Background to this inspection
Updated
14 December 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector and an expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Winchester House 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.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. This included details about incidents the provider must notify us about, such as abuse or when a person dies. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
During the inspection, we spoke with one person with limited verbal communication ability and carried out observation with others who were unable to verbally communicate with us. People who lived at the service had complex needs and were not able to tell us about their care and support. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We also observed staff interactions with people and observed care and support in communal areas.
The registered manager was away during the inspection. We spoke with two support worker, two senior support workers, the deputy manager, regional manager and the area director who supported staff with the inspection.
We reviewed a range of records. This included two people's care records and health care records. We also looked at three staff files including their recruitment and supervision records. We reviewed records relating to the management of the service, quality assurance records and a variety of policies and procedures implemented by the provider.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We received and reviewed the training data, action plan, agency cover details, staff survey and copy of rota sent to us in a timely manner.
Updated
14 December 2019
About the service
Winchester House provides accommodation and personal care for up to 12 people aged between 18 and 65 years, who have a learning disability and autism. At the time of our inspection, 11 people were using the service. Winchester House is one of several small homes owned by Aitch Care Homes (London) Limited.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
People’s experience of using this service and what we found
At our last inspection, there was inadequate staffing level in the service, which meant people’s needs were not being consistently met. During this inspection, we found that the provider had made improvements. There were enough staff deployed to meet people’s needs and staff morale had significantly improved.
People were safe at Winchester House. Staff knew their responsibilities in relation to keeping people safe from the risk of abuse.
Risks were appropriately assessed and mitigated to ensure people were safe. Medicines were managed so people received their medicines as prescribed.
The provider continued to operate robust recruitment and selection procedures to make sure staff were suitable and safe to work with people. Staff received training, support and supervision to enable them to carry out their roles safely.
People's care plans clearly detailed their care and support needs. People and their relatives were fully involved with the care planning process. The service had developed care plans which clearly detailed people’s likes, dislikes and preferences. Care had been delivered in line with people’s choices.
People received the support they needed to stay healthy and to access healthcare services. Each person had an up to date support plan, which set out how their care and support needs should be met by staff. These were reviewed regularly.
We observed people’s rights, their dignity and privacy were respected.
Staff supported people to maintain a balanced diet and monitor their nutritional health.
People knew how to complain and felt confident any concerns would be listened and responded to by the provider.
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.
There was a positive leadership in the service. The service was well led by a management team who led by example and had embedded an open and honest culture.
Effective governance systems to monitor performance had been fully embedded into the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 17 December 2018) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected:
This was a planned inspection based on the previous rating.
Follow up:
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.