Archived: Windmill Care Centre

Updated 14 January 2015

We visited Windmill Care Centre on the 15 and 16 July 2014. The inspection team consisted of an inspector and on the first day only, an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. In this case they had experience of services for older people, including people living with dementia.We last inspected Windmill Care Centre on the 14 November 2013 and found no concerns which required action by the provider.

We reviewed the Provider Information Record (PIR) and previous inspection reports before the inspection. The PIR was information given to us by the provider. This enabled us to ensure we were addressing potential areas of concern. We also asked health and social care professionals, for example, G.Ps and commissioners, for information to support the inspection process. We received information from four G.Ps and the local authority commissioners. We also reviewed notifications sent to us by the Provider. Notifications are information about important events the service is required to send to us by law.

Between October 2013 and May 2014 the local authority had placed a temporary restriction on admissions to the first floor of the service. This was because they had been made aware of concerns about how care was monitored and recorded and the care of people’s skin. Between December 2013 and May 2014 similar concerns also arose from safeguarding alerts made to the local authority. Following this visit we were informed the restriction on admissions had been lifted as improvements in care and records had been achieved by the service.

We spoke with 13 people who were living at Windmill Care Centre, 5 relatives of people who lived there, 14 members of the nursing and care staff team and with the manager of the home. We also spoke with two senior managers for Lifestyle Care (2011) plc and with a GP.

We observed people in different areas of the service, for example lounges and dining areas. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We also looked at records including six people’s care plans, staff training and those relating to the management of the service.

Updated 14 January 2015

Overall summary We carried out this unannounced inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This unannounced inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by the Care Quality Commission (CQC) which looks at the overall quality of the service.

Windmill Care Centre provides accommodation and nursing care for up to 53 older people over three floors. The first floor can accommodate up to 23 people who live with dementia. At the time of our visit there were 40 people living at the service.

There was a registered manager in post. A registered manager is a person who has registered with CQC to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

We spoke with 13 people who were living at Windmill Care Centre, 5 relatives, 14 members of the nursing and care staff team and with the manager of the home. We also spoke with two senior managers for the provider and with a GP.

People who lived in Windmill Care Centre and their relatives told us they were very satisfied with the care they received or observed. They said staff were caring and competent and communication between themselves and staff was good. They told us they were involved with their care, treated with respect and their dignity was protected.

People could be at risk from equipment which had not been maintained appropriately as routine maintenance had not consistently been carried out on fire alarms and smoke detectors and the provider had not always recorded when equipment had been tested.

Health and social care professionals involved with Windmill Care Centre and the people who lived there, told us there had recently been significant improvements in the standard of pressure care and associated care records. However we found in some cases further improvement was required to ensure care records were consistently well-completed.

Some care records were incomplete. For example, some people’s weight had not been recorded monthly and staff had not consistently recorded if they had assessed a person’s pain or their risk of depression. Care records could not always be relied upon to accurately reflect people’s care needs or the care provided.

People were offered choice and given the time to make decisions, for example about what they ate or if they wanted to participate in activities.

The service’s recruitment process included checks which protected people from the employment of unsuitable people.

Staff at all levels had a good understanding of the care needs of people and how these were to be met. Where people did not have capacity to make certain decisions about their care, there was a robust process in place and being followed to ensure that any decisions being made on their behalf were in their best interests.

Staff were supported through training and supervision. They knew how to identify signs of abuse and how to report it. Staff training was being monitored so updates could be identified and planned for. People could be confident their care was provided by staff who had received up to date training.

There was very positive interaction between staff and people they cared for. People told us they would like more activities outside of the home. This was being actively addressed; however there had been some disruption to the choice of activities due to staff sickness. We saw activity sessions took place on both days of our visit. One to one sessions were also programmed for individuals who might not be able or choose to access activities within the home.

Quality assurance and monitoring systems were in place. These had identified areas that needed improvement, including care and maintenance records. An action plan with expected completion dates was in place. This showed where improvement were required this had been identified by the provider and action was planned to improve the service for people.