Archived: Winterton House

Updated 14 July 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This comprehensive unannounced inspection was done to check that improvements to meet legal requirements planned by the provider after our comprehensive inspection on 4 November 2016 inspection had been made. This was because the service was not meeting some legal requirements and was put in special measures.

This inspection took place on 17 March 2017 and was unannounced. It was completed by two inspectors.

Before the inspection we reviewed information we held about the service and the provider. This included details of previous inspection reports and the registration details of the service. We also contacted the local authority commissioners and the local Healthwatch in order to get their perspective of the quality of care provided.

During the inspection we observed how staff interacted with people. We spoke with three people who used the service, the provider, and three care staff. We looked at six people’s care records, six staff files, four medicine administration records, the training matrix and policies. We observed care in the main lounge where three people were based for most of the day with a fourth person coming in and out of the lounge.

After the inspection we got a call from a relative with positive feedback about care delivered. We also received positive feedback by an email from a health care professional about care delivered.

Updated 14 July 2017

Winterton House is a care home registered to provide accommodation and support with personal care for up to nine older people, some of whom may be living with dementia. On the day of our visit there were six people using the service, one of whom was in hospital.

This service is not required to have a manager registered with the Care Quality Commission, as the service is provided by an individual who is the manager and registered person. 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.

The inspection took place on 17 March 2017 and was unannounced. At our previous inspection on 4 November 2016 we found that the provider did not meet legal requirements relating to safeguarding people from abuse, maintaining a clean and safe premises, staff training, appraisal and supervision, maintaining privacy and dignity, and quality assurance. We imposed conditions on their registration to restrict admissions and to provide us with monthly updates in relation to risk assessments and infection control. The overall rating for this service was ‘Inadequate’ and the service was therefore in ‘special measures’. The provider wrote to us to say she had taken action and was now meeting legal requirements. However, she did not adhere to the conditions requiring her to send us monthly updates, and during this inspection we found that the provider was still not meeting legal requirements and therefore the service has been rated inadequate overall and remains in special measures.

Shortfalls in the leadership of the service remained. There were ineffective systems in place to monitor the quality of care delivered. The provider lacked oversight on issues such as accidents and incidents and managing risk, and did not ensure there was an open culture which enabled staff, people using the service and their relatives to openly express their views about the service.

Records were not always accurate, were not always kept securely and could not be easily found when needed.

Although people told us they felt safe, they were not always safeguarded from avoidable harm and unnecessary restrictions. Staff had not attended any safeguarding training and were unsure of the process to follow if they were concerned a person was being abused. The safeguarding policy in place needed to be updated in order to reflect up-to-date information.

The provider and staff were aware of some of their responsibilities but demonstrated a lack of knowledge about the Mental Capacity Act (2005) and how it applied in practice. People were not supported to have maximum choice and control of their lives. Staff did not support them in the least restrictive way possible; the policies and systems in the service did not support this practice.

Medicines were not always managed safely leaving people at risk of not receiving their medicines as prescribed.

Staff had not yet received appropriate training, appraisal and supervision. This resulted in people receiving care that was not always evidence based or effective.

People were not always involved in planning their care, or in the way in which the service was run. They were not always offered choices. Activities provided did not always meet people’s needs particularly those living with dementia.

People were not always treated with dignity and respect as their wishes were not always respected. People were not always encouraged to maintain their independence.

There was a complaints procedure in place which was also available in pictorial format, however the provider could not show us she had appropriately recorded and responded to complaints.

We found nine breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the Care Quality Commission (Registration) Regulations 2009. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.