Background to this inspection
Updated
15 January 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 30 September and 1 October 2015 and was unannounced.
The inspection team comprised two adult social care inspectors and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. Our expert had experience of care for older people living with dementia.
Before the inspection we reviewed information we held about the service, including statutory notifications and safeguarding alerts and reviewed their website. During our inspection we spoke with 15 people using the service, 11 members of staff (including the management team) and five relatives.
We carried out general observations throughout the inspection. We looked at records about people’s care and support which included 12 care files. We reviewed records about staff, policies and procedures, general risk assessments, accidents and incidents, complaints and service quality assurance audits. We inspected the interior and exterior of the building and equipment used by the service.
Updated
15 January 2016
We visited James Terry Court on 30 September and 1 October 2015.
The inspection was unannounced. The last inspection took place on 7 June 2013 when it was found the service was meeting the regulations we inspected.
The service provides residential care and nursing care for up to 76 older people with a range of needs associated with old age including people living with dementia. The home is divided into a residential unit, a nursing unit and a dementia support unit. At the time of the inspection the service was caring for 74 people and two people were due to fill the remaining beds.
The service had 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 2008 and associated Regulations about how the service is run.
Care records were not always fit for purpose. We found parts of the record were not always put back in the right place; additional records were inserted in an ad hoc manner; some parts were incomplete; some records had not been reviewed; and, entries not dated. You can see the action we told the provider to take at the end of the full version of the report.
People at the service felt safe. Staff had completed knew how to recognise and report abuse and how to escalate concerns. They had completed safeguarding of adults training. People’s needs were assessed and risk assessments recorded. There were sufficient numbers of staff to meet people’s needs and safe recruitment procedures were followed. The service provided a safe and comfortable environment for people, staff and visitors. People were cared for in a clean, hygienic environment. Medicines were safely administered.
Staff had the skills, knowledge and experience to deliver safe and effective care, support and treatment. The provider ensured staff were trained and supported with regular supervision sessions and appraisals. Mental capacity assessments were completed to establish people’s capacity to make decisions although these were could be improved and in some records were missing. Where it was necessary to deprive people of their liberty to deliver care and support the service had applied for authorisations under the Deprivation of Liberty Safeguards (DoLS). Staff demonstrated an understanding of mental capacity and DoLS and had completed relevant training. People were supported to have a healthy diet and to maintain good health. Individual needs had been met by the adaptation, design and decoration of the service.
People and visitors commented positively about relationships with staff and care was delivered in a patient, friendly and sensitive manner. People and their representatives were supported to express their views. Staff respected people’s privacy and dignity.
Care plans were person centred and addressed a wide range of social and healthcare needs. People were encouraged to take part in activities to reduce the risks of social isolation and loneliness. A range of activities were available to people. The provider had systems to obtain feedback about the quality of the service they provided in order improve.
Staff spoke positively about the management team who had an open door policy if people, visitors of staff wanted to speak with them. Regular staff meetings were planned to exchange information and obtain feedback. The provider had a system of audits and surveys to monitor and assess the quality of service they provided.