas: safe, effective, caring and responsive. People were supported safely, received their medicines, had access to food and healthcare, and were treated kindly. They were involved in decisions, activities and planning their care.
The well-led rating was Requires Improvement. Some care records and assessments were not up to date, and there was no systematic way to decide how many staff were needed. The inspectors found improvements since the previous inspection, when the overall rating was Requires Improvement and well-led was Inadequate, but said further improvements needed to continue.
People felt safe
Inspectors found that people were protected from abuse and that risks were assessed, monitored and reviewed. Medicines were stored, administered and recorded safely.
“People continued to be safe living at the home.” from the report
Kind relationships
Staff knew people well and spent time with them beyond completing care tasks. Interactions observed by inspectors were kind and patient.
“The interactions we observed between the staff and people who used the service were kind and patient.” from the report
Choice and independence
People were involved in daily choices and care planning. Staff supported people to do things for themselves and provided information in formats they could understand.
“People were supported to be in control of their lives.” from the report
Improved oversight
The home had introduced audits and action plans to monitor care and make improvements. Staff also reported clearer roles and more support.
“There were now systems in place to monitor and assess the quality of care people received.” from the report
Care records were not all current
needs fixingSome people's records and assessments still needed to be reviewed and updated. One care plan included information dated August 2015 with no evidence that it had been reviewed.
“Further improvements were still identified to ensure that people's care records were reviewed so that the information for staff was up to date and relevant.” from the report
- 01Have all care records and assessments now been reviewed and brought up to date?
- 02How do you now calculate the staffing levels needed for each person's support?
- 03How do you check that staffing levels change when people's needs change?
- 04How are the improvements from this inspection monitored to make sure they continue?
- 05How will you make sure people's care continues to meet the agreed level of support?
This was an unannounced inspection covering all five CQC questions and checking whether improvements from the previous inspection had been made. This explanation was written from the published report of 6 December 2017 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.
What inspectors found, May 2017
James Court Residential Care Home was rated Requires Improvement; inspectors found kind and safe care, but serious weaknesses in leadership, staffing, decision-making and personalised support.
This was an unannounced inspection on 7 February 2017. One inspector spoke with five people living at the home, four care staff and the registered manager. They also looked at care records, staff records and quality checks, and spoke with three health and social care professionals afterwards.
The home was rated Good for safe care and caring. People felt safe, medicines were managed safely, risks were identified, and staff treated people with dignity. People had food choices, access to health professionals and opportunities for social activities.
The home Requires Improvement for effective care and responsive care, and was rated Inadequate for being well-led. Inspectors found repeated failures from the previous inspection had not been addressed. These included poor quality monitoring, incomplete capacity and best-interest assessments, inadequate training for challenging behaviour, and staffing that did not always provide the agreed individual support.
People felt safe
People said staff looked after them properly. Staff understood how to recognise and report possible abuse, and risks to people and the environment had been identified.
“People told us they felt safe when they received care.” from the report
Kind and respectful care
People had positive relationships with staff. Their privacy, dignity, choices and independence were respected.
“The atmosphere in the home felt homely and people knew each other really well.” from the report
Health and nutrition support
People had meal choices and dietary needs were recorded. Referrals to health professionals were made when needed and appointments were supported.
“We saw that referrals had been made to health care professionals in a timely manner and when people had attended their appointments, the outcome was recorded.” from the report
People did not always receive agreed individual support
seriousSome people had specific staffing hours agreed to meet their needs, including one-to-one support. Inspectors found these hours were combined with general staffing instead.
“People are not receiving the level of support they require and this can have an impact on how their day is managed.” from the report
Capacity and liberty decisions were not properly assessed
seriousAssessments did not consistently cover specific decisions or show that decisions were made in people's best interests. Information about liberty safeguards was confusing, creating a risk that care could restrict someone unlawfully.
“This meant we could not be sure that the provider understood their responsibility associated with DoLS and there was a risk that people were being deprived of their liberty for the purpose of receiving care or treatment without lawful authority.” from the report
Staff training was not sufficient
seriousStaff had not received formal training to support people whose behaviour challenged. The home had also not checked whether staff understood their training or could use it in practice.
“Staff have not received any formal training, this would certainly help them in establishing understanding of the behaviour plan.” from the report
Weak quality monitoring
seriousThe home had not introduced effective audits to identify patterns, risks or improvements. Care plans and risk assessments were not always easy to use because updated information was kept in different parts of the records.
“Effective systems were not in place to assess, monitor and improve quality of care.” from the report
Safeguarding notifications were missed
seriousSafeguarding referrals had been made to the local authority but not reported to the CQC, despite this having been raised at the previous inspection.
“We found that since our last inspection safeguarding referrals had been made to the local authority, however none of these had been reported to us.” from the report
Some activities were not age appropriate
needs fixingInspectors saw toys, puzzles and displays linked to children. Other social activities were available, but more suitable adult options had not been found.
“The pictures on display and the activities available for people were linked to things associated with children.” from the report
- 01How do you now make sure each person receives the individual staffing hours and one-to-one support set out for them?
- 02What training have staff completed for supporting behaviours that challenge, and how do you check their competence?
- 03How do you complete and review capacity assessments for specific decisions, including the use of monitoring equipment?
- 04How do you ensure best-interest decisions and Deprivation of Liberty Safeguards arrangements are lawful and clearly recorded?
- 05What audits and management checks are now in place, and how are safeguarding incidents and people's feedback reviewed and acted on?
This was an unannounced inspection looking at the overall quality of the home and all five key questions, following concerns raised at the January 2016 inspection. This explanation was written from the published report of 5 May 2017 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.
Every inspection of James Court Residential Care Home
3 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- December 2017Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at James Court Residential Care Home →
- May 2017Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
Read what inspectors found at James Court Residential Care Home →
- March 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- August 2011
Registered with the Care Quality Commission on 22 August 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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