Windsor Court Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of the legal regulation in relation good governance.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

An effective system was not fully in place to assess people’s needs. We identified shortfalls in the assessment of people’s needs in relation to medicines management, mental capacity, the provision of equipment, nutrition and fluids and supporting people who displayed distressed behaviours.

We found inconsistencies in care planning. For example, medicines management guidance was not always detailed or accurate, mental capacity assessments were not consistently documented, and restrictive practices for two people lacked professional input. Nutrition and information about people’s fluids was not always accurate or recorded.

Following our assessment, the registered manager told us these issues were being addressed. Regular medicines audits and checks were being carried out, care plans and risk assessments were being reviewed to ensure accuracy, and mental capacity assessments had been completed. They also told us that additional training was being carried out.

An effective system was not fully in place to ensure care and treatment were delivered in line with best practice. One person was cared for in bed, based on family preference, but this was not documented in their care plan, and there was no evidence of professional involvement. Nutrition and information relating to people’s fluids was not always accurate, with discrepancies between care plans and agreed professional advice, and food and fluid intake was not consistently recorded despite clinical need. Equipment was not always available to meet people’s needs. Care for people who displayed distressed behaviours did not always follow best practice.

An effective system was not fully in place to ensure staff worked well across teams and services to support people. In addition, there was a lack of evidence that staff had involved health professionals when implementing restrictive practices.

Records did not always accurately reflect the involvement of health professionals. For example, 1 person’s care plan stated that a dietitian was involved, but this had taken place at their previous care setting, not at Windsor Court. Another person’s records indicated input from a speech and language therapist, which staff confirmed was incorrect.

Following our assessment, the registered manager told us the shortfalls were being addressed. She explained that weekly clinical meetings were held to review and monitor people’s needs, agree any referrals to health and social care professionals and share updates from those professionals to ensure care plans remained accurate and up to date.

An effective system was not fully in place to support people’s health and wellbeing. There had been delays in obtaining equipment which posed a risk to people’s health and wellbeing. In addition, records relating to people’s care and support were not always accurate or well recorded.

Despite the issues we identified, there were positive aspects to people’s care. There was regular involvement from GP services and community nurses, who attended the home to support people’s health needs.

An effective system was not fully in place to monitor people’s care and treatment to continuously improve it. Audits and reviews were not consistently identifying or addressing gaps in care planning and delivery. We identified shortfalls in medicines management, records relating to people's social activities, distressed behaviours, positional changes and mental capacity which showed that people’s care was not being monitored effectively.

After our assessment, the registered manager told us these shortfalls were being addressed.

Despite these issues, we heard and observed examples of how living at the home had improved people’s health and wellbeing. There was regular involvement from GP services and community nurses, who visited the home to support and monitor people’s health needs.

An effective system to demonstrate how staff were following the Mental Capacity Act was not fully in place.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty had the appropriate legal authority and were being met.

Records did not always demonstrate how staff were following the Mental Capacity Act. For example, 1 person was cared for in bed, but there was no documentation to show this was the least restrictive option or in their best interests. Staff also described restrictive practices in the care of 2 people, which they told us were in the individuals’ best interests, but care plans did not describe these measures, and there was no evidence of professional advice to support them. In addition, information relating to covert medicines administration was not clear, and best interests decisions were not consistently recorded.

DoLS applications had been submitted to the local authority for authorisation, in line with legal requirements.

Following our assessment the registered manager told us the shortfalls had been addressed and mental capacity assessments were now in place.