CQC report explained · a residential care home
What the CQC found at James Dixon Court
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, October 2020
Rated Requires Improvement; inspectors found safe, kind care and better management, but the overall rating remained below Good.
This was a focused inspection on 15 September 2020. Inspectors checked whether the home had fixed problems found at the previous inspection, especially with medicines and management checks. They looked at records, medicines, staffing, risks and infection control, and spoke with people, staff, relatives and professionals.
The home had improved in the areas checked. Medicines were stored and given safely. Risks, accidents and incidents were reviewed. Inspectors found enough staff, safe recruitment and good infection control measures. They also found kind and respectful care, with staff knowing people well.
Safe and Well-led were both rated Good. However, the overall rating stayed Requires Improvement because this inspection did not reassess the other three areas. The home was no longer breaching Regulations 12 and 17, which had been breached at the previous inspection.
Safe medicines
Medicines were stored, recorded and given safely by competent staff. Errors were identified and action was taken to reduce risk.
“Medicines were managed safely and people received their medicines as prescribed by competent staff.” from the report
Kind, personal care
Staff treated people with kindness and respect. Inspectors said staff knew people well and provided care in an individualised way.
“Staff demonstrated kindness and respect in their interactions with people.” from the report
Enough staff
Inspectors found enough staff to meet people's needs and saw that staff responded promptly. Recruitment checks had also been completed.
“Staff rotas, the dependency tool and observations showed there were enough staff to meet people's needs, and staff attended to people promptly.” from the report
Improved management checks
The home had completed its improvement plan and introduced a new management structure. Its systems for checking safety and quality were found to be effective.
“The service had robust and effective systems in place to monitor, assess and improve the safety and quality of service being provided.” from the report
Overall rating still below Good
needs fixingThe overall rating remained Requires Improvement. This was partly because the other three care areas were not reassessed during this focused inspection.
“The overall rating for the service has remained Requires Improvement.” from the report
Manager registration pending
minorThe home did not yet have a manager registered with CQC when inspectors visited, although an application had been submitted.
“The service did not have a manager registered with the Care Quality Commission although an application had been submitted.” from the report
- 01What are the current ratings for Effective, Caring and Responsive, which were not reassessed in this inspection?
- 02Has the manager's application to register with CQC now been completed?
- 03How do you check that medicines continue to be administered safely and that any errors are acted on?
- 04What further work is planned to improve the overall rating from Requires Improvement to Good?
- 05What minor concerns were identified during the inspection, and what action was taken to address them?
This was a focused inspection of Safe and Well-led only; the other ratings carried over from the previous comprehensive inspection. This explanation was written from the published report of 10 October 2020 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, August 2019
James Dixon Court is rated Requires Improvement; inspectors found risks with medicines, care records and quality checks, and issued warning notices.
This was an unannounced inspection on 23 July 2019. Inspectors spoke with people, relatives, staff and visiting professionals. They observed care and reviewed care records, medicines records, staff files and management records.
The home was not always safe, effective, caring, responsive or well-led. Medicines were not managed safely. Some people were left without pain relief, records did not always explain people's needs, and fluid records were incomplete. Quality checks had not found or fixed these problems.
There were also positive findings. Staff numbers were sufficient, people spoke positively about many staff, and the home supported some people to regain skills and return home. However, the home remained Requires Improvement in all five areas. It had also been rated Requires Improvement at the previous inspection, and the report says enough improvement had not been made.
Kind and attentive staff
People expressed satisfaction with many staff. Inspectors saw staff taking time to discuss choices and supporting privacy, dignity and independence.
“Staff took time to speak with people and discuss options before providing care or activities.” from the report
Support to return home
The home provided reablement support after hospital stays. Inspectors saw evidence that this helped some people regain skills and return home.
“We saw evidence that this aspect of the service had been successful in supporting people to return to their homes.” from the report
Communication support
Information was provided in different formats. Staff usually knew how people preferred to communicate.
“Information was available in a range of formats to help people understand.” from the report
Clean environment
Inspectors found the home clean and hygienic, with cleaning routines and protective equipment available.
“Routine cleaning was carried out and the service was seen to be clean and hygienic.” from the report
Medicines were not reliably managed
seriousStaff competency checks were missing, night staff could not give medicines after 9pm, and two people were left without pain relief. Storage and controlled drug arrangements also did not meet required standards.
“Stock control systems were ineffective resulting in two people being left without pain relief medication.” from the report
Incomplete care and risk records
seriousSome records did not explain people's risks, needs or preferences clearly enough. This meant staff could not always be guided to provide safe, personalised care.
“Records were not completed to a standard which demonstrated people received personalised care to meet their needs.” from the report
Weak quality monitoring
seriousAudits did not identify or address important problems. The improvement plan from the previous inspection had not been completed within the agreed timescales.
“Audits and other management processes had failed to address a wide range of concerns identified during the inspection.” from the report
Food, drink and activities
needs fixingPeople did not always have enough choice of food or drinks, and some fluid records raised concerns about dehydration. Feedback about activities was mixed, with some people finding them insufficiently stimulating.
“People's needs and preferences for food and drinks were not always met.” from the report
Complaints records
needs fixingThe complaints procedure had not been shared with everyone. Relatives said they had raised concerns, but only one complaint was recorded in 2019.
“However, only one complaint was recorded in 2019.” from the report
- 01What changes have you made to ensure medicines, including pain relief and controlled drugs, are safely managed?
- 02How do you check that every person's care plan contains current risks, preferences and clear instructions for staff?
- 03How are food choices, fluid intake and the risk of dehydration monitored now?
- 04How are complaints and informal concerns recorded, investigated and followed up?
- 05Who is currently responsible for the home, and has the manager's CQC registration application been completed?
This was an unannounced comprehensive inspection covering all five key questions, prompted in part by concerns about medicines; the previous rating was published on 8 March 2019. This explanation was written from the published report of 22 August 2019 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 Dixon Court
3 rated inspections over 2 years: the service has held its Requires improvement rating throughout.
- October 2020Requires improvementcurrent ratingstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Good
- August 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- March 2019Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2018
Registered with the Care Quality Commission on 15 February 2018.
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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38 live-in carers within about an hour of Sefton
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,270 a week. 34 can care for a couple. 11 years' experience on average.
“He developed a close affinity with Terence, spending time talking with him before he retired to bed and looking after his needs during the night.”
“It was clear that she genuinely cared and her warm approach really helped put our minds at ease.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.