What life was like for people using this service:

• Since our last inspection, the service had improved in several key areas.

• People received safe, compassionate and good quality care.

• Risks from the building and equipment were better managed.

• People were protected against abuse, neglect and discrimination. Staff ensured people’s safety and acted when necessary to prevent any harm.

• Staff knew people well. They had developed good relationships with people. People clearly enjoyed the presence and attention from the staff.

• People were assisted to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems at the service supported this practice. People had an active say in how the service was operated and managed.

• People’s care was personalised to their individual needs.

• The provider had improved processes in place to measure, document, assess and evaluate the quality of care.

• The service met the characteristics for a rating of “good” in all key questions.

• More information about our inspection findings is in the full report.

Rating at last inspection:

• At our last inspection, the service was rated “requires improvement”.

About the service:

• The service provides accommodation and personal care to adults with learning disabilities or autism spectrum disorder. The care home accommodates eight people in one adapted building.

• At the time of our inspection, eight people used the service.

Why we inspected:

• All services rated “requires improvement” are re-inspected within one year of our previously published inspection report.

• This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

• We will continue to monitor the service to ensure that people received safe, high quality care. Further inspections will be planned for future dates.

5 Winston Court is a care home without nursing and provides accommodation and support to adults with learning disabilities or autism. The care home is located within a residential area of Maidenhead, Berkshire. There are two floors. On the ground floor are communal areas, the kitchen and laundry and some people’s bedrooms. The first floor has more people’s bedrooms, communal bathrooms and a staff office. In accordance with the current registration, the care home can accommodate up to eight adults. At the time of our inspection seven people lived at 5 Winston Court.

Our inspection took place on 22 September 2017 and was unannounced.

The service is required to have a registered manager. At the time of our inspection, 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 were protected from abuse and neglect. Staff were trained in protecting adults at risk and told us they would report any instances to the management, local authority or other relevant agencies.

People’s care risks were appropriately assessed by staff and recorded within their care files.

People were not always safe from premises risks. Although health and safety risks were assessed, the findings were not always promptly acted on by the provider. Remedial actions, such as repairs, were not communicated, planned or completed. The provider’s health and safety coordinator was replacing prior systems of managing premises risks in order to ensure essential works were completed.

There were long-standing vacancies of permanent care workers. Staff routinely worked overtime, cancelled their annual leave or dedicated training and there was ongoing use of agency workers. Staff had accrued high volumes of annual leave because they sometimes did not have the ability to use it if they worked instead. A robust system of calculating the number of staff hours for each shift was not in place. We made a recommendation about staffing deployment.

People’s medicines were satisfactorily managed.

Staff completed training, supervision and performance appraisals, but requirements were needed to ensure appropriate knowledge and experience was in place.

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

People had adequate food and drinks. People’s care was supported by healthcare professionals from the local area. The decisions of multidisciplinary healthcare teams were not always followed by staff when providing support to people.

Staff were friendly and enjoyed working with people who used the service. They knew people’s likes, dislikes and preferences well. Staff respected people’s privacy and dignity. We saw staff had a good understanding of people’s needs.

Care plans were in place for people, and we found these were person-centred. We made a recommendation about the use of advocates. There was a complaints procedure in place, but this was not clearly displayed within the service. Easy-read versions were required for people who used the service. We made a recommendation about the complaints system at the service.

The provider’s systems of measuring the safety and quality of care were not fit for purpose. Processes for the measurement of safe and quality care remained the same since a change in registration. Checks from the new provider were not in place. A service improvement plan was available but not updated with the latest information. Best practice in caring for people with learning disabilities or autism were not considered or put into place.

We noted there was a good workplace culture amongst the staf