Winsor Care Services

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

The provider had commissioned consultants since the last inspection but there had been a lack of stability in these appointments which had negatively impacted the governance of the service. There was a lack of uniformity within records and a lack of quality assurance data which could provide trends for analysis. The provider had plans in place to address the stability of governance. We found that since the last inspection, sufficient improvements had not been made by the Registered Manager to address all the breaches. We found a repeated breach of Regulation 17. Staff told us they felt supported by the management team and the Registered Manager gave us examples of being inclusive, diversity and that staff were included in the running of the service. Due to a focus on addressing previous breaches, there had been a lack of attention on innovative or collaborative practices. Partnership services told us that there had been an improvement in communication with the provider.

This service scored 32 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Staff told us that the leadership were responsive if they needed support. One staff member told us, "If I have any problems, I call her, and she assists me. Another staff member told us, "[Registered manager] always gives me instructions and helps staff to improve." The registered manager had recruited a consultant to support with the leadership of the service. The registered manager told us they recognised sufficient improvements had not been made since the last inspection and there had been delays. They were in the process of reviewing the governance of the service, ensuring that the leadership was capable of driving improvement promptly. The consultant instructed by the provider told us that the values of the service are "Happy, safe and effective care for everyone". The registered manager told us that integration amongst the workforce is encouraged. The registered manager said that occasions are celebrated and staff are invited to cook their national dishes and share them with the group. They told us, “We are quite a close family, I would say.” The registered manager also told us, "Changes have been made to staff rotas when they have had family issues...staff who observed Ramadan were offered the opportunity to work flexibly."

The provider was in the process of recruiting into the leadership team. There was a consultancy in place which were supporting actions to address the identified risks and we saw evidence of risk mitigation such as monitoring the timeliness of care visits in real time and re-assessing risks associated with peoples care. However the progress toward a capable leadership of the service had been delayed and there were still significant improvements to be made in order to have a clear oversight of the performance, ensuring people felt heard, and that records were consistently accurate and contemporaneous. We saw in staff records that the approach to supervision of staff and addressing performance concerns were compassionate. Staff who required adaptations to their work patterns for example were accommodated. We saw a staff handbook promoting an inclusive culture and support upon joining the service. We saw a policy for equality with aims to be open with staff about equality values.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The consultant supporting the provider told us, “The aim is to have a strong management team. A very good registered manager and myself as nominated individual.” The consultant supporting the provider told us that due to a focus on ensuring people received safe care, which had resulted in some improvements, the governance improvements were yet to be instilled to see sustainable practices. The consultant supporting the provider had completed some audits for the time they had been involved and they told us there was a plan to improve and continue with these. In order to schieve sustainability, the consultant supporting the provider told us, "We have put in some bank staff to cover sickness. We have fully trained staff from a recruitment company who can be here the same day or the next day.” There had been an electronic system in place to monitor the care provision and this was being used more fully. The consultant supporting the service told us, "I am happy the system that has always been here is now being used effectively.”

We saw that some quality assurance was taking place on a daily basis. Audits had begun for care visits but there was no available data for previous months which limited oversight of progress and patterns to be learnt from or responded to. There were some areas of service delivery and records which had not been audited which meant that areas for improvement and oversight of quality could not be obtained accurately.

People and relatives did not report that they were involved in the service. Feedback was not requested routinely. One relative told us, "{Person] has had these carers for 3 years and the manager has rung me twice in that time to ask for my feedback." They did however feel the service worked well in establishing partnerships and collaborating together. One relative told us, “They know that my wife has visits from the district nurse to give her insulin and they often say you may want to pass this on to the nurse when she comes.”

The consultant supporting the provider told us that they had implemented involvement and inclusion meetings with people face to face. They told us, "Not all service users have had the meeting to date, roughly 70% are complete, the remainder are scheduled and I have added the notifications prompt on our system to revisit every quarter or sooner if required." There were plans to improve working in partnerships and communities. The consultant supporting the provider told us "We hope to bring in trainee social workers to work with the service as part of their qualification." The consultant also told us that they have a compliance team to check changes in legislation and compliance. The registered manager had attended webinars focused on the sector of care provision the service provides which help managers with advice and guidance. The registered manager told us that networking with other heads of companies to share companies ideas and learning is something which is being looked into.

Feedback from professionals was that communication and collaboration has improved from the provider. One professional told us, "One person had a change of need and needed a new piece of medical equipment for which the provider had requested a medical professional provide training to staff in using."

We saw ‘Involvement and Inclusion Meetings’ carried out with people who use the service. The format of which support partnership working with people who use the service. The provider met with the local authority on a regular basis for support following the previous inspection. Despite the provider communicating with the local authority and other stakeholders regarding individuals care, the provider had not initiated any partnership meetings and collaboration with other organisations to share learning and drive improvement as a service. There was a lack of community engagement and no opportunity for the people receiving a service to join together as a community to share ideas and be involved.

The registered manager told us that they have learnt improved practices through engagement with consultants since the last inspection. The consultant for the service told us that a focus has been on the highest risk and so quality oversight is in progress. There is daily oversight of the care being delivered to people. The consultant told us, "All day long the care is being monitored.” The registered manager told us regular supervisions, appraisals have been highlighted to improve and be consistent. The registered manager was not able to show evidence of being creative in enhancing the equality of experience, outcome and quality of life for people. They had not contributed to research and innovative practice. The consultant told us, "We have been focusing on the highest risks and client experience as a priority."

We saw an action plan in place for improvements. We saw that audits for care visits had been analysed and concerns and trends from the audit had led to discussions with staff within supervision. We did not however see any audits for medicine administration, care plans and risk assessments. We saw that staff were receiving supervision and team meetings to promote continuous professional development.