23 February 2022
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.
As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.
This inspection took place on 9 February 2022 and was announced. We gave the service 24 hours notice of the inspection.
23 February 2022
This inspection took place on 5 and 6 December 2018 and was unannounced. Abbeyfield Winnersh is a purpose built residential care home for older people who all have some degree of dementia. 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 home is arranged over two floors with en-suite bedrooms on both floors and communal areas comprising of dining areas, lounges, quiet rooms a cinema, library and a hair dressing salon. It can provide accommodation and personal care for up to 62 people at any one time. On the day of the inspection 44 people were living in the service of which three were in hospital.
The service was registered on 3rd August 2016. This was the second comprehensive inspection since the home opened. At the last inspection we found that improvements were needed in relation to the clarity and relevance of risk assessments and the accuracy of information within care plans overall. Staff training was not up to date and many of the senior staff who were new to their roles and the required responsibilities were not adequately supported. Whilst the last inspection demonstrated that improvements were being made these were at an early stage. The scale of the task was such that a period of sustained improvement needed to occur in many areas of the home including communication within the team and with relatives and health and social care professionals. At this inspection we found improvements in all areas. Whilst it was acknowledged that improvements were still needed the home was now functioning to a good standard overall. There was a registered manager in post. He was an experienced manager who had transferred from another of the providers services. 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.
The provider continued to complete thorough recruitment checks on potential members of staff. Maintenance and checks of the property and equipment continued to be carried out promptly and within required timescales. Checks on the fire safety systems and equipment were completed in accordance with the provider’s policy and manufacturer’s instructions. The medicines management systems were conducted safely and appropriately. The provider had plans in place to deal with any emergencies that may arise.
People who use the service were able to give their views about the quality of the care provided. The majority of relatives and community professionals told us they were happy with the direction the service was going in. In addition, there was more satisfaction with the standard of care provided by Abbeyfield Winnersh and confidence that people were safe using the service. The service had improved systems to manage risks to both people and staff, and we saw more person-centred initiatives had been implemented to enhance the care provided. Staff were aware and confident about keeping people safe and the procedures for reporting concerns promptly was well understood. Information and guidance was readily available for staff to access in the event they had any concerns.
People were treated with kindness, dignity and compassion. People were respected and had their privacy safeguarded by staff who understood these principles. Feedback from relatives confirmed this. We saw that people and staff interacted in a positive manner, choices were offered and explanations were provided. Throughout the two-day inspection there was a relaxed and friendly atmosphere where a range of activities were being provided and engaged with by people. We saw people laughing and smiling with staff as they went about their daily routines. Visitors and professionals were welcomed at the service and there were no restrictions on visiting times.
People’s right to make decisions was protected. They were involved in decisions about their care as far as they were able. Staff understood their responsibilities in relation to gaining consent before providing support and care. Relatives/representatives told us they had been asked for their views on the care provided. Regular reviews of people’s care and support needs took place. The registered manager had ensured that up to date information was communicated promptly to staff through briefings, meetings and regular supervision sessions.
People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice. When people’s freedom had been restricted for their own safety appropriate authorisations were in place under the Deprivation of Liberty Safeguards. There was a programme in place to ensure that all those people who lacked mental capacity and may require restrictions on their freedoms had applications in progress. People had a choice of food and drink which they enjoyed. When necessary their nutrition and/or hydration was monitored to help ensure their well-being. People received appropriate health care support from health and social care professionals who were contacted promptly when necessary.
Staff felt well supported and the registered manager was praised for the support and clear direction provided. Staff confirmed they felt listened to if they raised concerns or suggestions and action was taken without delay. There was a programme of training in place to ensure that staff acquired the skills necessary for their role. New staff received a comprehensive induction and training in core topics. We found a very open culture in the service and staff were confident to approach the registered manager or any member of the management team for advice and guidance.
The registered manager had implemented the provider's vision and objectives which had formed the basis and direction for improvements and all staff were now familiar with. The quality of the service was monitored by the registered manager and members of the senior team and included a range of survey and feedback exercises for interested parties which had informed the improvements and the formal service improvement plan.