This inspection took place on 18 and 19 September and was unannounced. This was the services first inspection since Windmill Care Centre joined Maria Mallaband Care Group in August 2017. Windmill Care Centre provides care for up to 53 older people including nursing care. At the time of our inspection there were 43 people using the service.

The service was required to have a registered manager to manage the service. At the time of our inspection a registered manager was managing the service.

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 is run.

Windmill Care Centre is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Windmill Care Centre accommodates 53 people in one adapted building across three separate units, each of which have separate adapted facilities. One of the units specialises in providing care to people living with dementia.

Medicines were not managed effectively at the service. We found some people were without their medicines due to insufficient stock.

People spoke positively about the service and told us they felt safe. Comments included, “Good staff, a lot of changes since the new company took over, but it has settled down now” and “Everyone here will give you a positive response, they treat you like family.”

Staff had an awareness and understanding of abuse and knew what to do to make sure people were protected. Staff were up to date with training in safeguarding and followed local procedures when required. We saw local safeguarding procedures displayed in areas throughout the service.

Risk assessments were in place for people with an identified risk, such as repositioning due to frail skin and fluid monitoring for people at risk of dehydration. Records we viewed had been completed accurately.

The service followed the requirements of the Mental Capacity Act 2005 (MCA). We found clear information in relation to people’s applications, reviews and expiry dates for standard Deprivation of Liberty Safeguards (DoLS).

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the polices and systems in the service supported this practice.

Recruitment systems were robust and ensured only the right staff were recruited to support people. Files we saw contained relevant checks before staff were appointed. We observed there were sufficient numbers of staff to support people.

Care plans we viewed were specific to individual needs and were reviewed regularly or as people’s needs changed.

Whilst there were regular quality assurance systems which maintained an oversight of the quality of the service people received. Audits had failed to identify issues with staff training and competency checks being carried out.

People’s nutritional needs were met and appropriate measures were in place where people were at risk of malnutrition. There was good partnership working with community specialists to monitor people’s well-being.

We found clinical staff had not received specific training by the provider and had not had competency checks carried out to ensure they were safe to carry out clinical tasks.

The service provided a programme of activities and social events for people to take part in.

The service needed refurbishment and decoration at the time of our inspection. We saw areas of damaged ceiling tiles and poor-quality living areas. However, we were told refurbishment was soon to take place.

During this inspection we found three breaches of the Health and Social Care Act