Windsor House

Windsor House is a residential care home providing personal care for up to 17 people in one adapted building. The service provides support to older people. At the time of our inspection there were 16 people using the service.

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

People told us that Windsor House was a good place to live. One person said, “I would recommend it, would say you would be looked after alright, I cannot fault them.”

The service had appropriate policies, procedures and risk assessments in place to keep people safe and these were followed by staff. Care plans reflected the care and support people required to keep them safe and meet their preferences.

A system was in place to monitor the quality and safety of the service, this was effective in identifying and driving improvement. Safety checks of the premises and equipment were routinely carried out.

Staff had positive links with healthcare professionals which promoted people's wellbeing. Records confirmed the manager worked in partnership with stakeholders.

Mental Capacity Act all reports where covered in the scope of the inspection

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.

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 14 July 2018)

Why we inspected

We received concerns in relation to the care people received. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has not changed.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Windsor House 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.

There were 17 older people, some living with dementia, living in the service when we inspected on 4 June 2018. This was an unannounced comprehensive inspection.

At our last inspection of 20 October 2015, this service was rated good overall. The service had maintained the rating of good overall. However, well-led was rated requires improvement at this inspection. This was because, despite the systems in place to monitor and improve the service provided to people. the provider had failed to provide appropriate equipment for a person. The provider’s quality checks had failed to identify the issue. However, following our inspection this had been addressed by the provider, after we had identified the issue.

The service continued to provide people with a safe service. Staff were trained and understood how to safeguard people from abuse. Risks to people were assessed and staff were provided with guidance about how to minimise risks. Staff were available when people needed assistance. There were safe recruitment systems. Medicines were managed safely. There were infection control systems in place to reduce the risk of cross contamination. Where incidents had occurred, the service learned from them and used them to drive improvement.

Staff were trained and supported to meet people’s needs effectively. However, there were some gaps in staff training, but this was booked for the month of our inspection. People had access to health professionals when needed. People’s nutritional needs were assessed and met. Staff worked with other professionals involved in people’s care to provide people with an effective and consistent service. 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. However, the records relating to people’s capacity to consent would benefit from more detail, the registered manager said this would be addressed. The environment was appropriate for people using the service.

People were treated with care and compassion by the staff. People’s privacy and independence was promoted and respected. People were listened to and their views about how they wished to be cared for were respected.

People’s care was assessed, planned for and met. Care records guided staff in how people’s preferences and needs were met. People had access to social activities to reduce the risks of isolation and boredom. People’s choices were documented about how they wanted to be cared for at the end of their life. There was a complaints procedure in place and people’s complaints were addressed and used to improve the service.

This is a summary of what we found;

Is the service safe?

When we arrived at the service a staff member looked at our identification and asked us to sign in the visitor's book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.

People told us they felt safe living in the service and that they would speak with the staff if they had concerns.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. While no applications had needed to be submitted, relevant staff had been trained to understand when an application should be made, and how to submit one. We saw that the staff were provided with training in safeguarding vulnerable adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). This meant that staff were provided with the information that they needed to ensure that people were safeguarded.

The service was safe. We saw records which showed that the health and safety in the service was regularly checked.

We saw the staff rota and discussions with the registered manager and staff showed that the service assessed people's needs to ensure that there were sufficient numbers of staff to meet their needs. People told us that the staff were available when they needed them. One person told us that when they used the call bell, "They (staff) come more or less straight away."

Is the service effective?

People told us that they felt that they were provided with a service that met their needs. One person said, "I would not want to move from here, I have made this my home."

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information about how people's needs were to be met.

The service was clean and hygienic. This meant there were systems in place to ensure that people were protected from the risks associated with cross infection.

Is the service caring?

The staff interacted with people living in the service in a caring, respectful and professional manner. People told us that the staff treated them with respect and kindness. One person said, "They (staff) are all very nice."

People using the service, their relatives and other professionals involved with Windsor House completed satisfaction questionnaires. Where shortfalls or concerns were raised these were addressed.

Is the service responsive?

People using the service were provided with the opportunity to participate in activities which interested them. People's choices were taken in to account and listened to.

People's care records showed that where concerns about their wellbeing had been identified the staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance from health care professionals, including a doctor and district nurse.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

The service had a quality assurance system and records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

We also spoke with a person's relative who told us that they were happy with the service their relative was provided with.

People told us that the staff treated them with respect and kindness. One person said, 'They (staff) are all very good.' Another person said, 'They (staff) are all kind.' This was confirmed in our observations during our inspection. We saw that staff interacted with people in a caring, respectful and professional manner.

We found that people's complaints were listened to and acted upon.

We looked at the care records of four people who used the service and found that people experienced care, treatment and support that met their needs and protected their rights.

Four staff personnel records that were seen showed that staff were trained and supported to meet the needs of the people who used the service.

People who used the service were provided with a safe environment to live in.