Windmill Court is a care home which provides nursing care for up to 34 older people, some of whom had a diagnosis of dementia. On the day of the inspection there were 30 people using the service.

We carried out this inspection on 17 January 2017. At the last inspection, in October 2014, the service was rated Good. At this inspection we found the service remained Good.

The service is required to have a registered manager and at the time of our inspection a registered manager was not in post. However, the manager who was in overall charge of the day-to-day running of the service had applied to the Care Quality Commission to become the registered manager. 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 and associated Regulations about how the service is run.

People who were able to talk to us about their view of the service told us they were happy with the care they received and believed it was a safe environment. People and their visitors commented, “I love it here”, “[Person’s name] is always treated well “and “It’s excellent.” Where people were unable to tell us about their experiences we observed they were relaxed and at ease with staff. People had good and meaningful relationships with staff and staff interacted with people in a caring and respectful manner.

There were sufficient numbers of suitably qualified staff on duty and staffing levels were adjusted to meet people’s changing needs and wishes. Staff completed a thorough recruitment process to ensure they had the appropriate skills and knowledge. Staff knew how to recognise and report the signs of abuse.

People received their medicines on time. Medicines administration records were kept appropriately and medicines were stored and managed to a good standard.

Staff supported people to access to healthcare services such as occupational therapists, GPs, chiropodists and dieticians. Visitors told us staff always kept them informed if their relative was unwell or a doctor was called.

People received care and support that was responsive to their needs because staff were aware of the needs of people who lived at Windmill Court. Any risks in relation to people’s care and support were identified and appropriately managed. Some people’s care plans had not been updated to reflect the care they received. We have made a recommendation about the recording of people’s care needs.

There was a wide range of meals on offer and staff were knowledgeable about people’s likes, dislikes and dietary needs. People told they enjoyed their meals. One person said, “We have a good variety of meals. There is a change of menu every day.”

Management and staff had a good understanding of the Mental Capacity Act 2005 (MCA) and how to apply the principles of the MCA in the way they cared for people.

There was a management structure in the service which provided clear lines of responsibility and accountability. Staff had a positive attitude and the management team provided strong leadership and led by example. One member of staff commented, “We are a good team. We all work together and trust each other.” People and visitors all described the management of the home as open and approachable. One visitor said, “You can talk to the staff and managers and they really listen.”

People and their families were given information about how to complain. There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed.

We carried out an unannounced comprehensive inspection of this service on 7 October 2014. We found the service was not meeting the legal requirements. This was because some records relating to people’s medicines and creams were not always accurate or regularly completed by staff. Charts that recorded when people were moved in order to prevent pressure areas developing were not adequately kept.

After the comprehensive inspection the provider wrote to us to say what they would do to meet the legal requirements in relation to the breach. We undertook a focussed inspection on 29 May 2015 to check they had followed their plan and to confirm they now met legal requirements.

This report only covers our findings in relation to these topics. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Windmill Court on our website at www.cqc.org.uk.

Windmill Court is a care home that provides nursing and personal care for up to 34 people. At the time of the inspection there were 30 people living at Windmill Court.

The service is required to have a registered manager and at the time of our inspection a registered manager was in post. 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.

At our focused inspection on 29 May 2015 we found the provider had made improvements to record keeping in relation to people’s medicines and the monitoring of pressure areas. Therefore we found the legal requirements had been met.

People were supported to take their medicines safely. Staff kept accurate records of when and how people were given their medicines. This included when prescribed creams were used and the daily monitoring of the position of pain patches.

Records showed that people who were cared for in bed were regularly re-positioned, in line with their care plan, to help prevent and monitor pressure damage to their skin.

We inspected Windmill Court on 7 October 2014. Windmill Court is a care home for older people who require nursing or personal care. It provides ground floor accommodation for up to 34 people.  At the time of the inspection there were 33 people living at Windmill Court.

There was a registered manager in post at Windmill Court.  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 and associated Regulations about how the service is run.

People were happy living at Windmill Court.  The atmosphere was friendly and relaxed and we observed staff and people living at the service were relaxed in each other’s company.  One person told us; “We get wonderful loving care from the staff.”  We saw visitors come and go throughout our visit, one came with a pet dog. This was welcomed by the service.

During our inspection we saw people looked well cared for and their needs were met quickly and appropriately.  We found some records relating to people’s medicines and creams were not always accurate  or regularly completed by care staff. This meant it was not possible to establish if people had received prescribed medicines or creams. Some charts that recorded when people were moved in order to prevent pressure areas developing were not adequately kept. We have required the service to always keep the records of peoples care adequately.  You can see what action we told the provider to take at the back of the full version of the report.

People who used the service and their relatives were very complimentary about the care and support they received from staff and management who they felt were knowledgeable and competent to meet their individual needs.  For example one person told us; “They know me well and know what I like and how I like things done.”

People told us they felt safe. One person told us; “This is my home and it feels just like that.” We found the service was meeting the requirements of the Deprivation of Liberty Safeguards. People’s human rights were properly recognised and promoted.

Staff understood the needs of the people and we saw that care was provided with kindness and compassion. People and their families told us they were happy with their care. A relative told us it’s a; “Really nice place with a good team who make you feel really welcome” and “The management and staff are a brilliant bunch, it is always a pleasure to visit here.”

Staff were appropriately trained and skilled and provided care in a safe environment.  New staff received a thorough induction when they joined the home and fully understood their roles and responsibilities, as well as the values and philosophy of the service. Training was completed by staff to ensure the care provided to people was safe and effective and met their needs.

People were supported to live their lives in the way they chose.  People were asked about how they liked to spend their time and their choices were respected.  There was a programme of group and individual activities which people were encouraged to take part in if they wished

People were asked what they thought of their service at regular resident’s meetings.  People told us they saw the registered manager most days who they could speak with if they wished. Two visitors told us they found it very helpful to have a copy of the minutes of the last residents meeting attached to the current agenda for the next  meeting sent to them. Staff were asked for their views about  the service at regular staff meetings.

Care plans were well laid out and regularly updated to reflect people’s changing needs. People and their families were involved in the planning of their care and were treated with dignity, privacy and respect.

The premises were accessible, well maintained and comfortable. There were appropriate spaces for people to spend time with visitors; taking part in activities, just chatting together or spending time on their own.

There were positive relationships between staff and management. One staff member told us, “I am happy here, this is a good home to work in, we are a good team, we get good support.”  Everyone we spoke with spoke positively about the kindness and compassion at Windmill Court.

The provider took steps to help ensure staff were skilled.  Staff were encouraged to attend training in areas specific to the needs of people living at the home, for example, dementia care and mental capacity training.  This helped ensure best practice was followed by staff in the home.

The registered manager assessed and monitored the quality of care consistently. The home encouraged feedback from people and families, which they used to make improvements to the service.

We were able to speak with five people who lived at Windmill Court and one visiting family member, and spent time observing people and staff and the delivery of care during the day.

We witnessed staff interactions with people which were relaxed and calm. One person told us the staff were “lovely” and “very kind”. Another person stated the “manager is so kind” and “this is the best care home for miles”.

We saw people had been involved in their care and offered choices, such as if they wished a lock on their bedroom door, and what time they chose to get out of bed.

We found that appropriate action had been taken to keep people safe from abuse.

We were shown a training schedule was in place for all staff, and this was monitored and reviewed.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

We found people who used the service benefited from safe quality care, treatment and support due to effective decision making and the management of risks. This was done through quality monitoring and surveys of the people who lived at Windmill Court the families and carers, and the staff.

During our inspection we spoke with four people who lived at Windmill Court and two relatives. Overall, people who lived at Windmill Court were complementary about the staff and the care they received, comments included, “the staff are lovely and “I love it here”. Two people who lived at Windmill Court told us that they thought the place had changed since they had originally moved in and told us that this was due to staff changes.

Relatives told us, staff have, “love and compassion” and “staff are splendid, very caring, but I don’t think there are enough of them”.

We found, people’s views and experiences were not always taken into account in the way the service was provided and delivered in relation to their care. People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. However, people did not consistently experience care, treatment and support that met their needs and protected their rights.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

People who used the service, staff and visitors were not protected against the risks of unsafe or unsuitable premises.

There was an effective complaints system available. Comments and complaints people made were responded to appropriately.

We spoke with six people who use the service and three visitors to the home to seek their views of the service they receive.

All of the comments that people made were positive about Windmill Court and the service provided.

People who use the service told us ‘It is wonderful here, there is a lovely atmosphere, the food is beautiful with all my favourite dishes on the menu, I am quite satisfied’

‘The staff are lovely, they do anything to help me, the food is very good with lots of choice and the home is lovely and clean and there are never any smells anywhere’

‘It is just like a hotel we are looked after so well’

‘The staff are all very good, kind and helpful. I have not been well so staying in bed but they have been looking after me very well’

Visitors to the home who were visiting their relatives told us ‘It is fantastic at Windmill Court, the carers are excellent with no exceptions and provide high standards of care. The trained nurses are thorough and competent and know what they are doing at all times’

‘The staff are kind, compassionate, thoughtful and they provide excellent care. The food is very good’

‘The staff are very helpful, sometimes they are extremely busy and they always work really hard. All staff are kind and caring. The food is excellent. My relative is very happy here’.