Windermere Grange Care Home

People's experience of the service and what we found: Care plans provided guidance to ensure people received safe and responsive care and support. Risks were assessed and mitigated to keep people safe. However, where people may display distressed behaviours, the care plans we reviewed for older people lacked detail on what behaviours may be displayed and how these can be managed. Care plans were in place and contained person-centred information for people with a learning disability. However, care plans had not always been fully updated when changes occurred. Information in relation to people's goals or outcome was not always clearly recorded. Daily records were generic and didn't reflect the care needs identified in people's care plans or the care provided. We spoke with the registered manager and Director of Care and Development about this. They assured us that the new electronic system they were introducing would address this.

Medicines were managed safely. Handwritten medicine administration records were not checked thoroughly, or counter signed to ensure accuracy; this is not in line with national guidance. Staff received training in medicines administration and competency assessments had been completed. Audit processes were in place, however work was needed to ensure the correct audit was completed at the right time and they were reviewed appropriately. We have made a recommendation about this.

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 assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support People received care and support from staff who knew them well. People were supported to maintain and improve their independence. Risks in relation to people's care and support were well managed to assist people to live their lives as they chose, and to access opportunities. There were enough staff to meet people's identified hours of support, and this supported people to be able to access activities both socially and within their home.

Right Care People received care and support from a staff team who knew their needs. One relative told us, "From what I can see they get the best care. She can call for assistance when she needs it." The service worked with health

and social care professionals to ensure they met people's needs. A health care professional told us, "Staff know the residents really well. We come here knowing what issues there are and we always have a staff member accompany us during our visit. They follow up any guidance we put in place."

Right Culture People lived inclusive lives and were supported to take part in meaningful activities within the home and their local communities. One relative told us, "There are loads of activities going on. They do themed nights, and there are special foods from that country." People and their relatives spoke positively about the service. Comments included, "I think the home is run well. The staff are always busy but still have time if you need to speak to them."

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

There was a positive culture within the service. Staff felt supported by the management team. Their comments included that the management team were visible and approachable, and they could discuss concerns and share ideas.

The service worked in partnership with other social and health care professionals. Feedback from health professionals was positive and included the following comments: "Out of all the care homes we deal with, it is very organised. We come here knowing what the issues are. They send a list of who needs seeing on the day. All information is accurate. They are not resistant to change or our service input. They will follow up any guidance we put in place."

Systems were in place to monitor the quality of the service. However, there are some improvements required with the oversight of accidents and incidents. The registered manager understood their responsibility to follow the duty of candour and to be honest and open when something went wrong.

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