Background to this inspection
Updated
21 July 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was completed by two inspectors.
Service and service type
This is a domiciliary care agency. It provides personal care to people living in their own homes.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The service had a manager registered with the Care Quality Commission.
Notice of inspection
This inspection was announced. This was to ensure the registered manager was available to support the inspection.
We gave short notice on 13 June 2022 to the registered manager and arranged a video meeting with them for 14 June 2022. A further feedback video meeting took place with them on 20 June 2022. We visited the registered manager’s office on 22 June 2022.
Inspection activity started on 13 June 2022 and ended on 22 June 2022.
What we did before the inspection
We reviewed the information we had received about the service since registration. We contacted the Local Authority and asked for feedback from them. The provider was asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection
We used technology such as video calls and telephone calls to enable us to engage with people using the service and staff. We used electronic file sharing to enable us to review documentation.
During this time, we spoke with the registered manager – who is the director of the business and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. In this report, we refer to this person as the registered manager.
We also spoke with the finance manager and administration manager. We spoke and gained feedback from seven staff and seven people and relatives.
We reviewed a range of records. This included three care plans and medication administering information, risk and health management records and daily notes. We reviewed four staff’s employment records and staff training and competency assessments. We reviewed policies and procedures and quality monitoring records the registered manager used to assure themselves people received a safe service.
Updated
21 July 2022
About the service
Windmill Hill Consultants Limited (also known as Windmill Hill Care) is a domiciliary care agency which is registered to provide personal care and support to people in their own homes. The service is registered to provide support to younger adults and older people. At the time of our inspection the service was supporting 16 people who were receiving personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People’s experience of using this service and what we found
People and their relatives were satisfied with the care and support they received and shared positive feedback about staff and managers.
However, we found improvements were needed. Some quality checks were undertaken but were not always effective in identifying where improvements were needed. Other quality checks either took place informally and were not recorded or did not take place.
Some practices related to the handling of medicines were not safe. Immediate action was taken by the registered manager to ensure medicine practices were in line with best practice guidance and the medication policy.
Staff did not always have the skills or knowledge they needed for safe moving and handling techniques. Immediate action was taken by the registered manager to arrange for practical training sessions for staff.
Whilst risks were identified, the information available to staff was basic and did not always tell them how to reduce risks of harm or injury.
People had individual plans of care and these gave staff basic information. However, some people's individual needs had no plan of care in place for staff to refer to.
People were supported by consistent staff who knew people well. There had been no missed care calls. Staff and managers had a caring approach toward people, showing kindness in the hands-on day to day care. People and their relatives felt safe with staff in their homes and protected from the risks of abuse.
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.
Pre-employment checks were undertaken on staff to ensure they were suitable. Staff received an induction which included shadowing shifts so they could get to know people they supported.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good and the report was published on 22 December 2017.
Why we inspected
This was a planned inspection.
Enforcement
We identified a breach in relation to the governance of the service.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.