Winray Care Housing was rated Requires Improvement overall after a breach of Regulation 10 (dignity and respect) was identified, with staff observed using an abrupt tone and a person upset during a non-person-centred discussion. Governance shortfalls were also found, including failure to submit statutory notifications to CQC and gaps in safe recruitment checks.
Concerns (10)
critical
Person-centred care
: “During the inspection we observed staff using an abrupt tone of voice to one person.”
criticalPerson-centred care: “This was a breach of regulation 10 (dignity and respect) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.”
moderateGovernance: “Monitoring systems did not always pick up shortfalls and the provider did not always know when to submit statutory notifications about serious events to the CQC.”
moderateGovernance: “the provider did not always know when they had a legal duty to submit statutory notifications to the CQC such as following incidents that involved the police.”
moderateStaff competency: “one staff member had not disclosed their employment history. This is necessary for the provider to be assured the person is suitable for working in the caring profession.”
moderatePerson-centred care: “we saw one example where a person had become upset during this process because it was not person-centred”
moderatePerson-centred care: “people and their families were not always consulted about who they lived with in line with current guidance.”
minorMedication management: “A medicines policy was available online for reference, however this did not cover certain aspects of care; for example when people were away from home with staff.”
minorStaff training: “a relative told us further skills were needed in the area of restrictive practices.”
minorLeadership: “The provider was not aware of the guidance but demonstrated areas of the service that gave people good experiences.”
Strengths
· Staff supported people to have their medicines as prescribed and were trained to support them individually.
· Staff understood how to protect people from poor care and abuse and worked well with other agencies.
· Alerts were made to the local authority safeguarding team and the CQC when allegations of abuse were made.
· People received access to healthcare services and support including GP, opticians and psychologists.
· Staff understood the principles of the MCA and people consented to day to day aspects of their care.
Quality-Statement breakdown (19)
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
effective: Assessing people's needs and choicesGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: People are well treated and supported; respecting equality and diversity; privacy, dignity and independenceRequires improvement
caring: Supporting people to express their views and be involved in making decisions about their careGood
responsive: Planning personalised care to ensure people have choice and controlGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirements; continuous learningRequires improvement
well-led: Working in partnership with others; duty of candour; engaging and involving peopleRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringRequires improvement