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James Hirons Care Home Requires improvement

The provider of this service changed - see old profile


Inspection carried out on 18 November 2019

During a routine inspection

About the service

James Hirons is a care home, which provides accommodation and personal care for up to 23 older people, some of whom are living with dementia. The home has two floors, with numerous communal lounges, conservatories and a dining area on the ground floor. People had their own bedrooms, and most were en-suite. There is a large communal garden area. At the time of our inspection there were 22 people living at James Hirons.

People’s experience of using this service and what we found

People told us they were happy living at James Hirons and described the home as having a happy atmosphere with things to do. Most staff had a kind and caring approach toward people and gave support when needed, however, this was not consistent. Improvements were required to ensure staff consistently showed a caring attitude and responsive approach to people.

Staff did not always have detailed information available to tell them to keep people safe. Whilst some risks had been identified, risk management plans were not robust.

The provider and registered manager had not ensured staff always had the skills or knowledge to safely provide care and support to people. Competency assessments on staff’s moving and handling skills had not always been undertaken and unsafe practices were seen during our visit.

People had their prescribed medicines available to them, but staff did not always follow manufacturer’s guidance in how medicines should be given.

The home was well-maintained and good cleanliness reduced risks of cross infection.

Staff understood the importance of giving people choices. 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; the policies and systems in the service supported this practice.

People’s needs were assessed, and information was used to form plans of care. However, plans of care were basic and did not always contain all the information staff needed to deliver personalised care.

There were enough staff on shift to meet people’s needs and the provider had a system to ensure staff were suitable to work at the home. There were some gaps in staff’s employment history which had not been addressed.

Agency staff were used to cover shifts when needed, but agency staff profiles had not always been checked to ensure their training had been updated when required.

There were systems were in place for people and relatives to give their feedback on the service, although some people felt their comments were not always acted on. The provider’s complaints policy was displayed so people had the information they needed.

There were processes to audit the quality and safety of the service. Some issues had been identified as requiring improvements and were acted on. However, some audits, checks and falls analysis were not robust and had not identified where improvements were needed.

Following our inspection feedback, the registered manager took some immediate actions to make improvements. This included scheduling refresher training for staff’s moving and handling and taking action to ensure hazardous products were safety stored.

For more details, please see the full report which is on the CQC website at

Rating at the last inspection

The last rating for this service was Good (published 23 May 2017). During this inspection visit, we found the safety and quality of the service had deteriorated and some people’s care outcomes were not of a good standard: the service is now rated Requires Improvement. We identified breaches of the Health and Social Care Act 2014 (Regulated Activities):

Regulation 12 Safe care and treatment

Regulation 17 Good governance

Why we inspected

This was a planned inspection based on the rating of the last inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our inspection programme

Inspection carried out on 9 May 2017

During a routine inspection

We inspected James Hirons Care Home on 9 May 2017. The inspection visit was unannounced.

James Hirons Care Home provides accommodation for people in a residential setting and is registered to provide care for up to 23 people. There were 19 people living at the home when we inspected the service. People were cared for over two floors. On the ground floor there were a number of communal areas where people could choose to spend their time. There was one dining room split over two different levels, three conservatory areas, a library, a large garden area, and two separate lounge areas at the home.

A requirement of the provider’s registration is that they have 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 and associated Regulations about how the service is run. There was an experienced registered manager in post at the time of our inspection who had been at the service for several years.

People felt secure in the home and safe with the staff who provided their care and support. Staff understood their responsibilities to keep people safe and manage any risks associated with their care. Staff told us they would not hesitate to report any concerns they had about people's health or wellbeing. People had call bells and pendant alarms to hand so they could easily call for assistance.

People were at ease with staff and enjoyed being with them. Staff spoke with people in a warm and respectful manner, engaged them in conversations which were of interest to them and listened to what people had to say. Staff promoted people's dignity by supporting them with personal care in a way that was meaningful to them.

There were sufficient numbers of staff to provide safe, effective care and staff told us they had enough time to spend with people. The provider had a robust recruitment and selection process to ensure staff with the right skills and values worked in the home.

Staff received training and support so they felt confident in their roles. Staff worked within the principles of the Mental Capacity Act 2005. They supported people’s decision making by offering them choices and respected the decisions they made about their care. Staff used their knowledge of people to provide care that met individual needs and preferences.

Staff understood how to manage people’s specific healthcare needs and knew when to seek professional advice and support so people’s health and welfare was maintained. The provider’s procedures for the storage and administration of people’s medicines reflected good practice.

People were supported with their nutritional needs and they told us they enjoyed the food and drinks they were offered.

The home was well maintained and decorated and care had been taken to provide a relaxing, homely environment where people and their visitors felt welcomed. People were offered a range of activities that promoted physical activity, mental stimulation and social engagement.

There was an open and inclusive culture within the home. People, their relatives and staff felt informed and involved. Staff felt well supported and valued and described their relationship with the management team in positive terms.

There was a system of internal audits and checks completed within the home to ensure the safety and quality of service was maintained. The quality assurance system included asking people, visitors, relatives, and staff about their experience of the service so any areas where improvements were required could be identified.