Windmill Hill Consultants Limited

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.

This was the first inspection of the service and it was announced. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults.The service was providing care to seven people in receipt of personal care at the time of our inspection.

A registered manager who was also the provider was in post at the time of our inspection. 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 was run.

People were positive about the care staff took to promote their safety and told us staff assisted them to use the equipment they needed to remain safe. Staff took action to reduce the risk of people experiencing infections and knew what action to take if they had any concerns for people’s safety. People and their relatives told us they could rely on staff providing the care people wanted at the time and in the ways agreed. People, their relatives and health professionals highlighted people received care from staff who knew their safety and care needs well.

Some people received support to manage their medicines safely. In most of these instances, people required prompting to have the medicines they needed to stay well and safe. We found there were occasions when one person needed their medicines to be administered. We have made a recommendation about the management of some medicines, so there is a clear record people have been prompted to take their medicines and have received them as prescribed.

The views of people were taken into account when their care needs were assessed, and people were involved in deciding what care they wanted. Staff took action to involve people’s relatives and to incorporate health professionals’ advice when assessing the people’s care, when this was appropriate. People’s assessments took into account any additional help they needed to access other services.

People, their relatives and health professionals were complimentary about the ways staff used their skills and experience to sensitively support people. Staff had received training which matched the needs of the people using the service and incorporated their experience and skills to ensure people had the care they needed. This included caring for people so they were supported to attend routine health appointments and to have enough to eat and drink. As a result of this, people were supported to have the nutrition and care they needed, based on their preferences.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the provider's policies and systems supported this practice. This included involving people in decisions about their day to day care. Staff knew which people may need help to make some key decisions about their lives and understood what action to take so people received the support they needed in these circumstances.

All the people and the relatives we spoke with were complimentary about the staff that provided support and told us staff were kind, cheerful and happy to assist them. The registered manager and staff spoke warmly about the people they cared for. People, their relatives and heath care professionals told us the way their care was organised meant they were able to build trusting relationships with staff who knew them well. People and their relatives gave us examples of the way staff encouraged them to request any variations they wanted in their day to day care. Staff supported people by using their preferred communication methods, so their wishes and preferences would be identified. Staff took action to support people so their rights to dignity, independence and privacy were maintained.

People and their relatives had been involved in planning the care they wanted and this was regularly reviewed, so the registered manager could be assured people were benefiting from a service which met their individual needs. No one had made any complaints about the service provided. We saw there were processes in place to manage any complaints or concerns received. We also saw people had been encouraged to let staff know what they thought of the care they received, and that people’s comments had been very positive.

People and their relatives were positive about the way senior staff communicated with them. The registered manager and senior staff understood what notifications needed to be sent to The Care Quality Commission, (CQC). There had been a delay of approximately two weeks owing to technical problems in the registered manager advising CQC of their recent change of location. The registered manager subsequently ensured the necessary notification was sent to us without delay. The registered manager undertook checks on the quality of care provided, so they could be assured people were receiving good care. People, their relatives and staff told us the registered manager took action based on any suggestions they had made to develop the service and people’s care further.