Windmill Court

We found the following examples of good practice.

The home was clean and hygienic in appearance. There were appropriate procedures to ensure that infection control risks were reduced. For example, in the communal areas the furniture was arranged to enable social distancing. Increased cleaning schedules ensured that communal areas and high touch points around the home, such as light switches and hand rails, were cleaned regularly.

Infection control policies and procedures had been updated in line with the national guidance relating to COVID-19 and staff were provided regular updates to ensure they were following best practice recommendations. The training for staff regarding infection control had been updated to include guidance relating to COVID-19.

Audits and risk assessments had been carried out to identify areas where action was needed to increase the control of infection. Actions had been completed within agreed timescales. The registered manager was in the process of recording formal risk assessments for each staff member regarding their level of risk from COVID-19. Prior to this inspection the risk had been discussed and agreed informally.

The provider had a contingency plan to manage an outbreak of COVID-19 including segregating the home to keep people safe.

Signage and information posters were in evidence at the entrance to the home to inform visitors of the procedures to follow. Plentiful supplies of personal protective equipment (PPE) was in evidence at the entrance to the home and throughout the building. Additional signage identified the PPE to be worn when a person was assessed at higher risk of infection.

People who used the service were supported to communicate with their friends and family. Telephones and electronic devices were used to communicate. At the time of the inspection a national lockdown was in effect and visitors were not admitted to the home apart from to see people who were receiving end of life care. Visitors were able, by prearrangement, to speak to their friends and relatives through a glass door with a microphone and speaker system.

Windmill Court is a residential home providing personal and nursing care for up to 34 predominantly older people. At the time of this inspection there were 34 people living at the service. Some of these people were living with dementia or were receiving end of life care.

People’s experience of using this service and what we found

Some people were not able to tell us verbally about their experience of living at Windmill Court. Therefore, we observed the interactions between people and the staff supporting them.

People told us they received a good service and felt safe. Accidents and incidents were recorded, and risk assessments were in place. The registered manager understood their responsibilities about safeguarding and staff had been appropriately trained. Arrangements were in place for the safe administration of medicines.

People’s needs had been assessed and the registered manager ensured this information was made available to all staff. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The registered manager promoted an open culture within the service. Staff felt supported in their roles and were clear what was expected of them at work.

There were enough staff on duty to meet the needs of people. The provider had an effective recruitment and selection procedure and carried out relevant vetting checks when they employed staff. Staff were suitably trained and received regular supervisions and appraisals.

People were supported by a staff team that were both caring and compassionate and treated them with dignity and respect. People received person centred care and support based on their individual needs and preferences. Staff knew about people's life history, and their communication needs.

People’s health needs were being met. The service worked in partnership with a range of healthcare professionals and followed their advice.

People were supported with good nutrition and could access appropriate healthcare services. People's wellbeing was monitored and promoted.

There were quality assurance systems and processes in place designed to enable them

to monitor and improve the quality of people's care. The management team sought to involve people, their relatives and staff in the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: At the last inspection the service was rated as Good (report published 2 February 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We carried out this inspection on 17 January 2017. At the last inspection, in October 2014, the service was rated Good. At this inspection we found the service remained Good.

The service is required to have a registered manager and at the time of our inspection a registered manager was not in post. However, the manager who was in overall charge of the day-to-day running of the service had applied to the Care Quality Commission to become the 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 and associated Regulations about how the service is run.

People who were able to talk to us about their view of the service told us they were happy with the care they received and believed it was a safe environment. People and their visitors commented, “I love it here”, “[Person’s name] is always treated well “and “It’s excellent.” Where people were unable to tell us about their experiences we observed they were relaxed and at ease with staff. People had good and meaningful relationships with staff and staff interacted with people in a caring and respectful manner.

There were sufficient numbers of suitably qualified staff on duty and staffing levels were adjusted to meet people’s changing needs and wishes. Staff completed a thorough recruitment process to ensure they had the appropriate skills and knowledge. Staff knew how to recognise and report the signs of abuse.

People received their medicines on time. Medicines administration records were kept appropriately and medicines were stored and managed to a good standard.

Staff supported people to access to healthcare services such as occupational therapists, GPs, chiropodists and dieticians. Visitors told us staff always kept them informed if their relative was unwell or a doctor was called.

People received care and support that was responsive to their needs because staff were aware of the needs of people who lived at Windmill Court. Any risks in relation to people’s care and support were identified and appropriately managed. Some people’s care plans had not been updated to reflect the care they received. We have made a recommendation about the recording of people’s care needs.

There was a wide range of meals on offer and staff were knowledgeable about people’s likes, dislikes and dietary needs. People told they enjoyed their meals. One person said, “We have a good variety of meals. There is a change of menu every day.”

Management and staff had a good understanding of the Mental Capacity Act 2005 (MCA) and how to apply the principles of the MCA in the way they cared for people.

There was a management structure in the service which provided clear lines of responsibility and accountability. Staff had a positive attitude and the management team provided strong leadership and led by example. One member of staff commented, “We are a good team. We all work together and trust each other.” People and visitors all described the management of the home as open and approachable. One visitor said, “You can talk to the staff and managers and they really listen.”

People and their families were given information about how to complain. There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed.

We witnessed staff interactions with people which were relaxed and calm. One person told us the staff were 'lovely' and 'very kind'. Another person stated the 'manager is so kind' and 'this is the best care home for miles'.

We saw people had been involved in their care and offered choices, such as if they wished a lock on their bedroom door, and what time they chose to get out of bed.

We found that appropriate action had been taken to keep people safe from abuse.

We were shown a training schedule was in place for all staff, and this was monitored and reviewed.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

We found people who used the service benefited from safe quality care, treatment and support due to effective decision making and the management of risks. This was done through quality monitoring and surveys of the people who lived at Windmill Court the families and carers, and the staff.

Relatives told us, staff have, 'love and compassion' and 'staff are splendid, very caring, but I don't think there are enough of them'.

We found, people's views and experiences were not always taken into account in the way the service was provided and delivered in relation to their care. People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. However, people did not consistently experience care, treatment and support that met their needs and protected their rights.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

People who used the service, staff and visitors were not protected against the risks of unsafe or unsuitable premises.

There was an effective complaints system available. Comments and complaints people made were responded to appropriately.