CQC report explained · a residential care home
What the CQC found at Windle Court
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, September 2019
Rated Good; inspectors found safe, kind and person-centred care, with some care information needing improvement.
The inspection took place without notice over two days. Inspectors spoke with people living in the home, relatives and staff. They observed care and checked care plans, medicine records, staff files and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines practice, kind care, personalised support and systems for handling complaints and improving quality.
The home had previously been rated Requires Improvement. The provider had made improvements and was no longer in breach of regulations at this inspection. Inspectors did identify some areas where information and records needed to be strengthened.
Safe staffing and medicines
Inspectors found enough staff and safe recruitment checks. Medicines were administered by trained staff, stored correctly and recorded without gaps in the sample checked.
“There were enough numbers of staff who had been recruited safely.” from the report
Kind and respectful care
People and relatives spoke positively about staff. Inspectors saw people being treated with dignity, having their privacy respected and being supported to stay independent.
“People were treated with dignity and their privacy respected.” from the report
Personalised support
Care plans included people's backgrounds, preferences and choices. The home was developing activities around what people wanted, including individual wishes.
“Care plans were person centred and provided information and guidance to staff.” from the report
Visible leadership
Inspectors found an approachable management team and a clear, open culture. People, relatives and staff could share their views through meetings, questionnaires and everyday conversations.
“The culture of the service was person-centred, open and transparent.” from the report
Specialist diet information
needs fixingThe cook knew people's specialist dietary needs, but the information was not easy to access and did not follow current best practice guidance. The manager took immediate action during the inspection.
“The cook was aware of people's specialist dietary needs however this information was not easily accessible and was not in line with current best practice guidance.” from the report
Consent records
needs fixingThe electronic system showed staff signing consent on people's behalf because people could not sign within the system. The manager took immediate action to introduce a separate consent form.
“People's consent to care had been signed on their behalf by staff.” from the report
Some equality information
minorCare planning records did not always include information about people's sexual orientation. The provider was developing guidance to support a more inclusive service.
“care planning documentation did not always contain information about people's sexual orientation” from the report
End of life preferences
minorThe manager was still asking people and relatives to complete preferred priorities of care documents. This meant some future care preferences were still being recorded.
“The registered manager was in the process of getting people and relatives to complete preferred priorities of care (PPC) documentation.” from the report
- 01How do you now make sure information about specialist diets is easy for all relevant staff to access and follows current guidance?
- 02How do people give and record their consent to care now that the electronic system could not record their signatures?
- 03How do you record people's equality information, including sexual orientation, in a way that supports inclusive care?
- 04How far have you progressed with preferred priorities of care documents and recording people's end of life wishes?
- 05What activities are now available based on the wishes and interests of people living in the home?
This was a planned, unannounced inspection covering all five rating areas, with both the care provided and the premises considered. This explanation was written from the published report of 5 September 2019 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, September 2018
Rated Requires Improvement and out of Special Measures; inspectors found kind care and better staffing, but important safety, care records and management checks still needed work.
This was an unannounced inspection over three days in August 2018. Inspectors spoke with people, relatives, staff and health professionals. They observed care and reviewed care plans, medicines, staff records, complaints and quality checks.
The home had improved since its previous inspection, when it was rated Inadequate and placed in Special Measures. Staffing, safeguarding, medicines management and activities had improved. However, some care records were out of date or contradictory, infection control was not always effective, and some required records were inaccurate.
People were treated kindly and with respect. They were supported with food, drinks, healthcare, activities and contact with family. The overall rating was Requires Improvement. All five areas were checked: Caring was Good, while Safe, Effective, Responsive and Well-led were Requires Improvement.
Kind and respectful care
People and relatives spoke positively about staff. Inspectors observed patient, compassionate interactions and found that privacy, dignity and independence were respected.
“Throughout our inspection we observed all interactions between staff and people to be kind, considerate, patient and caring.” from the report
Improved staffing
Staff numbers and their deployment had improved since the previous inspection. This had a particularly positive effect on the separate Jasmine unit.
“At this inspection, we noted staff numbers had increased.” from the report
Better safeguarding
Staff understood how to recognise and report abuse. The management team had improved its oversight of safeguarding concerns and shared lessons with staff.
“The manager carried out an analysis of all safeguarding incidents and took an open and transparent approach to safeguarding concerns” from the report
Improved activities and complaints
People had access to group and one-to-one activities, including trips and regular visits from children. Complaints were recorded, investigated and used for learning.
“There were systems and processes in place to manage concerns, complaints and compliments.” from the report
Conflicting risk information
seriousSome risk assessments and care records did not agree with each other. This included risks involving choking, pressure sores and moving people, creating a risk that staff could provide unsafe care.
“Individual risks to people were not always being managed safely and some care records contained contradictory information.” from the report
Infection control
needs fixingTwo people had been sharing a hoist sling, and some furniture and flooring were dirty or difficult to clean. The manager took action during and after the inspection.
“Some of the furniture in communal areas to be dirty.” from the report
Mental capacity decisions
seriousCapacity and best-interest records did not always follow the law. Inspectors found decisions involving bed rails, covert medicines and relatives’ involvement were not properly supported or recorded.
“The above examples demonstrate a breach of Regulation 11 of the Health and Social Care Act 2008” from the report
Inaccurate daily records
needs fixingSome night checks, close-observation records and turning charts were inaccurate or had not been completed at the time. This made it difficult to confirm that required care had taken place.
“We found some inaccuracies and gaps in night time checks and close observation documentation and turning charts.” from the report
Medicines recording
needs fixingMedicines appeared to have been given, but some records were not signed at the time and topical cream charts were incomplete. Audit records did not always show that identified problems had been dealt with.
“It was therefore unclear as to whether their creams had been applied.” from the report
Management oversight
needs fixingQuality audits had improved but were not yet robust enough. The home also had no registered manager in post, although the current manager was applying to register.
“Although the quality assurance systems had improved, further improvements were needed to strengthen some processes” from the report
- 01How were the choking, pressure sore and moving-and-handling risks identified in the report corrected, and how are you checking that the information remains accurate?
- 02What changes were made to infection control, including individual hoist slings, clean furniture, flooring and hand-washing facilities?
- 03How do you now record mental capacity and best-interest decisions, including decisions about bed rails and covert medicines?
- 04Has the electronic care planning system been introduced, and how was each person’s information checked when it was transferred?
- 05Is the manager now registered with the CQC, and how do you check that improvements are being sustained?
This was an unannounced comprehensive inspection covering all five key questions and checking progress since the previous inspection, when the home was Inadequate and in Special Measures. This explanation was written from the published report of 25 September 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. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Windle Court
6 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- September 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2018Inadequatedown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- January 2017Goodstayed GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- November 2015Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- July 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 16 December 2010.
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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