CQC report explained · a residential care home
What the CQC found at Winchester House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found unsafe support and incomplete guidance for risks linked to choking, constipation, epilepsy and behaviours that may challenge. Medicines, infection control, safeguarding and recruitment systems were more positive.
- Effective?
- Requires improvement
- Some staff lacked required training, induction, refresher training, supervision and appraisal. Some restrictions had not been properly assessed under the Mental Capacity Act.
- Caring?
- Requires improvement
- Staff were often kind, patient and respectful, but people's independence and communication needs were not always supported. One person's access to their room had been restricted without the required assessment.
- Responsive?
- Requires improvement
- Care plans did not always describe people's communication, sensory and behavioural needs. Activities and personal goals were not consistently planned or monitored.
- Well-led?
- Requires improvement
- Audits and governance systems had not identified or fixed important problems. The new manager had started making improvements and staff said they felt supported, but oversight had not yet become reliable.
What inspectors found, April 2022
Rated Requires Improvement; inspectors found kind staff but serious gaps in risk management, staff training, consent, personalised care and oversight.
Inspectors visited unannounced on 7 and 9 February 2022. They spoke with people, relatives, staff and a visiting professional. They observed care and checked care records, medicine records, staff files and management records.
People were not always protected from risks linked to choking, constipation, epilepsy and behaviours that may challenge. Some agency staff had not read care plans or understood important safety procedures. Staff training, supervision and appraisals were not up to date.
The home did provide kind and respectful support at times. People were supported to make choices, keep relationships and access healthcare. Medicines systems, infection control and recruitment were found to be safe.
The overall rating and all five question ratings were Requires Improvement. The report identified five legal breaches. The home had a new manager who had started making changes, but inspectors said they needed to see lasting improvement.
Kind staff
People and relatives described staff as caring and well-meaning. Inspectors saw calm, patient and respectful interactions.
“People received kind and compassionate care from staff who used positive, respectful language which people understood and responded well to.” from the report
Safe medicines systems
Inspectors found that medicines were prescribed, given, recorded and stored safely. Staff followed principles intended to avoid inappropriate over-medication.
“Staff followed effective processes to assess and provide the support people needed to take their medicines safely.” from the report
Safeguarding
Staff knew people well, understood how to recognise abuse and worked with other agencies to protect people.
“People were kept safe from abuse because staff knew them well and what uncharacteristic behaviour would look like.” from the report
Choice and relationships
People were involved in care planning, meal choices and activities. They were supported to maintain contact with family and friends.
“Staff supported people to maintain links with those that were important to them.” from the report
New manager taking action
The new manager had begun addressing training, supervision, care planning and the service culture. Staff said they felt supported by the manager.
“We observed the manager re-directing staff, in a positive and supportive way, when they were supporting a person in a manner that was not in their care plan.” from the report
Risks were not managed safely
seriousInspectors found unsafe support with eating and gaps in plans for constipation, epilepsy and behaviours that may challenge. This created an increased risk of harm.
“The failure to reduce risks to people relating to choking, constipation, epilepsy, and behaviours that may challenge is a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Staff training and induction
seriousSome staff had not read care plans or understood fire safety procedures. Training, refresher training, supervision and appraisals were incomplete.
“One agency staff told us that they had been shown where care plans were, but they had not had time to read them.” from the report
Consent and restrictions
seriousSome restrictions, including limits on kitchen or room access, had not been assessed under the Mental Capacity Act or properly recorded.
“The failure to assess people's capacity and provide care in accordance with the MCA 2005 is a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Care plans were not personalised enough
seriousPlans did not consistently explain people's sensory, communication or behavioural needs. This meant staff could provide inconsistent support.
“The failure to provide person-centred care plans and support is a breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Weak management checks
seriousAudits had not identified or fixed several problems, including unsuitable sensory facilities and overdue staff training.
“Governance systems were ineffective in assessing, monitoring and improving the quality of the service provided.” from the report
End of life plans missing
needs fixingPeople did not have end of life care plans. The manager accepted these should have been completed and inspectors made a recommendation.
“We recommend the provider consider current guidance on planning end of life care and take action to update their practice accordingly.” from the report
- 01What has changed to make support with choking, constipation, epilepsy and behaviours that may challenge safer?
- 02How do you make sure agency staff read each person's care plan and understand fire safety procedures before providing care?
- 03Have all restrictions on room and kitchen access now been assessed under the Mental Capacity Act and recorded in best interest decisions or DoLS?
- 04How are each person's communication, sensory and behavioural needs recorded and shared with all staff?
- 05Have end of life care plans now been completed with the person, family or an advocate?
This was an unannounced inspection of the whole care home, covering all five key questions and infection prevention and control, and was carried out to assess the Right support, right care, right culture principles. This explanation was written from the published report of 28 April 2022 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 Winchester House
5 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- April 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2019Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2015GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- September 2020
Registered with the Care Quality Commission on 21 September 2020.
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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39 live-in carers within about an hour of Kent
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 £980 to £1,260 a week. 33 can care for a couple. 12 years' experience on average.
“Always on time and with a lovely smile for my mum. Theresa is kind and sensitive to my mum's needs.”
“Irene was a very kind and empathetic carer who knew just the right words to say to put a smile on my face.”
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