CQC report explained · a residential care home
What the CQC found at 5 Winston Court
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks from the building, equipment and medicines were better managed. Staffing levels were met, although the home continued to use agency staff and was advised to review its plans for recruiting permanent workers.
- Effective?
- Good
- Staff had completed relevant training and received regular support. People had care based on their preferences and health needs, although some consent forms were blank and unsigned.
- Caring?
- Good
- People were relaxed and comfortable with staff, who treated them with kindness, dignity and respect. Staff supported people to make choices and maintain their independence.
- Responsive?
- Good
- Care was personalised and included communication methods, health information and individual activities. Inspectors noted that some noticeboards and the complaints policy were not presented in the most accessible way.
- Well-led?
- Good
- The provider had improved its quality checks, care records and oversight since the previous inspection. Further work was still under way to fully implement suitable systems, and audits continued to identify actions.
What inspectors found, December 2018
5 Winston Court was rated Good; inspectors found safe, kind and personalised care, with some records and staffing issues still needing attention.
Inspectors made an unannounced visit on 1 November 2018. They spoke with four people, two relatives and staff, and reviewed care records, medicines records and management documents. The registered manager was absent during the visit.
The home provided accommodation and personal care for eight adults with learning disabilities or autism. Inspectors found people were safe, treated kindly, involved in decisions and supported to take part in activities and community life.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. This was an improvement from the previous rating of Requires Improvement. The home had improved its safety checks, staff training, care planning and quality monitoring.
Inspectors still identified some issues. These included continued use of agency staff, incomplete consent forms, gaps in an incident record and information that was not always easy to access. They asked the provider to make improvements, but recorded no current breaches.
Safer medicines management
Medicines were ordered, stored, given, recorded and disposed of correctly. Staff were trained and two workers checked medicines together.
“Medicines were correctly ordered, stored, administered, recorded and disposed of.” from the report
Kind and respectful care
People appeared comfortable with staff and had good relationships with them. Staff respected privacy, dignity and preferred ways of communicating.
“The service involved people in their care and treated them with compassion, kindness, dignity and respect.” from the report
Personalised support
Care plans included people's preferences, communication needs, health information and individual support needs. People were helped to make choices and remain as independent as possible.
“People received personalised care that responded to their needs.” from the report
More effective quality checks
The provider had strengthened its checks on safety and care quality. The home's audit score improved and the number of actions fell between June and September 2018.
“In September 2018, the service achieved a score of 83% compliance in the second audit.” from the report
Active social lives
People took part in day services, social clubs, community activities, holidays and outings. Staff supported individual interests such as art, football and eating out.
“People led an active social life.” from the report
Reliance on agency staff
needs fixingThe home's planned staffing levels were met, but it continued to use agency workers without enough new permanent staff joining. Inspectors recommended a review of the recruitment strategy.
“The use of agency staff continued and was not suitably offset by any new workers commencing employment at the service.” from the report
Incident records were incomplete
needs fixingAfter one person's seizure, the record did not explain what medical intervention took place. Inspectors also could not confirm whether all incident forms had been sent to head office.
“The service failed to keep a good record of events that occurred after the seizure.” from the report
Some information was hard to access
minorNoticeboards contained overlapping leaflets and printouts, which could cause confusion. The complaints policy was kept in the office rather than an accessible location.
“In the ground floor hallway, the noticeboards contained a lot of overlapping leaflets and printouts which could lead to confusion for people looking at the information.” from the report
Further quality actions remained
minorAudits still found issues with the premises and infection control, including actions linked to the fire risk assessment and a missing soap dispenser. These actions were being monitored.
“There were 15 actions required in the actions from the audit, for example a soap dispenser not present in one bathroom.” from the report
- 01How many permanent care workers are currently employed, and what is being done to reduce the use of agency staff?
- 02Have all consent forms for care, photography and information sharing now been completed and signed?
- 03How do you check that incidents are fully recorded, including any medical treatment and reports sent to head office?
- 04Have the issues identified in the fire safety and infection control audits been completed and signed off?
- 05How can residents and relatives easily access the full complaints policy and other important information?
This was an unannounced inspection covering all five key questions, including the premises and care provided; the previous Requires Improvement ratings were reassessed. This explanation was written from the published report of 5 December 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, October 2017
Rated Requires Improvement overall; inspectors found kind, personalised care, but important safety, staffing and management systems needed improvement.
Inspectors made an unannounced visit on 22 September 2017. They observed care for five people, spoke with the manager and four care workers, and checked medicines, care records, staff files, premises and quality checks.
People were protected from abuse and staff knew their needs well. Care was kind, respectful and personalised. People had support to communicate, stay independent and take part in activities in the home and community.
However, some building risks were not dealt with promptly. Staffing arrangements were not based on a reliable assessment of the number of staff needed. Health advice was not always followed, records and training evidence were inconsistent, and the provider's checks on quality and safety were not effective.
The home was rated Requires Improvement overall. Safe, Effective and Well-led were rated Requires Improvement. Caring and Responsive were rated Good. The report identified one breach, relating to good governance.
Kind and respectful care
Staff were friendly and understood people's individual needs. Inspectors saw staff protecting privacy and dignity during care.
“Staff were friendly and enjoyed working with people who used the service. They knew people's likes, dislikes and preferences well.” from the report
Personalised support
Care plans included people's routines, interests, relationships and communication needs. Staff used this knowledge to provide individual support.
“We found a significant focus on individual needs in support plans based on the detailed knowledge staff had of each person.” from the report
Promoting independence
People were supported to make choices and do as much as possible for themselves, including preparing food and managing parts of their personal care.
“Support plans indicated staff worked with people to encourage them to maintain as much independence as possible.” from the report
Activities and communication
People had regular activities and social opportunities. Staff used personalised communication guidance, pictorial signs and Makaton when needed.
“Care staff maintained a weekly schedule for each person and we saw this included a wide range of activities that met their social and health needs.” from the report
Building safety actions
seriousRepairs and other actions identified through fire and premises checks were not always planned, communicated or completed. Inspectors also found problems with a fridge handle and kitchen cupboards.
“Although health and safety risks were assessed, the findings were not always promptly acted on by the provider.” from the report
Staffing cover
seriousThere was no dependable method for working out how many staff were needed on each shift. Permanent staff sometimes worked extra hours, cancelled leave or missed dedicated training, while agency workers were used.
“A robust system of calculating the number of staff hours for each shift was not in place.” from the report
Health advice not followed
seriousA dietitian's advice was not followed for one person, which inspectors said increased the risk of diabetes. Healthcare visits and outcomes were also not consistently recorded.
“On the day of our inspection, none of the meals the person was offered were in line with the dietitian's advice.” from the report
Weak quality checks
seriousThe provider's audits did not reliably identify, record or act on problems. The service improvement plan was out of date and policies were sometimes old or not fully implemented.
“The provider's systems of measuring the safety and quality of care were not fit for purpose.” from the report
- 01What has been done to repair the building problems identified in the fire risk assessment, including the fridge and kitchen cupboards?
- 02How do you now calculate the number of staff needed on each shift, and how do you limit reliance on agency workers and overtime?
- 03How do you make sure dietitian and other healthcare advice is followed and recorded in people's care plans?
- 04How do you check that staff training, supervision and competency records are complete and up to date?
- 05How can people and visitors now access the complaints procedure, including its easy-read version?
This was an unannounced inspection covering all five CQC questions and was the first inspection since the change in provider. This explanation was written from the published report of 24 October 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of 5 Winston Court
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- December 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2017Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2017
Registered with the Care Quality Commission on 3 April 2017.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
83 live-in carers within about an hour of Windsor and Maidenhead
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,260 a week. 76 can care for a couple. 12 years' experience on average.
“I can truly say that Peter always put Dad at the centre of everything and I know that they found a great friendship in difficult times.”
“Not only has she looked after him beautifully, she has also been great company for him with lively conversation, kindness and humour.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.