Winchester House

Updated 20 August 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

This inspection was carried out by three inspectors, a specialist advisor who was a nurse and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Winchester House 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 the inspection

We reviewed the information we already held about the service. This included information submitted to us as notifications. Notifications are information about events which providers are required by law to inform us about. We reviewed the feedback we had received from members of the public, and local authority commissioners who were involved with the service. The provider was not asked to complete a provider information return prior to this inspection. 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 this information to plan our inspection.

During the inspection

We spoke with eight people who used the service and two relatives about their experience of the care provided. We spoke with 13 members of staff including the registered manager, deputy manager, team leaders, nurses, and care workers. We reviewed a range of records. This included nine people’s care records and multiple medication records. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at quality assurance records. We spoke with two professionals who regularly visit the service.

Updated 20 August 2021

About the service

Winchester House is a care home registered to support up to 123 people with nursing and care needs. It is divided into six units. One unit was for people with complex nursing needs and two were for people with dementia nursing needs. The home also had two residential units for people without nursing care needs, one of which was a residential unit for people living with dementia. The last unit was closed to admissions due to renovation At the time of our inspection 90 people were living at Winchester House.

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

There were enough staff to meet people’s needs. Records reviewed showed that there were appropriate numbers of suitably trained staff.

People told us that they felt safe, One person we spoke with, told us, "Oh yes it's safe here, and they always check on me." Another told us that, "[staff] are professional and do what I ask of them."

Safeguarding incidents and accidents/concerns were investigated thoroughly, and the registered manager worked closely with local authority safeguarding teams to prevent the risk of reoccurrence and identify the causes. The frequency of safeguarding alerts had reduced significantly since our last inspection.

People’s care plan files were up-to date and contained the information needed to support people. However, the care plans we reviewed were difficult to read and follow. They contained a large amount of information, were handwritten and did not contain a summary of the person's needs. This could pose a risk to people as new or agency staff may find it difficult to access the most up to date information needed to care for people safely.

Feedback on activities available to people was mixed. Some people were observed completing hobbies they were interested in, such as gardening however, on two nursing units there was a distinct lack of engagement for people who were cared for in bed.

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; the policies and systems in the service supported this practice.

People who were receiving support from external healthcare professionals had updates to their care plans and there was clear guidance in place for staff to support people appropriately.

People were supported to take their medicines as prescribed. Staff were given training they needed to perform their roles and the registered manager had a team structure in place for supervision and reporting, whilst fostering and open-door culture that encouraged staff to go to them.

There had been improvements in the quantity and frequency of quality assurance checks since the last inspection. The registered manager had implemented several changes to improve the service.

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 January 2020) where multiple breaches of regulations were 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 improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about staffing, people’s risk assessments and the culture of the service. A decision was made for us to inspect and examine those risks. We carried out an unannounced comprehensive inspection of this service on 12 November 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve person centred care, safe care and treatment, good governance, and staffing.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

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

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.