Winsford House is a 'care home'. People in care homes receive accommodation and nursing and personal care as a single package under a contractual agreement with the local authority, health authority or the individual, if privately funded. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Winsford House accommodates a maximum of 38 older people, including people who live with dementia or a dementia related condition, in one residential style building which has been adapted for that purpose. Winsford House is a large detached house situated in a quiet residential area in Clacton on Sea and close to all amenities. The premises is set out on two to three floors with each person using the service having their own individual bedroom and adequate communal facilities are

available for people to make use of within the service. At the time of our inspection 33 people were using the service.

At the last inspection on 10 June 2015, the service was rated 'Good'. At this inspection we found the service remained 'Good'.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

People were protected from the risks of abuse because staff were trained in recognising and reporting any safeguarding concerns. The registered manager checked staff were suitable for their role before they started working at the service and made sure there were enough staff to support people safely.

Risks to people's individual health and wellbeing were identified with the person and their representative and care was planned to minimise the identified risks. The provider and registered manager regularly checked that the premises, essential supplies and equipment were safe for people to use.

Medicines were stored, administered and managed safely. Staff followed best practice guidance to keep the service clean and mitigate the risk of cross infection.

People were cared for and supported by staff who had the skills and training to meet their needs effectively. The atmosphere was warm and happy and visitors told us they were made welcome to the service.

People were supported to eat and drink enough to maintain a balanced diet that met their preferences. People were referred to other healthcare services when their health needs changed.

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, relatives and staff felt well cared for. The registered manager and staff understood people's diverse needs and interests and encouraged them to maintain their independence according to their wishes and abilities.

Staff were happy working at the service. People were supported and encouraged to maintain their interests and to socialise in the service and in the local community. Staff respected people's right to privacy and supported people to maintain their dignity.

People and relatives knew the registered manager well and were confident any concerns or issues they raised would be dealt with promptly. People and their relatives were encouraged to share their opinions about the quality of the service.

There was a clear management structure in place. The manager and other senior staff were well respected by people and staff. Staff were positive about the registered manager's leadership, skills and experience to provide a quality service. The service people received was delivered in accordance with the fundamental standards of care.

The inspection took place on 10 June 2015 and was unannounced. Winsford House provides accommodation and personal care and support for up to 38 older people, some who may have a mental health need. At the time of our inspection there were 36 people who lived in the service.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act (MCA) 2005, DoLS and associated Codes of Practice. The Act, Safeguards and Codes of Practice are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals.

The service had appropriate systems in place to keep people safe, and staff followed these guidelines when they supported people. There were sufficient numbers of care staff available to meet people’s care needs and people received their medication as prescribed and on time. The provider also had a robust recruitment process in place to protect people from the risk of avoidable harm.

People’s health needs were managed by staff with input from relevant health care professionals. Staff supported people to have sufficient food and drink that met their individual needs. People’s privacy and dignity was respected at all times.

People and their relatives were involved in making decisions about their care and support. Care plans reflected people’s care and support requirements accurately and people’s healthcare needs were well managed. Staff interacted with people in a caring, respectful and professional manner, and were skilled at responding to people’s care and support needs.

People were encouraged to take part in interests and hobbies that they enjoyed. They were supported to keep in contact with family and develop new friendships so that they could enjoy social activities outside the service. The manager and staff provided people with opportunities to express their views and there were systems in place to manage concerns and complaints.

There was an open culture and the management team demonstrated good leadership skills. Staff were enthusiastic about their roles and they were able to express their views. The management team had systems in place to check and audit the quality of the service. The views of people and their relatives were sought and feedback was used to make improvements and develop the service.

As part of this inspection process we spoke with the manager, four members of staff, four people who used the service and two visitors.

Our observations indicated that people living at the service were very happy, that they felt safe and were well cared for. It was evident that people who used the service had a good relationship and rapport with the staff who supported them. Comments included, "I cannot fault the care I receive," "I am very happy here. The staff are very kind and caring. Nothing is too much trouble" and, "I get all the support I need. The staff are lovely."

People's health and personal care needs were assessed and there were detailed care plans in place for care staff to follow so as to ensure that people were supported safely and in accordance with people's individual preferences and wishes. Staff spoken with demonstrated a good understanding of people's health and personal care needs and how each person wished to be supported.

The provider was able to demonstrate that a robust staff recruitment policy and procedure was in place and followed to ensure that people living at the service were kept safe. We found that medication practices and procedures ensured people's safety and wellbeing. We found that staffing levels were appropriate to meet the needs of people living at Winsford House.

We used a number of different methods to help us understand the experiences of people who used the service, because some of the people using the service had complex needs which meant they were not able to tell us about their experiences. Where people were unable to provide a verbal response or tell us about their experiences, for example as a result of their limited verbal communication or poor cognitive ability, we noted their non verbal cues and these indicated that people were generally relaxed and comfortable and found their experience at Winsford House to be positive.

We observed that staff members were polite and attentive towards people who used the service, in particular those people with no or limited verbal communication. We saw that staff made good eye contact with people that were unable to communicate.

During our visit on 07 November 2012 to Winsford House people told us that they felt respected and involved.

People told us they were satisfied with the level of care and support they received at Winsford House and that they felt well looked after by the staff. We were told that the staff were caring and helpful to them. One person told us "The staff are lovely I could not live anywhere better, I am very happy here".

People told us they could choose whether or not to join in activities and could spend time alone in their room pursuing their own interests if they preferred.

People told us that they experience good care and are happy with the service they receive at Winsford House. One person with whom we spoke said “It’s a very nice atmosphere and the people are lovely here” Another said “ I feel safe here and the staff are always willing to help”.