Winchester House

Winchester House is a residential care home providing personal care to 11 people with a learning disability and autism at the time of the inspection. The service can support up to 11 people.

People’s experience of using this service and what we found

People were not consistently kept safe from risk of harm. We found risks relating to constipation, epilepsy, choking, and behaviours that may challenge that could have been managed more safely.

Staff did not always have the right training to carry out their role. Staff had not received regular supervision and appraisal, although the new manager had started to address this. Some agency staff had not read people’s care plans and some did not know about safety information such as fire safety procedures.

Some restrictions had not been assessed via the Mental Capacity Act 2005. One person sometimes could not access their room as the door was locked and there was no MCA assessment for this. Another person had access to the kitchen restricted but this was no in an MCA assessment or included in their DoLS.

Some people were diagnosed with autism but did not have effective assessments of their sensory needs. The service had a sensory room but this was not fit for purpose and had fallen out of use. Care plans did not always reflect people’s individualised needs.

People did not have end of life care plans, and the manager acknowledged the need for these to be completed. We have made a recommendation about this.

There were not robust governance systems in place to ensure that care and support was safe, effective or high quality. Shortfalls we identified had either not been highlighted by audits, or effective action to remedy them had not been taken. The manager reflected that these concerns had not been picked up in previous audits.

People told us they liked their staff and that they were kind and caring. One person said, “The staff are really, really, good. They're always helpful and there if I have a problem.” We observed some caring support from staff who knew people’s needs.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

The service was not able to consistently demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right Support

More work was needed to ensure that people could receive support that enabled them to meet their goals and aspirations. Some people were non-verbal but their relatives had not received a copy of their care plan despite asking. This left people at risk of not having person-centred goals. Improvements were needed to ensure that the environment was homely, clean, and well-maintained.

Right Care

The provider had not always ensured that risks faced by people had been assessed and planned for. Staff tried to provide personalised support to people, but this was difficult at times as there was not enough guidance around people’s communication or sensory needs.

Right culture

Some staff were not able to provide the support people needed with their sensory needs, and with needs associated with autism as they had not had the correct training or guidance. Some relatives told us that management changes meant there was not always consistency, although all relatives we spoke with were happy with the new manager and their approach.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 21 September 2020 and this is the first inspection.

The last rating for the service under the previous provider was good (published on 14 December 2019).

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support right care right culture.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement

We have identified breaches in relation to person centred support, consent, safe care, good governance, and staffing at this inspection.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.