Archived: Winsford Grange Care Home

Updated 1 January 2021

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.

As part of CQC’s response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure that the Infection Prevention and Control practice was safe, and the service was compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place.

This inspection took place on 18 December 2020 and was announced.

Updated 1 January 2021

About the service

Winsford Grange is a purpose-built care home for up to 60 people across four separate units. The service provides nursing care for frail older people and people with dementia. At the time of our inspection there were 36 people being supported across three units as one unit remained closed.

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

Since the previous inspection a new manager had been recruited, along with a non-clinical lead and nurses. The manager showed great awareness for the changes needed in order to improve the quality of the service and the care being provided. They had good insight into the previous issues and the impact this had on staff morale and was working to change this.

Staff told us that a long history of inconsistent management had resulted in a lack of faith and trust. They recognised the changes being made were required in order to improve care and clearly understood the new manager’s vision and values to provide people with the best care possible. It was evident there was a strong desire amongst all staff and managers to promote a person-centred culture.

Whilst there were enough staff on duty, a lack of team work and support from some senior staff and nurses created additional pressure on care staff and resulted in people receiving task-based support. The service used agency staff to cover gaps in staff levels; some agency staff were not familiar with the people they were supporting. Regular staff told us they felt rushed and at times unable to provide the person-centred care that people deserved. The manager was aware of the staffing issues and was working to address this through the changes being made.

People told us they felt safe living at Winsford Grange and family members were confident their loved ones were well looked after. Care plans provided staff with the information they needed to help keep people safe from harm and they knew what action to take if they had any concerns. Appropriate equipment was in place to support people’s mobility and alert staff to any concerns.

People’s medicines were managed safely by nursing and senior staff who had received appropriate training and who had their knowledge and abilities checked regularly by the manager. Where people received their medicines covertly (hidden in food), appropriate records had been completed and professionals involved in the decision making process.

People’s individual needs had been fully assessed in line with current best practice guidance. Care plans contained information and for staff to follow in order to provide safe and effective care. Where people received additional support from other health and social care professionals, this was clearly recorded and staff followed the guidance provided.

Meals were provided by an external food supplier who was aware of people’s individual dietary needs and requirements. Where people required additional support with their meals, staff provided this. Risks associated with poor food and drink intake were clearly recorded and guidance in place for staff to follow.

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.

Despite the low staff morale, people continued to receive kind, caring and compassionate care. It was evident that staff knew people well and were keen to give the best care possible. People and family members spoke positively about the caring nature of staff. Family members told us they felt welcome when visiting loved ones.

Care plans were in the process of being updated to provide more person-centred information. Those looked at contained detailed information about people’s life histories to help staff get to know people before providing support. People had access to a range of activities; the new activities coordinator was in the process of researching and implementing activities that provide better outcomes for people living with dementia. They showed passion for their role and were keen to improve this aspect of the service.

The service worked closely with health and social care professionals and community groups to help promote better outcomes for people and ensure their health needs were met. Regular meetings were held to enable people, family members and staff to provide their views about the service.

Effective systems were in place to check the quality and safety of the service. Regular checks and inspections were completed by the manager and provider and action plans created to aid improvements. There was a strong desire amongst the manager, clinical lead and quality business partner to improve the service.

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

Rating at last inspection (and update): The last rating for this service was requires improvement (report published 9 January 2019). There were multiple breaches of regulation. The provider completed an action plan to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

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.