Archived: Windsor Court Nursing Home

There were 18 people living in the home on the day of our inspection, all of whom were accommodated for residential care. The home was not providing nursing care at the time of inspection. We spoke with seven of the people living at the home and with one visiting relative. We also spoke with three members of staff.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found.

• Is the service safe?

• Is the service caring?

• Is the service responsive?

• Is the service effective?

• Is the service well led?

Is the service safe?

Care was planned to meet people's needs. Assessments had been carried out to identify people’s needs and care plans had been put in place to inform staff how to support people. Care plans were up to date and reflected the needs of people we case tracked through this inspection.

People had their medicines administered as directed by their GP.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLs) which applies to care homes. One application had been submitted and authorised by the relevant Supervisory Body.

Is the service caring?

Everyone we spoke with told us that overall they were happy with the care and support they received. One person told us, “No complaints whatsoever. The staff are very kind and helpful.” Other comments made by people included; “I don’t think I could wish for better. The staff are so caring.”, “This is the next best thing to home.”, “I don’t like to go to bed too early. So I sit outside in the fresh air, while the evenings are light.”

We observed that staff communicated with people in a sensitive and considerate manner and supported people appropriately. Overall, we found that people’s dignity and privacy were respected.

Is the service responsive?

People’s needs had been assessed before they moved into the home.

People were referred appropriately to other health care services and professionals when required. Records of visits from healthcare professionals were kept.

Is the service effective?

Complaints were recorded and we found action taken to address issues, where possible.

Is the service well led?

The provider had a system to carry out audits to check the quality of the service to people

A survey consulting people who lived at the home was to be carried out in October 2014.

The company that was managing the service had kept us informed of improvements being made at the home.

The new company took over management of the home on 11 April 2014. At the time of this inspection there were 18 people accommodated at Windsor Court none of whom were receiving nursing care.

At this inspection we spoke focused on the care of four people. We spoke with these people and with two visiting relatives. We also spoke with four members of staff on duty during the inspection.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

• Is the service caring?

• Is the service responsive?

• Is the service safe?

• Is the service effective?

• Is the service well led?

This is a summary of what we found-

Is the service safe?

We identified hazards during the inspection of uncovered radiators and free standing wardrobes that could be toppled. Following the inspection the new managers confirmed that action had been taken eliminate risk to people living at the home. A radiator cover had been fitted to the uncovered radiator and wardrobes bracketed to the wall.

Since the last inspection the home has worked with local safeguarding teams to make sure that people’s needs were being met safely.

A care planning system was in place to make sure there was consistent care provided to people living at the home and these plans were readily available to staff. Occupational therapists have worked with the home in developing safe moving and handling plans for peopel living at the home.

Is the service effective?

The staff and people we spoke with told us that there had been improvements in care delivery. Relatives we spoke with told us also confirmed this; “It’s been much, much better here in the last couple of weeks. It’s cleaner and more welcoming” and “I feel all Dad’s needs are met.”

Is the service caring?

The feedback from people we spoke with and from the staff, indicated that staff were kind and caring, treating people with respect. One visiting relative told us, “It’s excellent, I could not praise the staff high enough.” Another relative told us, “The staff know Mum really well and know how to look after her. They are wonderful with her.”

Is the service responsive?

The new management company sent us an action plan following the inspection to inform us of how they would be making all the necessary requirements identified at the last inspection in February 2014.

Feedback from visiting relatives we spoke with and people living at the home was positive. We found the home had started to address and respond to the required improvements.

Is the service well-led?

A new management company took over management of the home on 11 April 2014. The outcomes and Regulations concerning quality assurance were not assessed at this inspection as the company has not yet had sufficient time to make the necessary changes that we required. We will return to the home to assess the actions taken to comply with this regulation.

At the time of our inspection the service did not have a registered manager in place. The provider had engaged a management company to provide oversight of the home. A manager from this company assisted us throughout the inspection, which took place over two days. We also met with the operations manager for the company, who joined us on the first day of the inspection.

We spoke with seven members of staff, seven people who lived at the home, two social workers who were visiting the home and with two relatives who were visiting people at the home. We also observed people's care, where this was appropriate and attended a morning staff handover.

We found that people's care had been assessed and planned; however some plans were either not up to date, not in place or lacked sufficient detail to inform staff on how to meet people's needs.

We identified shortfalls in the assessment planning and delivery of people's pressure area care. Where people had a safe swallowing plan in place because to a risk of choking, we found that they had not been provided with appropriately thickened fluids as set out in their care plan. The provider had not taken proper steps to ensure that people were not at risk of unsafe or inappropriate care.

Immediate action was taken with regards to hazards we identified at the inspection and the managers were cooperative in working with us to address some of the major concerns identified throughout the inspection.

The service did not have effective systems in place to identify, assess and manage risks relating to the health, safety and welfare of people living at Windsor Court Nursing Home.

We spoke with six people, five relatives and five members of staff. We were able to observe the lunchtime meal. We also looked at the care plans of five people who we were able to speak with.

We found that people were supported to receive sufficient food and drink. When an individual was at risk of losing weight, appropriate actions were taken to minimise this risk and promote weight gain.

When people needed bed rails to minimise the risk of harm, an assessment had been carried out and the use of bed rails monitored to ensure individuals were safe.

We looked at duty rotas for the home and found there were sufficient numbers of staff available to support people. People we spoke with considered there were sufficient staff to meet their needs.

People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

At the time of our inspection 44 people were accommodated at the home and 29 of them received nursing care.

We spoke with six people who lived at the home, two visiting relatives, seven staff and a consultant employed by the provider to help with the management of the home.

People spoke positively about their experiences of living at the home and the quality of the service they received.

There were arrangements in place that ensured consent was obtained for the care and treatment people received. We saw that people generally received the support and help they required.

The provider also had arrangements in place that ensured; people's prescribed medication was managed safely; there were enough staff on duty at all times with the skills and experience to meet people's needs; and the quality of the service was monitored and improved where necessary.

Records were not always accurate, up to date or fit for purpose which could potentially compromise the care people received.

At this unannounced inspection we spoke with the manager, three members of staff, a visiting healthcare professional and with people who lived at the home.

People told us they enjoyed living at Windsor Court and they got on well with the staff who cheered them up.

People told us they were treated with respect and dignity by a staff team who were kind and knew them well.

We saw records that showed people were cared for, or supported by, suitably qualified, skilled and experienced staff.