The inspection took place on 31 January 2019 and 4 February 2019. The first day of the inspection was unannounced and the second day announced. This was the first inspection of this service under the new provider, Sefton New Directions Limited.

James Dixon Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

James Dixon Court a residential care home for 30 people. It is a purpose built, single storey building, situated in a residential area of Netherton, close to local facilities and transport links. The service provides long term care for people; placement for people who require support on a short-term basis, whilst awaiting long term care; support at an alternative care service; or return to their own home. The service’s own staff support people with this placement, along with the local authority and other external health professionals, such as an occupational therapist.

A registered manager was in post. 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.

During this inspection we found the provider was in breach of Regulation 12 and 17 of the Health and Social Care Act (Regulated Activities) Regulations 2014. Regulation 12 was in respect of unsafe administration of medicines and Regulation 17 for concerns around the completion of records pertaining to care and the service’s governance arrangements.

Risk assessments were needed to protect people from the risk of harm and to support people’s plan of care. We found examples where risk assessments were not accurate to reflect current risks and the support needed to keep people safe.

People had a plan of care to support their care needs. The plan of care did not always record the care and support they needed, or had been updated to reflect relevant changes. It is important that information is recorded clearly and correctly, so that staff can safely, effectively and consistently support people with their current needs.

We found the service’s monitoring arrangements for a number of key areas of the service were not all robust and effective. For example, we raised concerns regarding the completion of people’s care documents, analysis of accidents and incidents, staff supervisions and safe administration of medicines. We were not fully assured by the governance to maintain standards and drive forward improvements.

Formal feedback from people who used the service and relatives was limited as they had not attended any recent meetings or given the opportunity to complete quality surveys to share their views about the home. The registered manager informed us quality surveys would be sent out in the near future and residents/relatives' meetings were planned this month. People and relatives told us the registered manager was approachable and they could meet with them any time.

Recruitment checks were carried out to ensure staff were suitable to work with vulnerable people.

Staff received induction and training to guide them in their role. .

There was enough staff to meet people's needs and keep them safe. Our observations showed calls for assistance were answered promptly.

People and their relatives said they received safe care and attention in accordance with their individual needs.

Our observations showed staff were kind, caring, polite and patient when looking after people. Support was given in a safe manner. Many staff had been at the service for a long time and knew people well. People and relatives spoke positively regarding the staff team.

People told us they felt safe and well cared for. Sy