James Dixon Court

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 63 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure care plans fully reflected people’s needs. Reviews and discussions about health, wellbeing, and communication were not always consistent or updated. The provider explained this was challenging as some people stayed for only a short time and received therapy input, meaning their needs changed frequently. As a result, care plans did not always keep pace with these changes however, staff working within the home knew people well.

Care plans for permanent people were person-centred and developed in accordance with relevant legislation and best practice guidance. However, some plans required updating following feedback from CQC to ensure consistency across documentation. Nutritional needs were effectively managed, with comprehensive details recorded within the electronic care planning system.

The provider worked effectively across teams and services to support people. Information was shared with external professionals when necessary, so people did not have to repeat their story. Referrals were made to the appropriate professionals to ensure people’s needs were met. Multidisciplinary meetings were held weekly to plan and deliver care in a way that supported people. Support was carefully planned for when people returned home to ensure continuity of care and to meet their ongoing needs. However, concerns were raised in relation to communication between staff, one relative told us, “Communication between staff could be improved, sometimes the staff tell me they have only just come on shift so don’t know.” A staff member told us, “Sometimes we don’t get the information we need to support people.” This was discussed with the registered manager, who confirmed staff had access to all required information. However, he agreed to ensure that all information would be available in the office, not solely on the electronic system.

The provider supported people to manage their health and wellbeing, enabling them to maximise independence, choice and control. Staff encouraged people to take part in activities that promoted emotional wellbeing, such as social engagement. They supported people to maintain healthier lifestyles through balanced diets, and regular health checks, helping to prevent deterioration and reduce future care needs wherever possible. Although activities were limited, children from the local school visited the service weekly and provided feedback about their experience. One child shared, “I really like reading to them and making them pictures. I like talking to them because you get to know them better and learn their personalities.” These visits created meaningful connections and contributed positively to people’s emotional wellbeing.

We found people who received input from the therapy team and their care was monitored regularly, and communication between the management team and therapy staff was clearly recorded. This approach led to improvements in people’s health, and in some cases, it enabled some people to return home safely. For people in long-term care, care plans had been reviewed; however, there was limited evidence of involvement from people living at the service or their relatives. However, despite the lack of evidence of involvement, relatives told us they were involved in all care plan reviews and staff kept them informed whenever their loved one’s care needs changed. There was mixed views in relation to communication, whilst one relative informed us it could be improved, one relative we spoke with said, “Communication is spot on if something needs doing, they [staff] tell you."

Though people were consulted prior to commencing care, and we observed staff demonstrating respectful practices such as knocking on doors before entering, the provider did not consistently follow the principles of the Mental Capacity Act (2005). Specifically, not all restrictions had a recorded Mental Capacity Assessment and corresponding Best Interest decision to evidence that actions were taken in the person’s best interests. This indicated that, while day-to-day interactions were respectful, formal processes for assessing capacity and making Best Interest decisions were not applied consistently. This was fed back to the registered manager and provider, and steps have since been implemented to ensure Best Interest processes were followed and decisions were fully documented and kept up to date.