Archived: Windmill Care Centre

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 An application for registration of a manager had been withdrawn by the applicant shortly before this inspection took place.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.