Archived: Windmill Care Centre

Updated 4 April 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place 20, 21 and 27 February 2017 and was unannounced.

The inspection was carried out by one inspector. An expert by experience attended on the first day. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed notifications and any other information we had received since the last inspection. A notification is information about important events which the service is required to send us by law.

We contacted healthcare professionals, for example, GPs and the local authority commissioners of the service, to seek their views about people’s care.

We spoke with the manager and seven staff members. This included the clinical and non clinical deputy managers, the chef, activities organiser, nurses and care workers. We also spoke with a healthcare professional who visited the service whilst we were there. Six relatives and eight people who lived at the home told us about their experiences of the service. We sat in on a seniors’ meeting for heads of department and shadowed a medicines round to observe practice.

We checked some of the required records. These included four people’s care plans, 23 people’s medicines records, three staff recruitment files and five staff training and development files. We also looked at checks and certificates for premises safety, monitoring of the quality of care and a sample of policies and procedures.

Some people were unable to tell us about their experiences of living at Windmill Care Centre because of their dementia. We therefore used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 4 April 2017

This inspection took place on 20, 21 and 27 February 2017. It was an unannounced visit to the service.

This was the service’s first inspection since changes to its registration in November 2015.

Windmill Care Centre provides care for up to 53 older people and people with dementia, including nursing care. Forty four people were receiving care at the time of our inspection.

The service did not have a registered manager 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. An application for registration of a manager had been withdrawn by the applicant shortly before this inspection took place.

We received positive feedback about the service. Comments from people included “I’m very happy here, I’m comfortable,” “Nice and clean and always a staff member around” and “The girls do well with the activities.” Relatives’ comments included “We’re very appreciative that they fitted him in and they’ve been able to maintain his level of health. This is really fantastic” and “I do feel for staff, they run a skeleton staff. I’m sure they’d want to give more time and care but staffing impacts the time they can spend, but they are faultless when they do spend time with (name of person).”

We found staff to be motivated and enthusiastic about the care they provided. They understood about person-centred care and how to safeguard people from the risk of abuse. People’s needs were met in a timely way and we saw staff were caring and kind.

However, people were not protected from the risk of unsuitable workers. The home did not always use robust recruitment practices to make sure prospective staff and agency workers had the right skills, qualifications and attributes. Staff told us they felt supported but we found formal professional supervision had not been embedded at the home. We have made a recommendation for supervision to be carried out in accordance with the provider’s policy.

There were safeguarding procedures and training on abuse to provide staff with the skills and knowledge to recognise and respond to safeguarding concerns. We found a lack of clarity about whether safeguarding incidents between residents needed to be reported to the local authority each time they occurred. We have made a recommendation for the service to seek clarification about this.

People had access to healthcare professionals as needed. Medicines were handled safely and given to them in accordance with their prescriptions. Risks to people’s health and safety were managed well. The building was well maintained to ensure the premises were safe. We have made a recommendation for records of fire practice drills to be developed so these can be used as an opportunity for learning and improving safety.

We found the home was not always working within the principles of the Mental Capacity Act 2005. For example, copies of Lasting Power of Attorney documents had not been obtained to make sure appropriate people were consulted on residents’ behalf.

People said they enjoyed the food and there had been improvement since the current chef had been at the home. Meal times were relaxed and unrushed with second helpings offered to people with good appetites and encouragement to eat given to those people who needed it. We saw some people were unable to understand the meal choices offered to them. We have made a recommendation for plated meal options to be considered, to help people make a decision about what they would like to eat.

People’s needs were recorded in care plans. These had been kept up to date to reflect changes in people’s needs. We have made a recommendation for information to be recorded about people’s life histories, to ensure they receive person-centred care.

People were supported to take part in a range of social activities. Complaints were responded to and changes were made where appropriate.

People spoke positively about the manager. A healthcare professional told us “Since (the manager) has been in place there has been an improvement in the general care being given in the care home and a feeling of calm. He has successfully recruited more staff and improved the training of the existing staff.” A person who lived at the home said “You can tell him anything you want, he’s as good as gold he is.” A relative told us “Since the new management, things have got better.”

Monitoring took place to assess the quality of people’s care. There were clear visions and values for how the service should operate and staff promoted these. For example, people told us they were treated with dignity and we saw they were given choices.

We found care records were in good order and were easily located. Other records, mainly health and safety related checks and certificates were difficult for managers to find and show us. We have made a recommendation to improve filing and storage of records.

The manager had let us know about some important events they needed to tell us about. However, we were not informed of the outcome of applications to the local authority to deprive people of their liberty or about safeguarding incidents which happened between people who lived at the home.

We found breaches of the Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to staff recruitment and application of the Mental Capacity Act 2005.

We also found a breach of the Care Quality Commission (Registration) Regulations 2009, as the service had not notified us of all important events.

You can see what action we told the provider to take at the back of the full version of this report.