Archived: Winton Lodge

Updated 25 May 2016

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection took place on 22 and 23 February 2016 and was unannounced. It was undertaken by two inspectors in response to information of concern relating to staffing, training and care planning.

Before our inspection we reviewed the information we held about the home, including notifications of incidents the provider had sent us. We also spoke with the local authority safeguarding investigation team. We had already asked the provider to complete a Provider Information Return (PIR) but inspected as a matter of urgency before they had had a reasonable opportunity to complete this. A PIR is a form in which we ask the provider to give some key information about the service, what the service does well and improvements they plan to make.

During our inspection we spoke with two people who lived in the home. We also spoke with three support staff, the registered manager and their line manager. We observed care and support in communal areas and looked at the care records for two people and medicines administration records for four people. We also looked at records that related to how the home was managed, including four staff files and the provider’s quality assurance records.

Updated 25 May 2016

The inspection took place on 22 and 23 February 2016 and was unannounced. The service was first registered in November 2015 and this was our first inspection. Whilst the service had only been open a short time, we had received information of concern relating to people’s safety and to the skills and knowledge of staff. We found that the service was working to address the issues that had arisen.

The service is a care home for up to nine adults and teenagers with learning disabilities who also experience mental health difficulties and may behave in a way that is challenging to others. When we inspected, there were four adults living there and a further person was in hospital.

The service had a registered manager. 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.

People felt safe. They were supported by staff who understood their responsibilities as regards safeguarding adults. Staff felt well supported and were confident that the registered manager would take any concern they reported seriously.

People were treated with compassion and kindness by staff who were getting to know them and who prioritised their needs.

People received care and support to address their individual needs. Their independence was encouraged as much as possible and they were supported to take part in activities at home and out in the community.

At times people became upset, anxious or emotional, or behaved in a way that was challenging for others to cope with. Risks this presented had been assessed and positive behaviour support plans had been developed. These plans were detailed, specific to the person, and emphasised that the least restrictive possible measures should be taken.

Whilst there were enough skilled staff on duty to meet people’s needs, it was difficult for staff to attend to all aspects of their roles within their paid shifts. Because staff spent much of their time allocated to one-to-one support, they had little time to attend to non-contact tasks such as writing notes.

We identified two breaches of the Regulations.

There was a risk that people’s rights would not be protected because staff did not always follow the requirements of the MCA relating to the deprivation of liberty safeguards. A person had been stopped from leaving the home against their will yet this deprivation of liberty had not been authorised as required by the Mental Capacity Act 2005.

People’s consent to care, including restrictions that were in place to keep them safe, had not always been recorded. Where people had not given consent, there was no record of mental capacity assessments and best interests decisions in line with the Mental Capacity Act 2005.

You can see what action we told the provider to take at the back of the full version of the report.

We recommended the provider reviews their arrangements for training staff in similar new services in mental health to ensure staff have the skills they need when people start using the service. It had been over two months from when the home opened before all staff had received training in mental health and the skills needed to deal with behaviour that challenges others.

We also recommended that the provider keeps their staffing levels under review so that they can continue to ensure people’s safety and meet their needs.