CQC report explained · a nursing home
What the CQC found at Winslow
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, October 2021
Rated Requires Improvement; inspectors found serious fire safety and management weaknesses, although people received personalised support.
This was an unannounced focused inspection on 9 and 10 September 2021. CQC inspected Safe, Effective and Well-led after concerns from the local authority about safeguarding and management. Caring and Responsive were not inspected at this visit.
Inspectors found that fire checks and equipment maintenance were not always managed properly. Safeguarding concerns were sometimes reported late, and some staff lacked up-to-date safeguarding knowledge. Mental capacity checks and some staff competency checks also needed improvement.
There were good systems for medicines, infection control, recruitment and care planning. Staff knew people well and supported their health, choices, independence and community activities. However, CQC found breaches of Regulation 12 on safe care and treatment and Regulation 17 on good governance.
The overall rating fell from Good at the previous inspection, published in October 2019, to Requires Improvement. The Effective and Well-led ratings remained Requires Improvement, while Safe deteriorated from Good to Requires Improvement.
Personalised care plans
People had detailed care plans and risk assessments that reflected their current needs, likes and preferences.
“People had person centred and detailed support plans and risk assessments to guide staff on how to safely support them.” from the report
Medicines and infection control
People received their medicines as prescribed. Inspectors were assured that infection prevention and control arrangements were effective.
“People were supported to receive their medicines as prescribed.” from the report
Support for independence
People were offered choices about their daily lives and were supported to access the community and develop independence.
“People were encouraged to access local community with and for some people without staff support, and to be as independent as this was possible.” from the report
Staff knew people well
Inspectors saw positive relationships and a calm atmosphere. Staff supported people politely and understood their needs.
“We saw that staff and the registered manager had built positive relationships with people and knew them well.” from the report
Personal living spaces
People had individual apartments decorated around their likes and preferences, with access to outside areas.
“The apartments had been decorated based on people's likes and preferences.” from the report
Fire safety
seriousFire alarm checks had not taken place regularly, fire drills had not been completed since June 2019, and maintenance shortfalls had not been dealt with urgently. Inspectors said this put people at risk of harm.
“People, staff and visitors were at risk from fire related incidents, because fire detection systems and equipment had not always been maintained and serviced as needed.” from the report
Safeguarding delays
seriousSome safeguarding concerns were not acted on or referred promptly. Some agency staff also had limited knowledge of safeguarding procedures.
“Prior to our inspection, we were informed by the Local Authority that safeguarding concerns were not always promptly responded to or given sufficient priority by staff.” from the report
Mental capacity decisions
needs fixingSome capacity assessments were too general or based on assumptions. Representatives and advocates were not always involved, and one person's deprivation of liberty conditions had not been met.
“People who lacked capacity to consent to a specific decision had not always had appropriate assessments in place and some capacity assessments were not carried out in line with the MCA legal framework.” from the report
Weak management checks
seriousAudits did not always identify or deal with risks quickly. Management cover was also not always adequate when the registered manager was absent.
“Internal audit systems had not always been effective in monitoring the quality of the service.” from the report
- 01Have all fire alarm and equipment checks been completed, and when was the most recent fire drill?
- 02How are safeguarding concerns recorded, investigated and referred when the registered manager is absent?
- 03Have all mental capacity assessments and deprivation of liberty conditions been reviewed and corrected?
- 04How are nurses' medicine competencies checked now, and how often are they reassessed?
- 05How are people and their relatives now involved in reviewing care plans and giving feedback?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and the report says ratings from the previous comprehensive inspection were used where applicable. This explanation was written from the published report of 19 October 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 2019
Rated Good overall; inspectors found kind, safe and responsive care, but the Effective rating was Requires Improvement because training and health monitoring were not always strong enough.
This was an unannounced inspection on 12 and 13 September 2019. One inspector spoke with people, relatives, staff and visiting professionals, and checked care records, medicines, recruitment files, complaints, incidents and quality checks.
The home was rated Good overall. Safe, Caring, Responsive and Well-led were all rated Good. Inspectors found kind staff, safer medicines systems, better staffing consistency, personalised support and good opportunities for people to be active and independent in the community.
Effective was rated Requires Improvement. Mental health training was not detailed enough, some physical health monitoring records were incomplete, and nursing staff needed to improve how they assessed some health needs. Mental capacity assessments for physical intervention had also not been completed in some cases.
The previous overall rating was Requires Improvement, with one breach of regulation. Inspectors found enough improvement had been made and the home was no longer in breach.
Kind and respectful staff
People and relatives spoke positively about the care. Staff understood people's histories, diverse needs and what mattered to them.
“People received kind, caring and compassionate care and treatment from staff.” from the report
More consistent staffing
The use of agency staff had greatly reduced. This gave people more continuity and consistency in their care.
“The use of agency staff had significantly reduced.” from the report
Support for independence
People were supported to make choices, learn skills, take part in activities and move towards more independent living.
“People's quality of life had significantly improved by living in their local community.” from the report
Safe medicines management
Medicines were stored, given and disposed of safely. Audits had identified improvements and the resulting action was working well.
“Medicines systems were safely organised, and people were receiving their medicines when they should.” from the report
Mental health training
needs fixingStaff had not received enough detailed training about some mental health conditions. Inspectors said this could affect staff's understanding of people's complex needs.
“Staff had not received training in certain mental health conditions and this put people at risk of staff not fully understanding their care needs.” from the report
Physical health monitoring
needs fixingNursing staff had not consistently monitored one person's physical health needs, and some food and fluid records were incomplete. The management team took action during and after the inspection.
“Records to monitor these needs were found to be incomplete.” from the report
Physical intervention assessments
seriousMental capacity assessments had not been completed for people who might receive physical intervention as a last resort. Some care plans also lacked specific details about the type of hold to use.
“However, where people lacked mental capacity to consent to the use of physical intervention at times of heightened anxiety as a last resort, no MCA assessment had been completed.” from the report
End of life planning
needs fixingPeople had not been asked about their end of life wishes, and staff had not received end of life care training. The management team knew this needed to be addressed.
“People had not been asked about their end of life care wishes and staff had not received training in end of life care.” from the report
- 01What mental health training have staff completed since the inspection, and how does it cover the conditions and needs of people living here?
- 02How do you now monitor physical health, food intake and fluid intake, and how do managers check that records are complete?
- 03Have mental capacity assessments and best-interest decisions been completed for any physical intervention used as a last resort?
- 04How have care plans been updated to give staff clear and safe guidance about physical intervention?
- 05How will you discuss people's end of life wishes, and what end of life training will staff receive?
This was an unannounced, planned inspection covering all five CQC questions, including care, accommodation, records, medicines, staffing and management systems. This explanation was written from the published report of 9 October 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.
Every inspection of Winslow
3 rated inspections over 3 years: the service has held its Requires improvement rating throughout.
- October 2021Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2019Goodup from Requires improvementSafe: GoodEffective: Requires improvementWell-led: Good
- September 2018Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2016
Registered with the Care Quality Commission on 21 July 2016.
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
90 live-in carers within about an hour of Nottingham
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 £1,270 a week. 73 can care for a couple. 11 years' experience on average.
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.