Archived: Winton Care Home

Updated 30 September 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was undertaken by two inspectors, a pharmacist specialist and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the Care Quality Commission. The current manager had been appointed in May 2021 and had submitted an application to register with the Commission. If registered, this will mean that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Before the inspection, we reviewed all the information we held about the service including previous inspection reports and notifications received by the Care Quality Commission. A notification tells us about important issues and events which have happened at the service. We sought feedback from health and social care professionals. We used all of this information to plan our inspection.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

Some people were not able to fully share with us their experiences of using the service. Therefore, we spent time observing interactions between people and the staff supporting them in communal areas. We spoke with five people who used the service and seven relatives. We also spoke with the manager, head housekeeper, a registered nurse, a health care assistant and the laundry assistant.

We reviewed five people’s care plans in detail and a further nine people’s charts and others documentation. 18 medicines administration records, four staff files and a variety of other records relating to the management of the service were also viewed.

After the inspection

We spoke with five care workers and received written feedback from a further 12 staff across a variety of roles. Four health and social care professionals provided feedback about the service. We also continued to seek clarification from the provider to validate evidence found.

Updated 30 September 2021

About the service

Winton Care Home is a care home providing personal and nursing care to up to 39 people including those living with dementia. There were 28 people using the service when we inspected. The property is a grade 2 listed building. The accommodation is arranged into two main areas. The main house is the older part of the building and dates back to the 18th century. The newer wing was built in 2000 and was purpose built to be care home accommodation. Both wings have three storeys. The premises are located within extensive parkland.

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

There were not always enough staff available to be fully responsive to people’s needs. Risks to people’s health and wellbeing had not always been managed safely. Medicines were not always managed safely. Action was needed to address some environmental risks. As part of CQC's response to the coronavirus pandemic we conducted a review of infection prevention and control (IPC) measures in the home and found that some improvements were needed. There were systems and processes in place to safeguard people from the risk of abuse and to learn from safety related events.

This inspection found that the governance arrangements in place were not yet being fully effective at identifying all of the areas where improvements were needed. This inspection identified a number of areas where the quality and safety of the care provided had been compromised. Records were not always up to date or reflective of people’s needs and did not provide assurances that care was always being delivered as planned.

The manager had been in post for three months when we inspected. They had begun to identify areas where improvements were needed and had an action plan in place to meet these. The manager maintained a visible presence within the home and actively supported staff and interacted with people on a daily basis. Staff were clear about their role and responsibilities and spoke positively about the managers leadership and their impact on the service since their appointment.

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 February 2018).

Why we inspected

The inspection was prompted in part due to concerns we had received about medicines management and staffing levels within the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

We reviewed all the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has deteriorated to requires improvement. This is based on the findings at this inspection.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We have identified new breaches in relation to safe care and treatment, staffing, fit and proper person’s employed and good governance.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.