Archived: James Hince Court Residential Care Home for Older People

On the day of our inspection there was a registered manager in place. 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.

Staff could identify the potential signs of abuse and knew who to report any concerns to. Risks to people’s safety were continually assessed and reviewed although a small number of these required updating. There were enough staff to keep people safe and to meet their needs. People’s medicines were managed safely, although the way people liked to take their medicines was not recorded. Protocols for the safe administration of ‘as needed’ medicines were in place for most but not all of these medicines.

People were supported by staff who completed an induction prior to commencing their role. They had the skills and training needed and their performance was regularly reviewed to enable them to support people effectively.

The principles of the Mental Capacity Act (2005), including Deprivation of Liberty Safeguards, had been followed when decisions were made about people’s care. People were supported to maintain good health in relation to their food and drink and the majority of people liked the choices that were available for them. People’s day to day health needs were met by staff and referrals to relevant health services were made where needed.

Staff were kind, caring and compassionate and responded quickly to people when they showed signs of distress or had become upset. Staff understood people’s needs and listened to and acted upon their views. People’s privacy and dignity were maintained. People felt staff treated them with respect. People were involved with decisions made about their care and were encouraged to lead as independent a life as possible. This included extensive physiotherapy sessions to improve independence for people who were planning to return home. People were provided with information about how they could access independent advocates. People’s friends and relatives were able to visit whenever they wanted to.

There were limited opportunities for people to take part in the activities that were important to them. People living at the home had detailed person centred care plans in place that recorded their preferences and likes and dislikes. For people on shorter term stays this information was limited. People’s care records were reviewed, but some had not been updated as regularly as others. People were provided with the information they needed if they wished to make a complaint and they felt their complaint would be acted on.

The registered manager led the service well and was respected and well-liked by all the people we spoke with. People were encouraged to provide feedback about the quality of the service and this information was used to make improvements. The continued development of staff and the registered manager’s performance was a key aim of the provider. Quality assurance processes were in place to ensure people and others were safe in the home.

On the day of our inspection there was not a registered manager in place, however an application had been received for the manager to become registered with the Care Quality Commission. A registered manager is a person who has registered with the CQC 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.

During our previous inspection we identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was in relation to a lack of robust quality monitoring processes in place to identify and act on risks to people using the service and records relating to the running of the service were not always up to date. During this inspection we saw improvements had been made.

There were a number of quality assurance processes in place that regularly assessed the quality and effectiveness of the support provided. The quality of the records used in the running of the service had improved and in the majority of cases were now up to date.

The manager was new to their post but had the experience and skills from previous roles to manage the service effectively. Staff understood their roles and responsibilities and enjoyed working at the home. Attempts had been made to involve people with the development of the service. People and relatives felt the manager was available when they needed them.

The risk to people’s safety was reduced because staff had attended safeguarding adults training, could identify the different types of abuse, and knew the procedure for reporting concerns. However, some staff needed to attend refresher courses for this training. Accidents and incidents were investigated and used to reduce the risk to people’s safety. Regular assessments of the risks to people’s safety, the environment in which they lived and the equipment used to support them were carried out. However, access to the home was possible through two unlocked doors. Hot ovens used to store people’s food prior to meal times and were placed in each of the four units for up to two hours at a time, placed the safety of people at risk. People had personal emergency evacuation plans (PEEPs) in place.

People were supported by an appropriate number of staff. Appropriate checks of staff suitability to work at the service had been conducted prior to them commencing their role. People were supported by staff who understood the risks associated with medicines. People’s medicines were managed safely; however, when medicines were being administered, a member of staff, at times, left the trolley unlocked and unattended.

People were supported by staff who completed an induction prior to commencing their role and had the skills and training needed to support them effectively. However, some staff required refresher training to be completed.

The manager ensured they had recorded how the principles of the Mental Capacity Act (2005) had been applied when decisions had been made for people. The appropriate processes had been followed when applications for Deprivation of Liberty Safeguards had been made. Staff knowledge of DoLS was poor.

People spoke highly of the food and were supported to follow a healthy and balanced diet. People’s day to day health needs were met by staff and external professionals. Referrals to relevant health services were made where needed.

Staff supported people in a kind and caring way. Staff understood people’s needs and listened to and acted upon their views. Staff responded quickly to people who had become distressed and communicated well with people living with dementia.

People told us they were provided with the information they needed that enabled them to contribute to decisions about their care. Although evidence of people’s involvement was not always recorded within people’s care records. People were provided with information about how they could access independent advocates. People’s friends and relatives were able to visit whenever they wanted to.

People were involved with planning the care they wanted to receive from staff. People’s care records were written in a person centred way and staff knew people’s likes and dislikes and what interested them.

People’s care records contained information for staff that enabled them to support people in an effective way and to respond to their needs. However, there were a small number of examples where information about people’s current health needs and conditions was not recorded. People were encouraged to do the things that were important to them and they were supported to follow their hobbies and interests. People were provided with the information they needed if they wished to make a complaint.

We received an action plan from the provider that told us the steps they would take to rectify the identified problems.

At this visit we looked at a sample of six people's care plans in order to ensure that the correct procedures were being followed with regard to care planning and risk assessment.

People who used the service told us that they were satisfied with the care, treatment and support programmes they received. We found that people using the service had not had their needs assessed effectively in all instances.

Records showed that people received assessment and treatment from NHS health care professionals when required.

People who used the service told us that they were encouraged to undertake a range of social activities within the home and felt their social needs were being met.

People said they were safe in the home and felt the staff would always promote their safety and welfare.

People who used the service were provided with the opportunity to comment on the quality of service provision at residents meetings and were also able to discuss any issues which were important to them with the management team.

We found that the organisation had an effective recruitment process in place which adhered to current legislative requirements. We also found that the support staff had received a training package to ensure they were competent and confident in performing their duties.