Winsor Care Services

Updated 9 September 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 2 inspectors.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 25 May 2023 and ended on 20 June 2023. We visited the location’s office on 25 May 2023.

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. The provider did not complete the required Provider Information Return (PIR). This is information providers are required to send us annually with key information about the service, what it does well and improvements they plan to make. Please see the well-led section of this report for further details. We also reviewed intelligence information we held on our system including notifications about important incidents. We used all this information to plan our inspection.

During the inspection

We spoke with 4 people who used the service and 4 relatives. We received feedback from 6 professionals involved in people’s care. We spoke with 6 staff members including the registered manager. We looked at 5 people’s care records, their daily notes, medication and care visit records. We looked at 4 staff recruitment records.

Updated 9 September 2023

About the service

Winsor Care Services is a domiciliary care service providing personal care to people living in their own homes. The registered manager told us there were 68 people using the service but they were unable to give us the exact number of people receiving the regulated activity of personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. We only reviewed the records of people confirmed to be receiving personal care.

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

We found evidence of repeated breaches of regulations identified at the last inspection and that not enough improvement had been made.

There was lack of management oversight and a lack of reliable systems to inform the management of the quality of care people were receiving. People’s records showed medicine errors and incidents of people missing their medicines occurred. There was evidence people experienced missed, late or much shorter than required care visits. Staff were deployed unsafely and told us, they felt rushed to provide the care people needed.

The provider did not always inform the local authority of safeguarding concerns and did not communicate effectively with health and local authority professionals regarding investigations. The registered manager did not uphold their regulatory responsibility of notifying the CQC of all notifiable incidents when required to do so.

The provider failed to ensure people had risk assessments in place for known risks relating to their conditions and incidents to people occurred as a result of poor risk management. People’s care records did not reflect people’s current needs, choices or preferences.

People and their relatives told us, they experienced the continuity in the staff supporting them. Staff told us, they got to know the people they supported and their preferences. The continuity in rotas meant that the familiarity of staff with people reduced the impact of poor-quality assessments and care plans. People were supported to have choice and control of their lives and staff supported them in the least restrictive way and in their best interests; the policies and systems in the service supported this practice.

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 requires improvement (published 21 October 2022) and there were 6 breaches of regulations found. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

At our last inspection we recommended that people were involved in the care planning and given a choice of who they wanted to support them and that feedback from people was more consistently collected. At this inspection we found that people were not always involved in their care planning and feedback was not consistently sought from people, despite some improvements.

Why we inspected

The inspection was prompted in part due to concerns about risk management leading to incidents and accidents which had not always been reported to the CQC or local authority. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive 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.

Enforcement and Recommendations

We have identified breaches in relation to, person centred care, safe care and treatment, safeguarding people from the risk of abuse, duty of candour and good governance. Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘Inadequate’ and we are placing the service in 'special measures'. We do this when services have been rated as 'Inadequate' in any Key Question over two consecutive comprehensive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place services in special measures. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.