29 September and 1 October 2015
During a routine inspection
We carried out this inspection on the 29 September and 1 October 2015, and it was unannounced. We inspected this service due to concerns we had received. It was alleged that there was poor maintenance of the windows, no hand washing facilities, rooms were not clean and the quality of the food was poor.
94 Windmill Street is a privately owned care home. The service provided personal care, accommodation and support for up to 12 adults. There were seven people living at the service at the time of the inspection, together with a person who received respite care at the weekend. People had a variety of complex needs including mental and physical health needs and behaviours that may challenge.
Due to people’s varied needs, some of the people living in the service had a limited ability to verbally communicate with us or engage directly in the inspection process. People demonstrated that they were happy in their home by showing warmth to the manager and staff who were supporting them. Staff were attentive and interacted with people that used the service in a warm and friendly manner. Staff were available throughout the day, and responded quickly to people’s requests for help.
The service did not have a 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 2008 and associated Regulations about how the service is run. However, a manager was appointed in March 2015 and is currently applying for registration.
CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The registered manager and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).
Staff had been trained in how to protect people from abuse, and discussions with them confirmed that they knew the action to take in the event of any suspicion of abuse. Staff understood the whistle blowing policy and how to use it. They were confident they could raise any concerns with the manager or outside agencies if this was needed.
Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act (MCA) 2005 to ensure any decisions were made in the person’s best interests. Staff were trained in the Mental Capacity Act 2005 (MCA) and showed they understood and promoted people’s rights through asking for people’s consent before they delivered care.
Staff were knowledgeable about the needs and requirements of people using the service. Staff involved people in planning their own care in formats that they were able to understand, for example pictorial formats. Staff supported them in making arrangements to meet their health needs.
Medicines were managed, stored, disposed off and administered safely. People received their medicines when they needed them and as prescribed.
People were provided with food and fluids that met their needs and preferences. Menus offered variety and choice.
There were risk assessments in place for the environment, and for each individual person who received care. Assessments identified people’s specific needs, and showed how risks could be minimised. People or their representative were involved in making decisions about their care and treatment.
There were systems in place to review accidents and incidents and make any relevant improvements as a result.
The manager investigated and responded to people’s complaints and people said they felt able to raise any concerns with staff.
Staff respected people and we saw several instances of a kindly touch or a joke and conversation as drinks, or the lunch was served and at other times during the day.
People were given individual support to take part in their preferred hobbies and interests.
Staff were recruited using procedures designed to protect people from the employment of unsuitable staff.
Staff were trained to meet people’s needs and were supported through regular supervision and an annual appraisal so they were supported to carry out their roles.
There were systems in place to obtain people’s views about the quality of the service and the care they received. People were listened to and their views were taken into account in the way the service was run.