About the service Windmill Lodge is registered to provide nursing and residential care for up to 100 people. People may require support with residential care needs and or/ nursing care needs and may be living with dementia. It is a purpose built home which is divided into four separate areas. At the time of the inspection 43 people were receiving care and support at the home.
People’s experience of using this service and what we found
Staff did not always follow agreed processes to report incidents to senior management. Safeguarding notifications were not always made to local safeguarding authorities. Processes to help ensure suitable staff were employed to work at the home were in place and the home was clean and hygienic. People's medicines were managed safely. We recommend the provider reviews the recording of patch applications to ensure they are applied as per manufacturer’s guidelines.
People were supported by staff who had not always had training to enable them to meet people’s needs. Staff were effectively deployed. Nutritional risk assessments were carried out and care plans recorded the needs of people in relation to their nutrition and hydration needs. People were referred to external health professionals if this was required.
People's privacy and dignity was not always protected. One communal area of the home did not have window and a door covering. The environment did not always support the needs of people who lived with dementia. We have made a recommendation about this. People were supported by staff who were kind and patient in their approach and people told us they could make decisions about their care.
Checks and audits were carried out but these did not always drive improvement. The interim manager and nominated individual said when things could have been done differently, they would act openly and transparently. Staff said they felt the interim manager was making positive changes and they were committed to making improvements.
People could take part in a programme of activities if they wished to do so, and care records contained person centred information about people’s histories and personal routines. People’s communication needs were considered and documented to support people to communicate their needs and wishes. There was a complaints policy to support people to raise concerns or make complaints.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 26 April 2023 and this is the first inspection.
Why we inspected
The inspection was prompted in part due to concerns received about such as the admissions process, medicines, staffing and staff training. A decision was made for us to inspect and examine those risks.
You can see what action we have asked the provider to take at the end of this full report.
The provider increased staffing and ensured staff completed training during the inspection process. This minimised associated risks.
We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring and well-led sections of the full report.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement and Recommendations
We have identified breaches in relation to safeguarding people who may be vulnerable, staff training, dignity, and good governance. We have made recommendations about the safe management of medicines, and signage within the home.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.