CQC report explained · a residential care home
What the CQC found at James Hirons Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found that risks were recorded, medicines were managed safely, recruitment checks were completed and infection control arrangements were in place.
- Effective?
- Good
- Staff had training and support, and people's food, drink and healthcare needs were met. Care was adapted to people's needs and decisions were made with people's wishes and best interests in mind.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff knew people well, encouraged independence and involved them in decisions about their care.
- Responsive?
- Good
- Care plans reflected people's personal needs, routines and preferences. People were supported with communication, activities, family contact, complaints and end of life wishes.
- Well-led?
- Good
- Management had improved its checks on care quality and safety. Inspectors found an open culture, involvement from people, relatives and staff, and additional oversight from a Quality Committee.
What inspectors found, August 2021
James Hirons Care Home was rated Good overall; inspectors found safe, kind and well-managed care, with improvements since the previous inspection.
Inspectors visited on 7 July 2021 and checked all five areas of care. They spoke with five people, four relatives and 11 staff. They also reviewed care plans, medicines records, recruitment files, training information and management records.
The home was rated Good for Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people were happy, safe and treated with kindness. Medicines were managed safely, staff were trained, care plans were personalised and people could keep in touch with relatives and take part in activities.
The previous inspection had rated the home Requires Improvement and found two breaches of regulations. At this inspection, the provider had made improvements and was no longer in breach. The report says checks on care quality, medicines, staff training and recruitment had been strengthened.
Safe medicines
People received their medicines as prescribed. Staff had training and competency checks, and the provider carried out regular audits.
“People were now fully supported to have their medicines as prescribed.” from the report
Kind and respectful care
Staff spent time with people, respected their privacy and promoted independence. People and relatives described the care and atmosphere positively.
“People were treated equally and had their human rights and diversity respected.” from the report
Personalised care
Care plans included people's life histories, preferences and daily routines. Staff used this information to provide individual care.
“People's care plans were personalised and detailed information about their life histories, care needs and preferences.” from the report
Family contact and activities
The home supported people to maintain relationships during the COVID-19 pandemic and offered activities based on their interests.
“People had been supported to use various electronic communication devices, such as tablets and mobile phones, to keep in touch with family and friend.” from the report
Improved management checks
The provider strengthened quality monitoring after the previous inspection. A Quality Committee and named trustees also provided additional oversight.
“Following the last inspection, the provider had reviewed and updated how they checked the quality of care people received.” from the report
Inspectors raised no specific concerns in this report.
- 01How are medicines audits and staff competency checks carried out now?
- 02How are care plans reviewed when a person's needs or preferences change?
- 03How does the home support family visits and other contact arrangements now?
- 04What activities are available for someone with my relative's interests and communication needs?
- 05How can relatives give feedback, raise a complaint and see what action has been taken?
This inspection covered all five key questions and was carried out to check improvements after the previous inspection found two breaches of legal requirements. This explanation was written from the published report of 5 August 2021 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, December 2019
Rated Requires Improvement; inspectors found kind care and a clean home, but important safety, training, medicines and management checks were not reliable.
Inspectors visited on 18 and 19 November 2019. The first visit was unannounced. They spoke with people, staff and relatives, observed care, and checked care plans, risk records, medicines, incidents and management records.
People generally said they were happy and described a friendly atmosphere. The home was clean, there were enough staff overall, and people were offered choices and activities. However, care was not consistently kind or responsive, and care plans did not always give staff enough personal information.
Inspectors found unsafe moving and handling, weak risk plans, medicines not always given as instructed, and gaps in staff training and checks. Fire evacuation arrangements and some equipment checks also needed improvement.
The overall rating and all five question ratings were Requires Improvement. This was a deterioration from Good at the previous inspection in May 2017. The report says the provider breached Regulations 12 and 17.
Clean surroundings
The home was well maintained and clean. Inspectors said this reduced the risk of infection.
“The home was clean and tidy and odour free.” from the report
Enough staff overall
Inspectors found there were enough staff on shift overall, and people said staff responded quickly when they used their pendant alarms.
“Overall, there were enough staff on shift to meet people's needs.” from the report
Activities and interests
People could join activities, continue hobbies and attend a monthly church service if they wished.
“Planned activities took place and people were supported to take part in these, including arm-chair exercises and listening to local speaker events arranged to take place in the home.” from the report
Choice and consent
Staff supported people to make choices about their daily lives and generally sought consent before providing care.
“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” from the report
Unsafe moving and handling
seriousInspectors saw four incidents where staff used poor moving and handling techniques. This created a risk of injury.
“During our inspection visit, we observed four incidents of different staff members using poor moving and handling techniques.” from the report
Weak risk management
seriousRisk plans did not always contain the information staff needed. Falls were not consistently used to update plans, and some pressure-relieving equipment was set incorrectly.
“Individual risks had been identified but risk management plans were either not always in place, not robust or did not always contain the level of information staff needed.” from the report
Medicines not always given safely
seriousStaff did not always follow manufacturers' instructions. One medicine was routinely given outside its protocol, and a person who self-medicated had no risk plan.
“Medicines were not always given in line with manufacturer's instructions.” from the report
Training and competence gaps
needs fixingSome newer staff had not received training in a timely way. The manager had not consistently checked staff competence, including moving and handling skills.
“New staff did not always receive training in a timely way.” from the report
Care plans lacked detail
needs fixingCare plans did not always explain people's needs, preferences or how staff should respond to distressed behaviour.
“People had individual care plans, however, these did not always give staff detailed or personalised information about people's needs or preferences.” from the report
Management checks missed problems
seriousAudits and reviews did not identify several safety and quality problems. This included gaps in medicines checks, care records, falls analysis and fire information.
“Audits were not always robust and did not identify where improvements were required.” from the report
- 01What has been done to assess and observe every staff member's moving and handling skills?
- 02How are risk plans, falls records and pressure-relieving equipment checks now reviewed and updated?
- 03How do you make sure medicines are given according to manufacturers' instructions and each person's protocol?
- 04Have all staff, including agency staff, completed the training needed for their role, and how is this checked?
- 05What changes have been made to personal emergency evacuation plans, fire training and evacuation equipment?
This was a planned comprehensive inspection covering all five key questions, including the premises and care provided; all five ratings were given at this visit. This explanation was written from the published report of 20 December 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 Hirons Care Home
3 rated inspections over 4 years: the service has held its Good rating throughout.
- August 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2016
Registered with the Care Quality Commission on 30 June 2016.
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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