CQC report explained · a residential care home
What the CQC found at Winchcombe Place
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- People were generally protected from harm, and medicines, risks, infection control and recruitment were managed well. However, there had been unsafe staffing levels and the home needed to show that increased staffing was sustained.
- Effective?
- Good
- People received effective care and had good outcomes. Staff supported nutrition, healthcare, independence and individual needs, and had suitable training.
- Caring?
- Good
- This area was not inspected during this focused visit. The report says the previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This area was not inspected during this focused visit. The report says the previous rating was used in calculating the overall rating.
- Well-led?
- Good
- Management had effective quality checks, acted on problems and promoted a person-centred culture. Staff and relatives described the home as organised and supportive.
What inspectors found, December 2021
Winchcombe Place was rated Good overall; inspectors found safe, caring and effective support, but staffing levels needed to remain stable.
This was an unannounced, focused inspection on 9 and 10 November 2021. Inspectors examined Safe, Effective and Well-led. They spoke with people, relatives, staff and health professionals, observed care and reviewed care, medicines, recruitment and management records.
The home was rated Good overall. Effective and Well-led were rated Good. Safe was Requires Improvement because there had been serious staffing concerns, including a critical shortage when agency staff did not arrive. Staffing had been increased substantially by the inspection, but the home needed to show that this improvement would last.
Inspectors found people were protected from abuse, risks were assessed, medicines were managed safely and the home was clean. Staff were trained, kind and person-centred. Food, healthcare support, activities and the management of records had improved.
The previous overall rating was Requires Improvement. Earlier breaches relating to safe care and treatment and good governance had been resolved. Caring and Responsive were not inspected during this visit, so earlier ratings for those areas were carried forward.
Safe medicines
Medicines were given as prescribed and records were complete. Staff checked people's needs and preferences and explained medicines without rushing them.
“People received their medicines as prescribed, at the right time, in a way they preferred, in line with their medicine management plans.” from the report
Risk management
Staff had detailed information about risks such as falls, choking and skin damage. They followed people's individual plans and acted when needs changed.
“Assessment and monitoring records demonstrated that people received the support required to keep them safe, in accordance with their risk assessments and support plans.” from the report
Training and support
Staff received induction, training, supervision and checks of their skills. The report found this prepared them to meet people's individual needs.
“The registered manager operated an effective system of training, competency assessments, supervision and appraisals.” from the report
Food and drink
The home took nutrition and hydration seriously. Staff knew people's dietary needs and made mealtimes sociable and enjoyable.
“People consistently told us the food provided was very good.” from the report
Improved management
Quality checks had improved since the previous inspection. Audits identified problems, recorded actions and helped keep care records accurate.
“Robust auditing identified areas for improvement and necessary learning, with a clear audit trail recording when the required action had been taken.” from the report
Kind, person-centred care
Inspectors saw staff treat people calmly and respectfully. The management team promoted independence and put people at the centre of care.
“Observations showed that staff were passionate about what they did and consistently placed people at the heart of the service” from the report
Staffing stability
seriousStaff and professionals had previously raised concerns about unsafe staffing and heavy reliance on agency workers. Staffing had been increased by the inspection, but the home still needed to prove that this would continue.
“The provider needed time to demonstrate that increased staffing levels implemented to meet people's needs safely had become sustained and embedded in practice.” from the report
Previous critical shortage
seriousThree agency staff did not arrive for a night shift in October 2021. No person was harmed, but staff reported being exhausted.
“No person was harmed during this period of time, though staff reported being exhausted.” from the report
Communication if staffing falls
needs fixingA health professional was concerned that information about changing needs might not be shared effectively if staffing levels reduced again.
“A health and social care professional raised a concern that updates of people's changing needs and sharing of information may become a risk, if staffing levels were reduced again.” from the report
- 01How many permanent care staff and registered nurses are now deployed on each shift?
- 02How often are agency staff used, and how do you make sure agency staff know each person's needs?
- 03What evidence can you show that the increased staffing levels have remained stable since the inspection?
- 04How do staff make sure changes in people's needs and risks are passed on at every handover?
- 05What ratings currently apply to Caring and Responsive, which were not inspected during this visit?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 10 December 2021 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 2020
Requires Improvement; inspectors found kind, responsive care but ongoing medicines and record-keeping risks.
This was an announced focused inspection on 24 August 2020. Inspectors checked whether the home had acted on problems found at the previous inspection. They reviewed care, medicine and management records, spoke with people, relatives, staff and health professionals, and observed the home.
The home was rated Requires Improvement overall. Safe and Well-led were also Requires Improvement. Medicines information was sometimes missing or contradictory, including allergy details and instructions for medicines given when needed. Records about people's care and risks were not always accurate or complete.
Responsive was rated Good. People received personalised care, complaints were recorded and followed up, and end of life wishes had been explored. Inspectors also found enough staff, suitable infection control arrangements and a clean home.
The home remained in breach of Regulations 12 and 17. It had improved in person-centred care and was no longer in breach of Regulation 9. CQC said it would monitor progress, ask for regular updates and return for another inspection.
Infection control
The home had infection control procedures, visitor checks and protective equipment stations. Inspectors found the home clean and free from unpleasant smells.
“The home was clean and odour free and had dedicated staff responsible for the cleanliness of the home.” from the report
Personalised care
Care plans recorded people's likes, dislikes and important preferences. Staff understood that people needed different types of support.
“People's likes, dislikes and what was important to the person were recorded in their care plans.” from the report
End of life support
The home had explored people's end of life wishes and recorded them in care plans. Staff had relevant training and relatives could receive additional support when visiting.
“End of life wishes was an area the service had proactively explored with people since the last inspection.” from the report
Open management
People, relatives and staff were encouraged to share their views. Inspectors found the management team accessible and willing to make improvements.
“There was an 'open door' management approach.” from the report
Medicine records
seriousAllergy information was sometimes missing or did not match across records. Instructions for as-needed medicines were often not detailed or specific enough, creating a risk of medicines being given inappropriately.
“The information provided was not detailed or person centred in most PRN records.” from the report
Inaccurate care records
seriousSome records gave conflicting information about mobility, choking risks, weight and epilepsy care. This could make it harder for staff to follow the right care plan.
“People's records and care plans were not always accurate, complete and contemporaneous.” from the report
Agency staff communication
needs fixingSome relatives said temporary staff did not always know people's needs. Inspectors also heard that communication could be difficult with some agency staff.
“Some of the agency staff are very difficult to understand…I struggle to understand them.” from the report
- 01How do you now check that allergy information matches across care plans, medicine records and as-needed medicine instructions?
- 02How do you make sure as-needed medicines have clear, person-specific instructions for staff?
- 03What checks are now in place to prevent conflicting information about mobility, choking, weight loss and epilepsy care?
- 04What action has been completed on the legionella recommendations, thermostatic mixing valves and the dead-end pipe?
- 05How do you make sure agency staff understand each person's needs and can communicate effectively with them?
This was a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and the previous ratings for those questions were carried forward. This explanation was written from the published report of 22 October 2020 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 Winchcombe Place
6 rated inspections over 7 years: the service has held its Good rating throughout.
- December 2021Goodcurrent ratingup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2020Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- September 2019Requires improvementup from InadequateSafe: Requires improvementEffective: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2019Inadequatedown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- August 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2014
Registered with the Care Quality Commission on 23 April 2014.
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.
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42 live-in carers within about an hour of West Berkshire
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. 36 can care for a couple. 14 years' experience on average.
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