31 October 2018
During a routine 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.