CQC report explained · a residential care home
What the CQC found at Windmill House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People had risk assessments and care plans, medicines were managed safely, and staff recruitment and safeguarding procedures were in place. Inspectors recommended clearer guidance and better practice for managing pain.
- Effective?
- Good
- Staff had the training, skills and support needed. People's health, nutrition and changing needs were monitored, with support from health and social care professionals.
- Caring?
- Good
- Staff were observed to be kind, respectful and knowledgeable about people. However, this rating had fallen from Outstanding at the previous inspection.
- Responsive?
- Good
- Care was personalised and reviewed when people's needs changed. People were supported to maintain relationships, follow interests, join activities and raise complaints.
- Well-led?
- Good
- People, relatives and staff spoke positively about the management. Audits, meetings and reviews of incidents, complaints and risks were used to monitor and improve the service.
What inspectors found, December 2019
Rated Good; inspectors found safe, kind and responsive care, with improvements recommended for pain management and caring rated lower than at the last inspection.
Inspectors made an unannounced visit on 12 November 2019. They spoke with 16 people, five relatives, eight staff members and a visiting health professional. They also observed care and checked care, medicine, training and quality records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people were protected from abuse, received their medicines safely, and were supported by trained staff.
People were involved in their care and were treated with kindness, dignity and respect. The home offered activities based on people's interests and welcomed relatives and friends.
There was one recommendation to improve pain management. Caring had fallen from Outstanding at the previous inspection to Good, while the other ratings remained Good.
Risk management
People's needs and risks were assessed, and staff had care plans to help reduce avoidable harm. Equipment and professional advice were used where needed.
“People's support needs were assessed, and care plans provided staff with the information they needed to manage any identified risks.” from the report
Kind and respectful care
Inspectors saw staff treating people with dignity and respect. People and relatives gave very positive feedback about the caring approach.
“Staff treated people with dignity and respect. Staff received training in dignity, equalities and diversity.” from the report
Personalised support
Care plans reflected people's wishes and were updated as needs changed. Staff supported people to keep relationships, follow hobbies and take part in activities.
“People's care was person centred. Care Plans were held electronically and kept under review as their needs changed.” from the report
Strong management
The management team was described as approachable and supportive. Audits and meetings were used to identify improvements and share information with staff.
“Management oversight was evident with regular meetings exploring ways to drive improvement.” from the report
Pain management
needs fixingInspectors saw one person in pain during three transfers. Staff had not responded promptly when the person's needs changed, so the provider was asked to improve its guidance and practice.
“We recommend the provider consider current guidance on managing pain to ensure there is clear guidance for staff to follow in consultation with other professionals and take action to update their practice accordingly.” from the report
Lower Caring rating
minorAlthough Caring was still rated Good and inspectors found kind care, this rating had fallen from Outstanding at the previous inspection.
“At the last inspection this key question was rated as Outstanding. At this inspection this key question has now deteriorated to Good.” from the report
- 01What new pain management assessment or guidance was introduced after the inspection?
- 02How do staff recognise and respond when a person's pain or other needs change?
- 03Why did the Caring rating fall from Outstanding to Good, and what improvements have been made since then?
- 04How are care plans reviewed when people's needs change?
- 05How are relatives' views and complaints used to improve the service?
This was an unannounced planned inspection covering the home and all five CQC questions; the previous overall rating was Good, published in June 2017. This explanation was written from the published report of 18 December 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, June 2017
Rated Good overall, with Outstanding care; inspectors found safe, effective and kind support, but some medicine records were incomplete.
This was an unannounced inspection on 22 and 25 May 2017. Inspectors spoke with people living in the home, relatives, staff and health professionals. They reviewed care records, staff rotas, training records, medicines arrangements and quality checks.
The home was rated Good overall. Safe, effective, responsive and well-led were rated Good. Caring was rated Outstanding. Inspectors found enough staff, well-managed risks, suitable training, prompt healthcare support and individual care plans.
People were treated with dignity and kindness. Staff supported activities, independence, family contact and personal choices. Inspectors found one shortfall in medicine records for medicines not supplied in blister packs. The home said this would be addressed.
Kind and respectful care
Inspectors saw staff explaining care, seeking consent and supporting people sensitively. People and relatives described staff as kind, attentive and compassionate.
“People were treated with dignity, respect, compassion and kindness.” from the report
Strong personal knowledge
Staff understood people's preferences, routines and wishes. Care plans included detailed information about how people wanted to be supported.
“Staff at all levels were committed to working in a person-centred way to promote people's well-being.” from the report
Safety arrangements
Risks were assessed and reviewed, staff numbers were sufficient and equipment and the environment were checked. The home was clean and free from odour.
“People received a safe service because risks to their health and safety were being well managed.” from the report
Choice and activities
People could choose meals and where to eat. The home offered regular activities, entertainment and trips, and supported people to remain independent.
“People's nutritional needs were being met. People were able to express their views and make choices on what to eat.” from the report
Incomplete medicine stock records
needs fixingThere were no stock records for medicines that were not in blister packs. This meant the home could not always account for them, although the manager said this would be addressed.
“There were no stock records for medications that were not in the blister packs. This meant they could not always account for these medications.” from the report
Quality checks during management change
needs fixingThe current manager was preparing to move to another service. The home recognised that its quality assurance tools needed strengthening when the manager was no longer running the home day to day.
“The registered manager was aware that they would have to develop more robust quality assurance tools when they were not in day-to-day charge of the home.” from the report
Occasional post delays
minorOne person said newspapers sometimes arrived late and post could be delayed. They said this did not affect their overall view of the care.
“One person told us, sometimes they received this late and had to chase this up with staff.” from the report
- 01How do you now record and check medicines that are not supplied in blister packs?
- 02Who is responsible for quality checks after the planned change in registered manager?
- 03How are the 26 outstanding Deprivation of Liberty Safeguards applications being monitored?
- 04What has changed in response to earlier complaints about clothes labelling, dietary needs and repairs?
- 05How do you make sure newspapers and personal post arrive promptly?
This was an unannounced inspection covering the overall service and all five key questions; the previous inspection in November 2014 found no concerns and the Good rating remained. This explanation was written from the published report of 24 June 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Windmill House
3 rated inspections over 5 years: the service has held its Good rating throughout.
- December 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- January 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 21 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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39 live-in carers within about an hour of South Gloucestershire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,280 a week. 32 can care for a couple. 11 years' experience on average.
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