Windmill House

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 requires improvement. At this assessment the rating has changed to 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.

Staff worked closely with people, their relatives and external health and social care professionals to ensure people’s care and support needs were thoroughly assessed and remained under regular review to reflect any changes. We observed the care and support provided to be tailored to people’s individual preferences; and staff demonstrated an in-depth knowledge of people’s needs. Our findings were reflected in feedback we received, a relative told us, “Key worker [Name] has their finger on the pulse, they know if my relative is not feeling one hundred percent or if they need anything. It gives me confidence that staff know my relative’s needs. I feel the staff are trained.”

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.

Evidence based assessment tools were in use for monitoring areas of people’s care such as their weight and nutritional needs. People’s care and support plans contained detailed information regarding people’s life histories, hobbies, preferences and personal interests. This was particularly important for those people living with dementia, to ensure their past wishes and preferences were clearly reflected in the care provided.

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.

Staff and leaders recognised each person as an individual and took the time to get to know people well, to enable them to advocate on people’s behalf where required. Systems were in place to ensure the required information and records went with a person for example if admitted to hospital to ensure hospital staff would know how to effectively meet their needs. We observed staff to work as a cohesive team, our findings were reinforced by a relative who told us from their own observations, “Staff work well together.”

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 where possible, reduce their future needs for care and support. People and relatives spoke highly of the chef and kitchen team, and the quality of food provided. Records confirmed support was provided to ensure people maintained healthy weights. Exercise and activities such as walking groups were available to support people to maintain their health and wellbeing while living at the service. Relatives also told us about the wellbeing benefits of people being supported to access the local community in wheelchairs, to get fresh air and visit the local shops.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and

consistent, or that they met both clinical expectations and the expectations of people themselves.

We identified daily care records were not always being completed in real time, or by the staff member that completed the care task. We identified gaps in the recording of people’s repositioning charts, particularly during the day as well as with recording the daily checks required of pressure mattresses to ensure these remained in working order. These findings were of concern where the person’s care plans detailed the need for repositioning and monitoring to be in place to protect the condition of people’s skin. Immediate action was taken by leaders in response to our feedback, and subsequent assurances received of measures implemented to reduce the risk of reoccurrence.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff and leaders completed personalised mental capacity assessments, adhering to the principles of the Mental Capacity Act (2005). Appropriate Deprivation of Liberty Safeguards (DoLS) referrals had been made to the local authority. Staff involved people and their relatives in the assessment and decision-making processes, demonstrating a clear understanding of the importance of supporting people in the least restrictive ways possible. Relative feedback confirmed our inspection findings. A relative told us, “If [Relative] does not want to participate in an activity it is completely their choice. The staff do not make them do any activities they do not wish to be involved with.”