17 August 2021
During an inspection looking at part of 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.