Windsor Street Care Centre

Improvements had also been made to staff recruitment, staffing numbers, and staff skills, which had improved how people were kept safe and supported. Changes in the management of the home had improved the overall governance of the service and resulted in positive results for people who lived in the home and the staff who worked there. This action and the improvements completed support the service's overall rating of 'Good' awarded at this inspection.

Windsor Street Care Centre is a purpose built 'care home'. People in care homes receive accommodation and nursing or personal care, as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

People, relatives and staff referred to the home as 'Windsor Street' so this has been done in this report. Windsor Street specialises in the care of those who live with dementia, but also provides nursing care to some people. There were four beds commissioned by the NHS, these were called 'safe haven' beds. These were used for people who required a short admission; either after a stay in hospital or to avoid a hospital admission. Referrals for these beds were made by people's GPs. People's medical care was temporarily handed over to the GP who attended Windsor Street. Once discharged, people's medical care was transferred back to their own GP. In total 81 people can be accommodated in one adapted building. At the time of this inspection 63 people were receiving care.

People lived on 5 units referred to as 'households'. Four households provided care to people who lived with dementia; one of these provided nursing dementia care. A fifth household also provided nursing care. Single bedrooms with private toilet and washing facilities were provided. Each household had a lounge, dining/kitchen area and additional adapted toilets and bathrooms. A passenger lift helped with access to upper floors. There was a secure, large garden and balconies for outside use. Car parking was available. The home had wheelchair access.

The home had a registered manager in post who had managed the home since May 2017. Previous to this they had been the home's deputy manager and dementia care lead. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Arrangements were in place to keep people safe and to protect them from abuse and discrimination. Improvements had been made to how the home was staffed. Staff had been recruited safely, providing the home with enough staff with the right skills, knowledge, experience and commitment. People lived in a clean home where good infection control measures reduced the risk of infection. The staff had support from the home's visiting GP, which meant people's health needs and medicines were reviewed and managed well.

Staff were trained and well supported. Robust assessment of people needs meant these were well identified and understood by the staff. Frequent reviews of people's needs and their abilities meant staff were quick at identifying changes and deterioration in people. People and where appropriate their representatives, were involved in reviewing the care delivered.

People were supported to have a voice. People who lacked mental capacity had decisions made on their behalf but, in their best interests and lawfully. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies, systems in the home and staff training supported this practice. Staff ensured people had enough food and drink. All risks relating to people's ability to maintain their nutritional wellbeing were identified and addressed.

Staff were caring and compassionate. People were treated with respect, dignity and their rights were upheld. Staff treated people equally, as individuals and differences were respected and celebrated. Care was planned around people's diverse needs, their likes, preferences and wishes. The home did particularly well at meeting many different and diverse needs in a personalised way.

People were supported to take part in social activities which meant something to them and which they enjoyed. Activities which promoted a healthier life were also provided, for example, singing for the brain, yoga and physical exercises. People at the end of their life were supported to have a dignified and comfortable death. Relatives were able to visit freely and to remain with a relative who was dying. Relatives were encouraged and provided with support to be part of the Windsor Street 'family'. They were valued and positive input was seen as integral to people's ability to live well with dementia.

The home benefited from strong leadership. The registered manager was supported by their deputy and senior staff team. Since the registered manager had been managing the home there had been a focus on changing the staff culture. The registered manager had made their expectations clear, as well as their vision for the home and the values they wanted to see followed. All the staff we therefore spoke with put people at the centre of what they did. They were committed to improving people's wellbeing and quality of life.

The registered manager was approachable and transparent in how they managed situations, incidents and complaints. They expected their staff to work likewise. They met on a regular basis with people, relatives and all grades of staff. Both managers welcomed feedback and used this to help them improve the service.

Managers used the provider's quality monitoring processes to ensure the home remained compliant with necessary regulations and legislation. Actions necessary to make improvements were carried out and followed up by the provider to ensure these were fully completed. There was a strong desire to further improve the services provided to people and to become a centre of excellence.

The five questions we ask about services and what we found