Windmill Manor

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question Good. At this assessment the rating has remained Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. People told us they were involved in the assessment of their needs, and in the planning of their care to ensure they received person-centred support. Relatives told us, “The GP comes round once a week and [person] can see them and they usually tell me the outcome” and “Staff communicate with me if the GP sees [person]. They also told me about a hospital appointment.” However, whilst staff understood the process for creating care plans, we found that some plans lacked detail and were generic in style. Some management plans lacked detail with regards to, for example, catheter care. We found there was no impact on people’s health and wellbeing, since staff we spoke with demonstrated a good understanding of people’s needs. The registered manager told us that all care plans would be re-written in preparation for the new computer system due to be installed in March and all staff would be trained on the system. There would be a provider offsite team who would complete monthly reports on quality of plans and monitoring.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. The registered manager told us they accessed internal support from the provider’s dementia specialist which, “helps us to be up to date on current best practice.” In addition, dementia champions were appointed and they attended forums run by the local authority where they met other dementia champions and shared ideas on good practice. Staff used nationally recognised tools appropriately to assess and monitor people’s needs to identify people at risk of malnutrition. Lunchtimes were well organised and staff knew about people’s favourite food and how they liked their drinks. We observed staff replenishing drinks and offering people second helpings.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. However, some health care professionals told us they occasionally observed gaps in staff knowledge, and there were times when referral information lacked detail related to onset of symptoms and current condition of the person. Healthcare professionals told us the registered manager, deputy manager and care staff were always open to additional advice and support and engaged well in bite-sized training sessions to improve their understanding and clinical decision making. We observed good teamwork between all members of staff. Communication was clear and polite, and they alerted colleagues of their whereabouts at all times, to ensure people were not left unsupported.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and monitored people’s health for changes and signs of deterioration. For example, food and fluid intake and weight loss or gain was monitored which helped to detect early signs of deterioration. Staff were aware of the process in place to share information with emergency services in the event of someone requiring hospital treatment. People were seen by healthcare professionals when they needed to and were involved in regular reviews of their health and wellbeing. There was evidence they were supported to see their GP, and to have eye tests, dental checks and seasonal vaccines. Healthcare professionals told us, ‘The nurses engage well with the nurse advisors they have available from the Integrated Care Board and the old age psychiatry teams.’

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. Professionals who worked closely with the service confirmed they were involved in monitoring people’s health and wellbeing to ensure it continued to meet their needs.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. We found mental capacity assessments and best interest decisions were largely generic and were not personalised or decision specific. However, whilst not all staff were familiar with the terminology of the Mental Capacity Act, they could describe how they managed certain situations which showed their understanding of the Act. They ensured that people’s mental capacity was assessed in a comfortable environment and at a time of people’s choosing. Where needed, applications were made to restrict people’s liberties to keep them safe. A relative told us, “They all know [person’s] name and always make sure [person] understands what they are about to do, like doing their hair” and “They do give [person] choices about lots of things.”