Winsor Care Services

At the last inspection we found that there were not risk assessments in place for people with known diagnoses and needs with associated risks. We also found that there were safeguarding concerns relating to the same risks. At this assessment we found that there were more risk assessments in place, but not in all instances. We found that action had been taken to mitigate the resulting risk by staff having access to tasks to complete at each care visit which related to the appropriate risk management. We found that through lack of consistent assessment there was a continued breach of Regulation 12.

We found that safeguarding concerns had reduced and there was a good record of how incidents and accidents had been recorded, responded to and lessons had been learnt. We saw that staff were vigilant about raising their concerns relating to risks and people told us they felt safe when being supported by the staff. We found that the provider was no longer in breach of Regulation 13.

We found that peoples needs were not always accurately assessed and often the local authority assessment had been relied upon for information rather than the provider gathering information themselves. Staff did not always feel they could rely on assessments for accurate information but were vigilant at gathering peoples preferences from people directly. This contributed to the breach we found of Regulation 12. People did not always recall having a face to face assessment with the provider but were confident in the carers listening to them and how they wanted their care delivered. We found that the staff worked well with the office staff and other services to help people receive effective care.

People told us they felt staff knew them and their individual preferences well. They felt that care had been catered to their personal needs. Staff gave us examples of how they adapt their support for individuals. Staff told us they communicated well as a team and provided each other with handovers if another staff member was covering a care visit they could not attend.

Some people and relatives were dissatisfied with poor continuity in their care, either by not being informed of changes or inconsistent carers which they could not form a relationship with. We were assured by the consultant of the provider that processes are being improved to ensure people and their relatives are better informed of changes. We saw minimal information sharing from the service to people. The provider had recently implemented a new face to face meeting with people to encourage involvement but this had not yet been embedded.

The provider had commissioned consultants since the last inspection but there had been a lack of stability in these appointments which had negatively impacted the governance of the service. There was a lack of uniformity within records and a lack of quality assurance data which could provide trends for analysis. The provider had plans in place to address the stability of governance. We found that since the last inspection, sufficient improvements had not been made by the Registered Manager to address all the breaches. We found a repeated breach of Regulation 17.

Staff told us they felt supported by the management team and the Registered Manager gave us examples of being inclusive, diversity and that staff were included in the running of the service. Due to a focus on addressing previous breaches, there had been a lack of attention on innovative or collaborative practices. Partnership services told us that there had been an improvement in communication with the provider.