Windsor Court

Windsor Court is a residential care home providing personal and nursing care for up to 44 people. At the time of our inspection there were 39 people living at the service. People’s bedrooms were arranged over three floors with communal lounges and dining areas on each floor. Care was provided to older and younger people, who were being supported with both their physical or mental health needs.

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

People and relatives we spoke with said they found the home to be welcoming and staff were friendly. One relative told us, “I find the place very warm and friendly. I have easy access to anyone that I need to speak to.”

Risks to people were appropriately assessed and managed. Staff had a good understanding of how to keep people safe and report any accidents or concerns. Risk assessments were in place to support people to be as independent as possible.

Safe recruitment practices were followed to ensure people were supported by staff with appropriate experience and of good character. There were sufficient staff to meet people’s needs. Staff we spoke with told us they felt supported by management and had the opportunity to maintain their skills and knowledge through access to training.

Systems were in place to ensure medicines were managed safely. People had access to healthcare professionals to meet their health care needs. One relative told us, “I think that they respond very well. If there is anything that he needs, they will tell me.’’

Staff were aware of people’s dietary needs and preferences. People’s needs and preferences were also clearly recorded in their care plans. One relative told us, “I know she must be eating more, because they told me the other day that they had put on three kilograms in weight. I don’t have any current concerns about their diet.”

The service was clean and odour free. Systems were in place to monitor how cleaning was being completed and to ensure safe care was maintained for people during the COVID-19pandemic.

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.

Quality assurance systems were in place to monitor the quality of service being delivered and the running of the home.

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

Rating at last inspection

The last rating for this service was good (published 18 January 2019).

A targeted inspection took place in March 2021 (published 1 April 2021).

The service was inspected but not rated and therefore this did not change the last rating for the service.

Why we inspected

The inspection was prompted in part due to concerns received about safeguarding people, how people’s nutritional needs were being met and the management of the service. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe, effective and well-led sections of this full report.

For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating.

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. This included checking the provider was meeting COVID-19 vaccination requirements.

The overall rating for the service has not changed following this focused inspection and remains good.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Windsor Court is a residential care home providing personal and nursing care for up to 44 people. At the time of our inspection there were 32 people living at the service. People’s bedrooms were arranged over three floors with communal lounges and dining areas on each floor. Care was provided to older and younger people, who were being supported with their physical or mental health needs.

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

Systems were in place to safeguard people from the risk of harm or abuse. The registered manager dealt with and responded to all safeguarding concerns.

Staff knew how to identify if people were at risk of harm or abuse and what actions they needed to take should they suspect abuse was taking place. Staff we spoke with felt confident that actions would be taken by the registered manager or deputy to address any concerns raised.

People were protected by the prevention and control of infection. Staff had received training in the appropriate use of PPE and were able to correctly explain how they put in on and took it off.

Arrangements were in place in line with national guidance, to ensure relatives, friends and others were prevented from spreading infection when visiting the home.

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

Rating at last inspection

The last rating for this service was good (published 18 January 2019).

Why we inspected

The inspection was prompted in part due to concerns received about infection control and safeguarding people. A decision was made for us to inspect and examine those risks. 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.

CQC have introduced targeted inspections to follow up on Warning Notices, breaches of Regulations or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

The overall rating for the service has not changed following this targeted inspection and remains good.

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.

People’s experience of using this service:

People, relatives and staff told us Windsor Court was very 'homely'. People looked relaxed and comfortable. Staff were friendly and knew people well. The registered manager told us they wanted people to feel the service really was their home. Relatives were warmly greeted and made to feel welcome with cups of tea and offered to share meals with their family member. Special occasions were celebrated with birthday cakes and parties. People were treated with dignity and their independence was promoted.

People told us they felt safe. Staffing had improved since our last inspection with more staff working during busier times of the day. People told us their requests were responded to quickly. Processes were in place to make sure the home was safe. Equipment was checked regularly to make sure it worked properly. Medicines were well managed. The home was clean.

Staff were well trained and knowledgeable about their roles and the care people needed. People's needs had been assessed. Staff had detailed and specific information about how to care for people. However, we saw less information was available about how to support people when their behaviour could challenge staff. We have set a recommendation about this. Staff were proud of the innovative work and good outcomes they had achieved in reducing people's risk of pressure damage.

Improvements had been carried out to the building since our last inspection. There was better use of signage, communal areas had been refurbished and the decoration had been chosen so it was meaningful for people who lived at the home.

People's rights were upheld. People were given choice and their decisions were respected. Where people did not have capacity to make decisions, they were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

A full time activities coordinator planned a range of events and activities within the home. People also attended social groups and visited their local community regularly.

The service was well run. The provider and registered manager carried out checks to make sure that the service was delivering a good service. They had introduced new strategies since our last inspection to improve the service.

Rating at last inspection: Requires Improvement (Published in November 2017)

Why we inspected: This was a planned inspection based on the rating at the last inspection.

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

This was the first inspection of Windsor Court since it was registered with the Care Quality Commission in February 2016. The premises had previously been owned by another provider.

Windsor Court is registered to provide personal and nursing care to a maximum of 44 older people, including people who live with dementia or a dementia related condition. At the time of inspection 42 people were using the service.

A registered manager was in post. 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 said they felt safe and they could speak to staff as they were approachable. We had concerns however that there were not enough staff on duty to provide safe and effective care to some people.

People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. When new staff were appointed, thorough vetting checks were carried out to make sure they were suitable to work with people who needed care and support.

Appropriate training was provided and staff were supervised and supported. Staff had a good understanding of the Mental Capacity Act 2005 and best interest decision making, when people were unable to make decisions themselves.

People were supported to have maximum 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.

People received a varied and balanced diet to meet their nutritional needs. Improvements were required to people's dining experience. Activities and entertainment were available to keep people engaged and stimulated.

People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care they needed. Systems were in place for people to receive their medicines in a safe way.

Risk assessments were in place and they accurately identified current risks to the person as well as ways for staff to minimise or appropriately manage those risks. Staff knew the needs of the people they supported to provide individual care, however records did not always reflect the care provided. We have made a recommendation that staff receive training about person centred care and personhood. Care was provided with kindness and people’s privacy and dignity were respected.

Changes had been made to the environment. Some areas had been refurbished. However, not all areas of the home were clean and well maintained for the comfort of people who used the service. The home was not designed to promote the orientation and independence of people who lived with dementia, although plans were in place to address this. We have made a recommendation that the environment should be designed according to best practice guidelines for people who live with dementia.

A complaints procedure was available. People had the opportunity to give their views about the service. There was regular consultation with people and/ or family members and their views were used to improve the service. People had access to an advocate if required.

Staff and relatives said the management team were approachable. Communication was effective to ensure staff and relatives were kept up to date about any changes in people’s care and support needs and the running of the service.

The home had a quality assurance programme to check the quality of care provided. However, the systems used to assess the quality of the service had not identified the issues that we found during the inspection with regard to staffing levels, people’s dining experience, environmental design and record keeping.

During this inspection we found breaches of Regulations 17 (governance) and 18 (staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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