Winslow

Updated 19 October 2021

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team consisted of one inspector.

Service and service type

Winslow is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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 inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. Due to technical problems, the provider was not able to complete a Provider Information Return. 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. We used all of this information to plan our inspection.

During the inspection

We spoke with two people who used the service about their experience of the care provided. We spoke with seven members of staff including the provider, registered manager, deputy manager, nurse, healthcare assistant, housekeeper and agency care workers. We observed interactions between staff and people throughout our inspection.

We reviewed a range of records. This included two people’s care records and multiple medication records.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed. We spoke with one relative and two staff member and received feedback from one professional who regularly visit the service.

Updated 19 October 2021

About the service

Winslow is a nursing home and accommodates up to six people with a learning disability and/or autistic people. Some of whom have additional needs relating to their mental health. People had their own individual apartments and received high levels of staff support. On the day of our inspection, six people were living at the service.

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

Fire safety was not always regularly monitored and managed, and this put people at risk of harm. We shared our concerns about fire safety with Fire Prevention Officer. Processes for reporting and responding to safeguarding concerns was not always effective which resulted in delays in referrals to the Local Authority. Governance systems were not fully embedded in the service which lead to shortfalls in the overall quality of the service. Regular feedback from people and their relatives was not regularly sought.

People had person centred and detailed support plans and risk assessments to guide staff on how to safely support them. Care plans reflected people's current needs and had been regularly updated. People had received their medicines as prescribed. Infection prevention and control processes were in place and were effective. Staff were recruited safely, and pre-employment checks were completed.

People were supported and encouraged to have good and fulfilled life. People were supported by staff who knew them well. People’s physical and mental health was monitored and when it was needed, help from external healthcare professionals was requested. People’s apartments were person centred and decorated based on their likes and preferences.

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, however, the policies and systems in the service did not always support this practice.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Based on our review of safe, effective and well-led key questions the service was able to demonstrate how they were meeting underpinning principles of Right support, Right Care, Right Culture. People were encouraged to access local community with and for some people without staff support, and to be as independent as this was possible. People were offered choices about their day to day life. For example, people made decisions about what they would like to do during the day or what food they would like to eat. Ethos, values, attitudes and behaviours of leaders and care staff ensured people using services lead confident, inclusive and empowered lives. The registered manager and staff were passionate about improving people’s quality of life.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was good (published 9 October 2019).

Why we inspected

We received concerns from Local Authority in relation to reporting and managing safeguarding concerns and governance of the service. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe, effective and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Winslow on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service/We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to fire safety and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.