The Care Quality Commission
  • Care Home
  • Care home

Archived: Signature at Winchester

Overall: Outstanding read more about inspection ratings

Stockbridge Road, Winchester, Hampshire, SO22 5JH (01962) 814400

Provided and run by:
Sunrise Operations Winchester Limited

Important: The provider of this service changed. See new profile
Important: This care home is run by two companies: Sunrise Senior Living Limited and Sunrise Operations Winchester Limited. These two companies have a dual registration and are jointly responsible for the services at the home.

All Inspections

4 December 2017

During a routine inspection

A planned comprehensive inspection of Sunrise of Winchester was completed on 4 and 5 December 2017.

Sunrise of Winchester is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. This home is a dual registered location. This means that two registered providers are responsible for the service delivery at this home. This registered provider, Sunrise Operations Winchester Ltd, and Sunrise Senior Living Limited, are both equally responsible for the delivery of all services at this home.

Sunrise of Winchester accommodates up to 103 people in a purpose built community across three separate floors. The second floor provides specialist adapted care facilities for people who live with dementia. At the time of our inspection 81 people lived in the community.

A registered manager was in post. 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.’

People, their relatives and staff were very proud of the community they lived and worked in. They felt valued, respected and an integral part of a community which worked together to provide a supportive and nurturing environment for all.

Staff had the specialist knowledge and skills required to meet the needs of people who lived with dementia. Specialist dementia care training was provided so staff could interact with people and fully understand and respond to their needs. This training was evident in all staff interactions with people which were excellent.

People felt safe and well supported by staff who knew them well. Person centred care planning was evident throughout our inspection and a high level of engagement with people about their previous life experiences and hobbies.

Staff took time to ensure activities in the home were planned and focused around people’s experiences and interests. People were actively encouraged to share their life experiences with others and celebrate these in the community.

The community worked closely with other services and organisations in the local wider community to enhance people’s lives.

People received outstanding end of life care which provided dignity and respect for people and their relatives at this difficult time.

The registered manager embraced the registered provider’s visions, values and a Mission, “To Champion Quality of Life for all Seniors”. This mission was evident throughout the community in the way people and staff were supported, respected, nurtured and worked together for the good of people who lived there and those who were important to them.

Health care professionals were highly complementary on the care and support people received in the community. They spoke of staff who had a very good understanding of people’s needs and a clear drive to enhance people’s lives.

Staff had a good understanding of how to keep people safe, identify signs of abuse and report these appropriately. Robust processes to check the suitability of staff to work with people were in place.

There were sufficient staff deployed to meet the needs of people. Staff received excellent support and training to enable them to meet the needs of people. They knew people well and could demonstrate how to meet their individual needs.

People enjoyed an excellent dining experience at the home which respected their choices and promoted their independence. Special dietary needs were met and cultural difference in diets had been celebrated with themed meals.

Medicines were managed in a safe and effective manner. People were supported to maintain their independence with medicines as appropriate.

The community was very clean, well maintained and adapted to meet the needs of people who live with dementia. All communal areas of the home provided a warm and homely environment for people to relax and interact with others. People were encouraged to personalise their own areas of the community.

A robust system of governance in the community meant people received safe and effective care. Learning from incidents, accidents, audits and reviews in the community was shared and embraced to enhance the provision of care in the community.

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2 and 3 December 2015

During a routine inspection

This inspection took place on the 2 and 3 December 2015 and was unannounced.

Sunrise of Winchester provides nursing and personal care for up to 103 people, including people living with dementia.

The home consists of two communities. The reminiscence community is for people living with dementia and is based on the second floor of the building. This community has secure access. The assisted living community is based on the ground and first floor of the building. People living in both communities were supported with nursing needs. At the time of our inspection there were 32 people living in the reminiscence community and 60 people on assisted living. The home provides accommodation in ensuite rooms and suites that include bathrooms, bedrooms, kitchens and living areas. There was a large garden and a secure outside terrace on the second floor. People had access to a range of facilities such as; community dining areas, a private dining room, library, activity and entertainment areas, TV parlour and a 24 hour bistro for self service drinks and snacks.

The service was overseen by a registered manager. 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.

People told us they felt safe living at Sunrise of Winchester. Staff completed training in safeguarding people from abuse and knew how to act on any concerns. The registered manager took action to ensure people were protected from harm to themselves or others.

People were supported to manage risks to their safety. Risk assessments guided staff on how to support people safely and these were followed in practice. People’s risk assessments were regularly reviewed to ensure they were updated with any changed needs. People experienced safe care and treatment.

People told us there were enough staff to meet their needs safely. The provider assessed their staffing levels against people’s care and treatment needs to ensure enough staff were deployed to meet these. Action had been taken to address a shortfall in nursing staff and staffing needs were kept under daily review. Staff had the time to meet people’s needs at their pace and to enjoy social interactions with people.

Staff were recruited safely and all the required checks were carried out to ensure people were protected from the employment of unsuitable staff.

People’s medicines were managed safely. Staff administering medicines were trained and assessed as competent to do so. People were supported to achieve a reduction in the use of anti-biotic and anti-psychotic medicines where other interventions could achieve a positive result. This included increasing fluids to prevent a urinary infection and responding to people’s behavioural needs without the use of medicines to control their anxieties.

People were supported by staff who completed training to meet the needs of the people they supported. Staff were assessed as competent to carry out their role at induction through completion of the Care Certificate. The Care Certificate sets out learning outcomes, competences and standards of care that care workers are nationally expected to achieve.

Staff told us they were adequately supported in their role and records showed staff had regular supervision and appraisal. Staff had access to professional qualification training to enable their professional development. People were supported by staff who were trained and assessed as competent in their role.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act 2005 (MCA). The application procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS). Appropriate DoLS applications had been made on behalf of people following the completion of proceedures under the MCA.

Staff understood the principles of the MCA and people’s consent was sought prior to care and treatment being provided. People rights under the MCA were upheld.

People were supported with their nutrition and hydration needs where risks had been identified. Where people required assistance with eating and drinking this was provided. People told us and we observed the food was good quality and people were offered plenty of choice to meet their dietary needs and preferences.

People were supported to meet their health needs by nursing staff on site and treatment provided by other healthcare professionals. People told us they achieved good health outcomes and were well cared for when they were ill.

People experienced kind and compassionate care from staff who knew and understood their needs and preferences. People’s care plans included information that detailed their personal histories, likes and dislikes and this enabled staff to provide appropriate support. People told us they enjoyed positive relationships with staff.

Staff supported people to make decisions about their care and treatment and gave people choices. People who lacked the capacity to make decisions and express choices were supported by family and representatives to inform the way their care was delivered. People had access to an independent advocate to represent their feelings and wishes when they faced important decisions they may not be able to make alone.

People received dignified care and their right to privacy was respected. People’s relatives valued the sensitive approach taken by staff at the home when their loved one died.

People received person-centred care. People’s care plans included information about their preferences and how staff should support people in the way they preferred. People’s care and treatment was regularly reviewed with them or those lawfully able to represent them and adapted to meet their changed needs.

People received nursing care to meet their assessed needs.

People living with dementia were cared for in a calm and unhurried manner. The reminiscence community environment was adapted to meet the needs of people living with dementia and resources were available to meet their needs. For example; when people retreated to past memories they had access to items that helped them recreate their experience.

People’s activity and social needs were met through a wide ranging programme that included group and individual activities. People told us about the activities they enjoyed and this included learning new skills and interests.

A complaints system was in place and information on how to complain was available to people, their families and visitors. People’s concerns were promptly addressed and complaints were acted on.

There was a positive, open and inclusive culture within the home. Staff spoke positively about their work and felt well supported by their managers. A recognition scheme was operated by the provider and the registered manager to acknowledge when staff made positive contributions to the quality of care people experienced.

Staff completed training in the provider’s values and evidenced the application of these in their work with people. For example; staff were seen to be joyful in their interactions with people and treated them and each other with respect.

The registered manager and her management team worked closely with each other and kept service needs, concerns and risks under daily review. Regular staff meetings were held to ensure all staff were informed of concerns, required improvements and the opportunity to contribute to service development. This supported staff to understand their role and accountabilities.

People, their relatives and representatives were given opportunities to feedback on the quality of the service they received. This included formal processes such as a satisfaction questionnaire as well as informal opportunities such as drinks with the managers. Feedback was acted on to improve the service.

A quality assurance system was in place to audit, review and monitor service delivery. Information from this system was used to drive continuous improvements and ensure people received safe and appropriate care. A clinical governance meeting was held weekly to review people’s nursing care. The meeting included activities and catering staff to ensure people’s needs were considered in a holistic and person centred way.

8 July 2013

During a routine inspection

During our visit we spoke with eight residents, one visiting relative, the deputy manager and 14 staff members. The manager of the service was on leave when we visited. We also spoke to a visiting mental health professional and observed care generally. At lunch time, we carried out an observation, using the Short Observational Framework for Inspectors tool in the dementia unit (known as Reminiscence).

We found that people's needs were assessed and documented and they were cared for in accordance with their care plans. The service had effective systems for monitoring people's care and welfare and acting upon incidents, health needs and people's concerns.

People's specific nutritional needs and risks were assessed and there were clear processes for ensuring people had suitable foods and drink. The catering contract had recently changed and people's views about the new menus were being listened to.

There were usually enough staff available for provide care and treatment, and staff recruitment was in progress to develop the care team. Staff were up to date with most of their mandatory training and we were told that further training had been arranged in subjects such as the Mental Capacity Act 2005 and dementia care. Staff usually obtained consent before providing care or treatment, and were aware of the importance of this.

3, 11 December 2012

During an inspection looking at part of the service

This inspection was carried out to follow up on the areas of non-compliance we identified at our previous inspection in September 2012. The provider sent us an action plan outlining planned improvements and when they would be implemented. We visited the service twice in December 2012. We spoke with five people who use the service or their relatives, three members of staff, and the manager and deputy manager. We also reviewed five people's care documentation.

People said their care and treatment was good, and the staff were 'All very kind.' One person said; 'I have never seen mum looking so good.' We were told that staff responded promptly when called, and 'will do a bit extra' if requested. We found the service assessed people's needs and implemented accurate care plans. Staff shared information and if people's health or wellbeing changed, appropriate action was taken. Care files had been reviewed and checked. One person commented that they felt the service had improved, saying it was better organised and the manager listened to people's feedback and acted on it.

Everyone we spoke with said they felt safe. One person said they were encouraged to feel at home here and that they were supported to maintain their independence. Staff had been trained in safeguarding protocols. We saw evidence that the provider had responded appropriately to incidents and involved the local safeguarding team when necessary. This meant that they helped keep people safe.

12 September 2012

During a routine inspection

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We used SOFI in this inspection because the 'reminiscence' floor of Sunrise Operations Winchester provides a service for people with dementia and many of the people using the service were not able to provide direct feedback to us about their experiences.

During the observations we saw staff interacting with people in a friendly and respectful manner. Staff took the time to respond to questions and to ask people their preferences. Staff helped people to make decisions about activities that were taking place and to make choices about food and drinks. Staff demonstrated a good understanding of people's needs and communicated with people in different ways. Staff responded to requests for support, for example, to go to the toilet and to get more comfortable in an armchair. We saw that staff were available to respond to requests for assistance. Staff were able to spend time with people, providing reassurance where necessary. In other areas of the home we observed that there were sufficient staff available to help people with their meals and that calls for assistance were answered promptly.

We talked to four people, one relative and a volunteer about medicines. All the people we spoke to told us that their medicines were managed well. One person we talked to looked after their own medicines. They took control of the whole process including ordering their own medicines. They told us that they liked to be in charge of their medicines. All the people we spoke to told us that they were happy with the way their medicines were managed.

Although we received positive feedback from people using the service, we identified that the systems for planning people's care, recording the care that had been provided and keeping people safe from abuse were not suitable. This increased the risk that people may receive inappropriate or unsafe care. The provider needed to take action to resolve these issues.

17 November 2011

During an inspection looking at part of the service

People told us that they were encouraged to maintain their independence, and that staff were courteous and helpful. We observed that people were supported to engage in activities, but some people would like more assistance to go out more often. People said their health was well looked after and that they felt safe. If they had concerns, however, they told us they would be confident to raise them and that their views would be respected. We were told that people's rooms were kept clean and that the food was good.

11 March 2011

During an inspection looking at part of the service

All people we spoke to during our visit said that staff were kind and considerate. Some people told us that they enjoyed living at Sunrise Operations Winchester. Some people felt that there was insufficient care available for those with greater needs. One person told us that she was not confident that she always received her medications, and that sometimes she thought she received them late. Another person was very dissatisfied with the quality of care provided, and told us about a serious medication error, inadequate needs assessment and poor overall nursing and personal care.

26 October 2010

During a routine inspection

People told us about a range of issues that led us to have major concerns about the service. We received feedback from service users and carers as well as from health and social care professionals. Concerns related to all the quality and safety outcomes, apart from the outcome relating to the premises.

We heard about poor standards of cleaning and a lack of response to calls for assistance. We were told about staff who were not competent and did not always treat people safely or with respect. Poor medicines management was evidently of significant concern and people told us that medicines were neither ordered nor administered efficiently and correctly. Both people using services and care professionals told us that they were concerned with staff skill levels, and also about the lack of staff to provide care. They also commented on the poor organisational arrangements at Sunrise Operations Winchester.