Winchester House

Updated 30 November 2018

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was an unannounced inspection which took place on 31st October 2018. It was undertaken by two inspectors. We did however advise the registered manager of the inspection the day before as they lived some way from the service and we needed them to be present on the day of inspection.

Before the inspection, we reviewed the previous inspection report and records held by CQC which included notifications, complaints and safeguarding concerns. A notification is information about important events which the registered person is required to send us by law. This enabled us to ensure we were addressing potential areas of concern at the inspection. In the planning of this inspection, we gathered feedback from a health and social care professional who had recently been involved with the service.

On this occasion we did not request a Provider Information Return (PIR) before our inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This was because this inspection was to follow up on concerns highlighted at the service’s last inspection which rated it as requires improvement overall.

During our inspection we observed how the staff interacted with people and we spent time observing the support and care provided to help us understand their experiences of living in the service. We observed care and support in the communal areas, the midday meal, and we looked around the service. Some people were able to talk with us about the service they received but others could not. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed the records at the service. These included three staff files which contained staff recruitment, training and supervision records. Also, medicine records, complaints, accidents and incidents, quality audits and policies and procedures along with information with regard to the upkeep of the premises.

We looked at three people's care documentation along with other relevant records to support our findings. We also 'pathway tracked' people living at the service. This is when we looked at their care documentation in depth and obtained information about their care and treatment at the service. It is an important part of our inspection, as it allowed us to capture information about a sample of people receiving care.

During the inspection we spoke with four people, three staff, and the registered manager who was also the provider and one healthcare professional. We observed the care which was delivered in communal areas to get a view of the care and support provided.

Updated 30 November 2018

Winchester House is a 'care home'. People in care homes receive accommodation and nursing and personal care as a single package under a contractual agreement with the local authority, health authority or the individual, if privately funded. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Winchester House accommodates a maximum of nine older people, including people who live with dementia or a dementia related condition, in one residential style building which has been adapted for that purpose. Winchester House is a large detached house situated on a main road in a residential area of Kirby Cross, Frinton on Sea, and is close to local shops. The premises is set out on the ground floor of the building with each person using the service having their own individual bedroom and adequate communal facilities are available for people to make use of within the service. At the time of our inspection eight people were using the service.

At the last inspection in February 2018, we found multiple breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014 and the service was rated 'Requires Improvement' overall. The registered manager sent us an action plan detailing the actions that they were going to take to make the necessary improvements. At this inspection we found the service had made all the required improvements and has now achieved an overall rating of ‘Good'.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

People were protected from risks relating to their physical and mental health and possible abuse. Staff had assessed individual risks to people and had taken action to seek guidance and minimise identified risks. Staff knew how to recognise possible signs of abuse.

Where accidents and incidents had taken place, these had been reviewed and action had been taken to reduce the risks of reoccurrence.

Recruitment procedures were in place to help ensure only people of good character were employed by the service. Staff underwent Disclosure and Barring Service (DBS criminal record) checks before they started work.

Staffing numbers at the service were sufficient to meet people's needs. Staff received regular supervision and appraisal.

Staff supported people to take their medicines safely and staffs' knowledge relating to the administration of medicines was regularly checked.

Staff received thorough training in all areas relating to people's individual health needs and holistic activities. Staff also received support from external healthcare professionals about how to best care for people.

Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and put this into practice. People were involved in all aspects of their care and were supported by staff to communicate their wishes, likes, dislikes and decisions. People were supported through the use of verbal communication, pictorial forms and accessible communication formats.

People were supported to have enough to eat and drink in ways that met their needs and preferences. Meal times were social events and people were supported to ensure their specific needs around food and drink were met.

Staff demonstrated to us they cared strongly about people's wellbeing in every aspect of their lives and worked towards improving each person's happiness and wellbeing. Staff promoted people's equality, diversity and ensured their human rights were upheld. Staff spoke confidently to us about how they upheld people's rights and gave us examples which demonstrated they put people's individuality and personal wishes first.

Staff treated people with respect and kindness. There was a warm and pleasant atmosphere at the service where people and staff shared jokes and laughter. Staff knew people and their preferences well.

The people who lived in Winchester House were provided with high quality, safe, caring, person centred support which was responsive to their needs. People received personalised support and there was a clear understanding that staff saw each person as an individual, with their own social needs.

People had access to health care professionals as and when needed and when people moved into the service staff assessed their needs in order to help ensure they could provide appropriate care. Staff worked in conjunction with external agencies to provide suitable and responsive care to people.

Staff. people and relatives told us they felt comfortable raising concerns. People, staff and relatives felt involved in the service and we heard that people felt the service was well managed. Where ideas and suggestions had been raised these were listened to and relatives told us the registered manager was approachable and managed the service well.

Staff told us they felt supported and valued by the registered manager and enjoyed working in the service. The registered manager was aware of their statutory duties in relation to registration with CQC and as such had notified us of any significant events. The registered manager had a clear vision for the service and the care they wished to provide.

People, relatives, staff and healthcare professionals were asked for their feedback and suggestions in order to improve the service. There were systems in place to assess, monitor and improve the quality and safety of the care and support being delivered.

Further information is in the detailed findings below.