We carried out a review of the data available to us about White Horse Care Trust - 24 Windermere on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about White Horse Care Trust - 24 Windermere, you can give feedback on this service.
White Horse Care Trust - 24 Windermere is a residential care home providing personal care to two younger adults with learning disabilities and/or autistic spectrum disorder needs at the time of the inspection.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The service was the same size and design as other domestic properties in the residential area. It was registered for the support of up to two people. This is in keeping with current best practice guidance. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff did not wear a uniform when supporting people at home or when accessing the wider community with them.
People’s experience of using this service and what we found
People felt safe and staff treated them with respect and dignity. People were comfortable and relaxed when interacting with staff and had formed positive relationships with them. Risks to people were managed through regular reviews and detailed support plans which included guidance from health professionals.
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. When restrictions were needed to maintain people’s safety, for example, when going out into the community, the least restrictive approach was taken. Arrangements made on people’s behalf were made in line with Mental Capacity Act requirements when people could not consent to decisions about their care.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. People’s wishes and support needs were reviewed regularly, with the staff member they chose to work with. Staff were committed to helping people achieve their goals and to ensuring people’s disabilities did not prevent them from living a fulfilled and happy life. People were supported to participate in activities they enjoyed and were interested in.
People's support focused on opportunities to gain new skills and become more independent. People were empowered to contribute and be independent as far as possible, for example through use of technology. People enjoyed regular trips out and had formed friendships with others they saw regularly. People were supported to maintain relationships with others who were important to them.
The registered manager had worked openly and transparently with outside agencies in response to concerns about the service in 2018. Improvements had been made to ensure this would not happen again.
The service was caring and person-centred. People using the service and the staff supporting them, were valued and listened to. The provider and registered manager understood their responsibilities and monitored the service to ensure any improvements needed were carried out.
For more details, please see the full report which is on the CQC website at www.cqc.co.uk
Rating at last inspection
The last rating for this service was ‘Good’ (published 12 May 2017).
Why we inspected
This was a planned inspection based on the previous rating.
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.
At the last inspection in January 2015, the service was rated as ‘Good’. At this inspection we found the service remained ‘Good’.
A registered manager was employed by the service but was not present during our inspection. The deputy manager and area care manager were available throughout our inspection. 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 benefitted from a safe service where staff understood their responsibilities to safeguard people from potential harm or abuse. Staff understood the procedure they needed to follow should they suspect abuse might be taking place. Risks to people’s safety were identified and plans put in place to help reduce the risk of them occurring and to support staff to manage people’s safety.
People’s medicines were managed and administered safely. People’s health care needs were monitored. Records confirmed that where people’s health needs had changed they had access to appropriate healthcare professionals.
People were able supported to eat and drink sufficient amounts and maintain a balanced diet.
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.
Staff received appropriate training to ensure they had the necessary skills and knowledge to support people to meet their needs. Staff treated people with kindness and respected people’s privacy and dignity. People were supported in a way that allowed them to be as independent as possible.
Care plans were person centred. They contained detailed information of the person’s daily routines, preferences, likes and dislikes. Records showed care plans were reviewed regularly and any changes to care updated.
The service had systems in place to monitor the quality of care provided and these were reviewed on a regular basis. The service had a clear process for the handling of complaints.
The inspection took place on the 8 and 12 January 2015. This inspection was announced. We gave the provider 24 hours’ notice. This was because there are only two people living at 24 Windermere and we wanted to ensure people were at home during our visit. During our last inspection we found the provider satisfied the legal requirements in the areas that we looked at.
The home 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.
24 Windermere provides accommodation and personal care for two people who have learning disabilities. The main focus of the service is to treat everyone as individuals and involve them in choices which promote their independence. Relatives were positive about the service their family member received.
CQC is required by law to monitor the application of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The Mental Capacity Act 2005 sets out what must be done to make sure that the rights of people who may lack mental capacity to make decisions are protected, including when balancing autonomy and protection in relation to consent or refusal of care or treatment. This includes decisions about depriving people of their liberty so that they get the care and treatment they need where there is no less restrictive way of achieving this. DoLS require providers to submit applications to a ‘Supervisory Body’, the appropriate local authority, for authority to do so. We found that the service had complied with the requirements of the MCA and DoLS.
Because of people’s complex needs they were unable to tell us verbally about their experiences of living at 24 Windermere. However, staff members communicated with people effectively. Staff treated people in a caring, kind and respectful way. They knew the people they cared for and supported well and always used people’s preferred names.
People were involved in deciding what food and drink they had. They were supported to access healthcare services to maintain and promote their health and well-being. They were encouraged to make their rooms at the home their own personal space. People and their relatives had been involved in the development of their care plans which were reviewed on an annual basis, or more frequently if required.
They were supported in a range of interests, both as activities together or on an individual basis, which suited their needs. They were encouraged to take part in activities outside of the home to enable them to access their local community.
There were enough qualified, skilled and experienced staff to meet people’s needs. All necessary checks had been completed before new staff members had started work at the home and they had completed an induction programme when they started work. Staff members received training in areas that improved their capability in providing care and support to people who lived at the home and had regular supervision and appraisal meetings with the manager at which their performance and development were discussed
Staff members were able to demonstrate a good understanding of procedures in connection with the prevention of abuse. Risk assessments in respect of the home and the provision of care and support to people had been carried out, regularly reviewed and steps taken to reduce the on-going risk.
The provider had systems in place to ensure that medicines were administered and disposed of safely. All medicines were stored securely.
The provider had an effective system to regularly assess and monitor the quality of service that people received and an effective complaints system.
People's health needs were correctly monitored and a healthy diet was promoted. Choice around food was encouraged.
All staff received training in adult protection.
The service had an effective recruitment policy in place and the appropriate checks were completed on new starters.
The provider had systems in place to monitor the quality of the service being delivered and to identify and manage risk.
Relatives told us that their family member felt really safe and happy because the staff knew him so well. One relative said, 'He loves it there. After visiting us his face lights up and he can't wait to go back'. Other relatives told us that they were always kept up to date with changes to medication and daily care plans. One parent said, 'They always treat him so well. I've never seen him so happy'.
Appropriate arrangements were in place in relation to obtaining, handling and storing medicine. Relatives said they had seen staff giving people medicine in an appropriate and friendly manner.
Families told us that the staff provided excellent care, which made them confident in the quality of their training. They said the staff were well trained and were like another family to the people they supported.
Relatives we spoke with confirmed they had not made a complaint but were aware how to do so and understood the process. In a visitors survey a community nurse said, 'The staff are always so welcoming and friendly. You can see the way they support people is totally based on giving them choice and preferences'.
We spoke to two relatives on the telephone. They were confident that their family members' needs were met and that they were well cared for at Windermere. One person told us: 'I think X is very happy there. He is always keen to go back when we have taken him out. Both people said that they were always made welcome in the home and were kept informed of their relative's progress. One relative told us however that multidisciplinary reviews of their relative's care took place at inconvenient times and they were unable to participate in them. They said that as a result of this, they were not well informed about their relative's current medicines.