Windsor House Care Home

We found the following examples of good practice.

The service had updated their policies and procedures to ensure infection prevention and control (IPC) processes were robust. All visitors had their temperatures checked and were risk assessed before entering. The provider had implemented a separate visitation lodge in the garden to facilitate safe visits for people and their relatives. The process for safe visits included separate entry points for visitors and people, an air sterile system to clean the air within the lodge and cleaning regimes after each visit.

The service was working closely with Wigan Council's health protection team where telephone support was regularly provided. The service was conducting regular infection control audits, to ensure infection prevention and control (IPC) processes were robust.

Donning and doffing stations were situated in the service and personal protective equipment (PPE) was available throughout the building. Staff had designated areas to change into their uniforms and staff uniforms were washed on site. All staff had received training in IPC and PPE in relation to COVID-19.

The provider changed the cleaning company to ensure robust processes were in place and that the products were suitable for COVID-19. Cleaning processes and staff’s cleaning hours were increased throughout the service.

Windsor House is a care home providing personal care to 15 people at the time of the inspection. The service accommodates up to 16 people in one building split over two floors.

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

People’s outcomes were consistently good, and people’s feedback confirmed this. One person told us, “I came here for respite, but I have enjoyed it so much I am planning to stay here.” People also told us they felt safe. Staff had a good understanding of how to safeguard people from abuse.

Staff spoke enthusiastically about their roles and were dedicated and caring. They knew people's history and preferences and used this knowledge to support them in the way they wanted. Staff promoted a positive and inclusive culture. Staff had received training in equality and diversity and they were committed to ensuring people had equal opportunities. People told us they were confident the service was managing their needs and care well.

Staff engaged with people in a friendly and caring manner. Their conversations with people were familiar and good natured. Staff were also attentive to people's needs. Relatives told us, “All staff are approachable and very welcoming”, “The carers are very nice, kind and caring” and “Staff listen and taken on board my suggestions.”

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.

Wellbeing was at the heart of both the service and the provider's vision. The service had facilitated a number of well-being projects. Care plans clearly explained how people wished to be supported and the outcomes they wanted to achieve. Staff worked extremely closely with people to find out about their specific individual likes, dislikes, hobbies, interests and things that mattered to them.

Staff celebrated people’s lives and used innovative ways for people to remember their life experiences. For example, staff arranged a representative from an organisation a person had retired from to be presented with photograph memorabilia. This person commented, “They [from organisation] had been to every camp I had been to. I thought it was very good of them to come and I felt honoured. They gave me photographs and I knew all the planes in the photographs. It was brilliant.”

The provider had recently employed an occupational therapist (OT) who started working across the providers homes. The OT’s role involved working with people to improve their mobility and provide quicker access to aids and equipment to meet people’s needs. This helped bridge the gap between people awaiting input from other professionals when referrals to other services were made in relation to people’s mobility and falls.

The service was well led. Governance and quality assurance systems used provided effective oversight and monitoring of the service. Staff spoke positively about how the service was managed and the management team.

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 good (published 24 June 2017).

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.

Windsor House is a care home that has been converted from a large detached house in Standish, Wigan. The service provides care for up to 16 people. There are five double and six single bedrooms. Toilets and bathrooms are in close proximity to the bedrooms and communal areas. There is a large garden at the rear of the home. There were 12 people living at the home on the day of the inspection.

At the time of the inspection there was an acting manager who was in the process of registering with the Care Quality Commission. 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.

Staffing levels were sufficient staff to meet the needs of the people who used the service. There was a robust recruitment system which helped ensure that people were suitable to work with vulnerable people.

Safeguarding issues were dealt with appropriately and staff at the service, staff had undertaken training and demonstrated a knowledge and understanding of safeguarding issues.

Health and safety records at the service were complete and up to date. Accidents and incidents were recorded appropriately and there were safe medicines systems in place.

There was a thorough induction programme and a good programme of training was on-going for all staff. Staff supervisions and appraisals took place regularly.

There was a choice of nutritious food and nutrition and hydration was monitored when required.

The service was working within the legal requirements of the Mental Capacity Act (2005) (MCA) and the Deprivation of Liberty Safeguards (DoLS).

We observed in communal areas throughout the day and saw that interactions between staff and people who used the service were friendly and respectful.

We saw records of residents meetings which took place on a regular basis and people were involved in their care planning and reviews.

The service tried to ensure that people could remain at the home if they wished to when nearing the end of their lives.

The care files included a range of health and personal information. People’s preferences, likes and dislikes were clearly documented and people told us these were respected.

There were few activities happening at the service, but a new activities coordinator was being sought to address this. Funding had been obtained for new items to help people with social activities and interests.

There was a complaints procedure which people and their relatives were aware of. However there were few formal complaints made. We saw a number of compliments which had been received by the service.

There was an ‘open door’ policy at the home and people told us the management were very approachable.

We saw minutes of staff meetings, which were held on a regular basis. The provider regularly visited the service to check on care provision.

A number of quality audits and checks were carried out by head office to help drive improvement. Regular satisfaction surveys were sent out to relatives, staff and people who used the service.

We found that people were cared for in a calm and dignified manner. We saw people's nutritional needs were met and there were no concerns about the safety of people living at the home. People's medicines were also managed safely.

We spoke with staff and saw that they were aware of the best way to meet people's needs. We saw evidence that confirmed the provider had suitable recruitment arrangements in place.

At our last inspection we found that the standards relating to infection control and record were not being met. The provider had made improvements and we found that these standards were now being met.

We found that there was an effective process in place for monitoring the quality of care provided at Windsor House. The people we spoke with told us they were not aware of any changes required at the home.

We heard positive comments about the staff and the care given. We were told "the staff are champion'; 'I get on well with the staff. I am OK living here' and "I cannot find any faults with the home at all." We found that people received the care was needed but that action was required regarding the maintenance of the home. The home did not have a sufficient number of foot-operated pedal bins for disposing of clinical waste.

Staff told us they received appropriate training and that they were well supported in their roles.

We found that there was a complaints procedure in place and this was followed when a complaint was received. People told us that would be happy to approach the manager with any concerns that they had about their care or the care of their relatives.

We found that some people were at risk because their care records did not accurately reflect their current circumstances.