CQC takes action to protect people at Norfolk care home rated Inadequate

The Care Quality Commission (CQC) has placed The Windmill Care Home Ltd in Norfolk into special measures after rating the service Inadequate following an inspection that concluded in May.

The home provides accommodation and personal care for up to 35 people, most of whom have dementia. At the time of CQC’s inspection, 33 people were living at the service.

The inspection was carried out following concerns about the quality and safety of care. The home was downgraded from Good to Inadequate overall, with all five assessment areas – safe, effective, caring, responsive and well-led – also rated Inadequate.

Inspectors found staff did not always identify or respond appropriately to risks to people’s health. CQC highlighted cases where significant weight loss had not resulted in adequate monitoring of food and drink or referral to a dietician, and where medical advice was not sought after redness developed on an area of a person’s skin at risk of pressure damage. The area later developed into an open wound.

Concerns were also identified around care planning. CQC found contradictions within some records which could make it difficult for staff to understand how people should be supported.

Inspectors found falls and incidents were not always sufficiently recorded or investigated to understand why they had happened and reduce the risk of recurrence.

Medicines management was another area of concern. Controlled drugs were not always signed for, while checks did not identify missing signatures. CQC also found that one person prescribed insulin did not have a recorded blood glucose range to guide safe dosing.

The regulator raised concerns about confidentiality after finding staff were sharing people’s personal information through a social media messaging app on personal phones. CQC said the practice breached the home’s own social media policy and stopped after inspectors raised concerns.

CQC also found weaknesses in recruitment processes, including risk assessments for staff with previous criminal convictions which were not sufficiently robust.

Inspectors said people were not always involved in decisions about their care and found examples where staff schedules were prioritised over individual preferences. End-of-life wishes were also not always discussed or properly recorded.

The regulator said leadership checks had failed to identify some of the serious issues subsequently found by inspectors, while staff did not always receive the training required to support people living with dementia and behaviours that challenge.

However, people living at the home and their families generally told inspectors they were happy with the care provided, and some staff said they felt supported and able to raise concerns with managers.

The home has now been placed into special measures and will be closely monitored by CQC while improvements are made. The regulator has also begun the process of taking regulatory action in response to its concerns, which The Windmill Care Home Ltd has the right to appeal.

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