CQC report explained · a residential care home
What the CQC found at Winscombe Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, April 2018
Rated Good; inspectors found safe, kind and personalised care, with previous legal and management issues resolved.
This was an unannounced inspection on 21 and 22 February 2018. Inspectors spoke with people living in the home, relatives, staff and healthcare professionals. They also checked care records, medicine records, staff files, complaints and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough suitable staff, safe medicine arrangements, appropriate training and good support for people's health, communication, choices and activities.
At the previous inspection in December 2016, the provider had breached rules about consent and good management. At this inspection, inspectors found the required improvements had been made and the regulations were being met.
Safe staffing and medicines
Inspectors found enough skilled staff to meet people's needs. Medicines were stored, given and recorded safely, with checks in place.
“There were enough skilled staff deployed to support people and meet their needs.” from the report
Respectful care
Staff supported privacy, dignity and independence. They asked permission before entering rooms and adapted communication to people's needs.
“We repeatedly observed staff knocking on peoples' doors and asking for permission before entering.” from the report
Individual support
Care plans included people's needs, interests, preferences and communication aids. Staff involved people in reviewing their care.
“Care plans were person-centred and reflected peoples' individual needs.” from the report
Activities and inclusion
People were supported to take part in activities and trips suited to their interests, including holidays and special events.
“People were supported to take part in a wide range of activities and staff often went the extra mile to help people achieve their dreams.” from the report
Improved management
The provider had improved its consent and quality monitoring systems since the previous inspection. Inspectors found the earlier breaches had been resolved.
“At this inspection we found improvements had been made and the provider had met the regulations.” from the report
Inspectors raised no specific concerns in this report.
- 01How have you maintained the improvements to consent and quality monitoring found at the 2018 inspection?
- 02How do you currently check that there are enough staff on each shift when people's needs change?
- 03How are medicines recorded and checked now, and what happens if a person refuses a medicine?
- 04How are relatives involved in best-interest decisions and reviews of care?
- 05Which activities and community trips are currently available, and how are they matched to each person's interests?
This was an unannounced inspection covering all five CQC questions and the overall rating, with findings based on a sample of four people's care and the records and evidence reviewed. This explanation was written from the published report of 18 April 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, April 2017
Rated Requires Improvement; inspectors found safe, kind and responsive care, but consent records and quality checks needed improvement.
This was an unannounced inspection on 7 December 2016. Inspectors spoke with people living at the home, relatives, staff and other professionals. They also observed care and checked care records, staff files, medicines and management records.
The home was rated Good for Safe, Caring and Responsive. Inspectors found enough staff, safe recruitment, safeguarding arrangements, kind care, respect for privacy and dignity, personalised care plans and a good range of activities and outings.
The home was rated Requires Improvement for Effective and Well-led. One legal authorisation for restricting a person's freedom had expired and consent was not always recorded. Quality checks had also failed to identify important problems. The overall rating was Requires Improvement, and the report recorded two breaches of regulations.
Kind and respectful care
Inspectors saw positive relationships between people and staff. People said their privacy, dignity and independence were respected.
“Staff knew the people who lived at the service well and we saw that they responded to their care needs appropriately.” from the report
Personalised support
Most care plans were clear, current and tailored to the individual. People were involved in creating and reviewing them.
“Care plans were legible, up to date and personalised.” from the report
Activities and community life
People were supported to enjoy activities and to go out into the local community, including trips chosen by them.
“People were supported to go out into the local community on a regular basis and also went on outings of their choice, for example to the beach, zoo and cinema.” from the report
Staffing and safeguarding
Inspectors found sufficient staff on duty and appropriate recruitment checks. Staff understood how to recognise and report possible abuse.
“Robust recruitment procedures were in place and there were sufficient skilled and experienced staff on duty to meet people's needs.” from the report
Food and healthcare
People had access to healthcare professionals and their dietary needs and preferences were catered for. They were involved in menu planning.
“People's individual dietary requirements and personal preferences were catered for and people using the service were involved in preparing menus.” from the report
Expired liberty authorisation
seriousOne person had been deprived of their liberty for five months without the required legal authorisation being in place. The renewal application was made only shortly before the inspection.
“At the time of our inspection this person had been deprived of their liberty for a period of five months without the appropriate legal authorisation being in place.” from the report
Consent was not always recorded
seriousThe home did not always show that people had agreed to their care and treatment. This included the use of bed rails for one person who was recorded as having capacity to decide.
“Consent to care and treatment was not always recorded.” from the report
Quality checks missed problems
seriousAudits did not identify the expired authorisation, missing consent records or some medicines and care-record issues. Feedback from people and relatives was collected, but there was no formal action plan.
“Effective systems and processes were not in place to monitor and improve the quality of the service.” from the report
Care notes lacked detail
needs fixingDaily notes were complicated, time-consuming and did not give a clear enough record of how people had been during a shift. The problem had already been identified but records had not improved.
“This was an over complicated and time consuming process that was lacking in detail and therefore an accurate record of how people had been during a shift was not being kept.” from the report
Medicine checks needed strengthening
needs fixingStaff had medicine training, but regular competency checks were not being done for all staff. Medicine storage temperatures were also not always recorded or within safe levels.
“Although staff had received the relevant training the registered manager only assessed the competency of new staff after their initial training.” from the report
- 01How do you now check that every person's consent is recorded, including consent for equipment such as bed rails?
- 02How do you monitor and renew liberty authorisations before they expire?
- 03How often are staff checked as competent to administer medicines, and how are medicine storage temperatures recorded?
- 04What changes have been made to daily care notes since the inspection?
- 05How do you turn feedback from people and relatives into a documented action plan?
This was an unannounced inspection covering all five CQC questions and the overall quality of the home. This explanation was written from the published report of 8 April 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 Winscombe Care Home
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- April 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2017Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2014
Report published without a new overall rating.
- April 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- December 2011
Registered with the Care Quality Commission on 1 December 2011.
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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