CQC report explained · a nursing home
What the CQC found at James Page
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found safe staffing, secure medicine storage and detailed risk assessments, but some medicine, equipment and incident records were not always complete.
- Effective?
- Good
- This area was not inspected during this visit. Its previous rating was used when calculating the overall rating.
- Caring?
- Good
- This area was not inspected during this visit. The report says people had positive relationships with staff and were treated in a caring and respectful way.
- Responsive?
- Good
- This area was not inspected during this visit. Its previous rating was used when calculating the overall rating.
- Well-led?
- Good
- The home had a positive culture, approachable management and regular checks on quality. Managers responded to issues raised during the inspection and improved some monitoring systems.
What inspectors found, January 2024
James Page is rated Good; inspectors found safe, kind care, with some records needing improvement.
This was an unannounced focused inspection on 28 and 30 November 2023. Two inspectors spoke with people using the home, relatives, staff and a healthcare professional. They also checked care records, medicine records, staff files and management records.
The home was rated Good for Safe and Well-led. People told inspectors they felt safe and were happy living there. Staff knew people well, staffing levels were safe, and people had personalised care plans and risk assessments.
Inspectors found some minor problems with medicine records, air mattress checks and accident records. The management team acted straight away and improved some systems during the inspection. The overall rating stayed Good because the other three areas were not inspected and their previous ratings were carried forward.
Personalised risk management
Care plans and risk assessments were detailed and regularly reviewed. They gave staff the information needed to manage people's risks.
“People had detailed, personalised risk assessments which were regularly reviewed and gave staff enough detail to manage risk associated with people's care.” from the report
Kind and respectful care
Inspectors saw staff offering choices and speaking respectfully. People and relatives gave positive feedback about the care.
“People were offered choice and spoken to in a caring and respectful manner.” from the report
Safe staffing
Recruitment checks had been completed and staffing levels were considered safe. Regular agency workers were used to provide consistency.
“Staffing levels were safe. Agency staff were sometimes used, however regular individuals were employed from the agency to ensure consistency.” from the report
Responsive management
The manager was available during the inspection and acted promptly when inspectors raised concerns. Quality checks were changed and developed in response.
“The registered manager was on hand throughout the inspection and was responsive to issues we raised.” from the report
Medicine records
needs fixingNurses did not always record where transdermal patches were applied. The home also needed clearer guidance for some medicines given only when needed.
“People received their medicines as prescribed, however, nurses did not always record the exact application site of transdermal patches.” from the report
Guidance for medicines when needed
needs fixingGuidance was missing for one newly admitted person and did not include all the steps staff should try before offering some medicines.
“Appropriate guidance had not been developed for 1 newly admitted person who had medicines prescribed on an 'as required basis'.” from the report
Air mattress checks
needs fixingSome air flow mattresses were not correctly calibrated to people's weights. The home addressed the shortfall and reviewed its monitoring system.
“However, not all were accurately calibrated to the individual's weight.” from the report
Incident records
needs fixingSome accident and incident records were inconsistent and lacked clarity. The manager took action after inspectors raised this.
“We identified some recording inconsistencies which meant some records lacked clarity.” from the report
- 01How do you now record the exact application site of transdermal patches?
- 02What written guidance is now in place for medicines given on an as-required basis?
- 03How do you check that each air flow mattress is correctly calibrated to the person's weight?
- 04What changes have been made to make accident and incident records clear and consistent?
- 05What were the ratings for Effective, Caring and Responsive at the previous comprehensive inspection?
This was an unannounced focused inspection of Safe and Well-led; the ratings for Effective, Caring and Responsive were carried forward from the previous inspection. This explanation was written from the published report of 11 January 2024 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 2018
Rated Good; inspectors found safe, kind and responsive care, with some care records needing more detail.
This was an unannounced, comprehensive inspection on 27 and 28 November 2018. Inspectors observed care, spoke with people, visitors and staff, and checked care records, staff files and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines practice, good cleanliness, suitable training and regular safety checks.
People and relatives spoke positively about the care. Staff were seen treating people respectfully, involving them in decisions and supporting their health, meals, activities and end of life wishes.
The rating stayed Good, as at the previous inspection. Inspectors noted some care plans did not contain enough detail about equipment or cleansing, and personal preferences were not recorded in most care records.
People felt safe
People told inspectors they felt safe. The home used risk assessments and regular safety checks to reduce risks.
“Everyone who lived in the home said they felt safe.” from the report
Kind and respectful staff
People and relatives praised staff's attitude. Inspectors observed respectful and caring interactions.
“Everyone living in the home was very complementary about the attitude of the staff and the way they were treated.” from the report
Safe medicines practice
Medicines were stored securely, given as prescribed and checked through audits. Staff received regular training.
“Medicines were administered and managed safely and effectively.” from the report
Activities and choices
People could choose when to get up and go to bed. The home offered regular activities, trips and entertainment.
“Activities were organised to encourage social interaction and physical activity by a dedicated activity coordinator” from the report
Good management checks
The management team used audits and incident reviews to monitor care and act on improvements.
“The governance arrangements provided a clear and accurate picture of the service.” from the report
Some care plans lacked detail
needs fixingA small number of support plans did not give staff specific instructions about equipment and cleansing procedures. The report says this information was recorded elsewhere in the care record.
“However a small number of support plans lacked specific instructions for staff to follow in relation to equipment and specific cleansing procedures.” from the report
Personal preferences not usually recorded
minorStaff knew people's likes, dislikes and routines, but this information was missing from most care records. This could make it harder for all staff to provide care in the person's preferred way.
“We found staff knew about people's preferences and personalised care was provided; however, this information was not recorded in most people's care records.” from the report
Vacancies covered by agency staff
minorThe home had vacancies for care and nursing staff. Regular agency staff were being used while these posts were filled, although inspectors found staffing levels met people's needs.
“The vacant posts were currently being filled by regular agency care and nursing staff.” from the report
- 01How will you make sure care plans contain clear instructions about equipment and cleansing procedures?
- 02How do you record each person's likes, dislikes, daily routines and social background?
- 03How many care and nursing vacancies are there now, and how often are agency staff used?
- 04How do you make sure agency staff know each person's care needs and preferences?
- 05What is the current position on the outstanding Deprivation of Liberty Safeguards authorisations?
This was an unannounced comprehensive inspection covering all five key questions and the overall rating. This explanation was written from the published report of 13 December 2018 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 Page
4 rated inspections over 8 years: the service has held its Good rating throughout.
- January 2024Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2018Goodstayed GoodSafe: GoodWell-led: Good
- August 2017Goodstayed GoodSafe: GoodWell-led: Good
- June 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 26 January 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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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.”
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