Background to this inspection
Updated
23 June 2021
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.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by one inspector and an expert by experience. An expert by experience is a person who has experience of using or caring for someone who uses this type of service. The Expert by Experience made telephone calls to relatives of people living in the home.
Service and service type
Millennium Care Limited – 1 Old Park is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. 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.
Notice of inspection
This inspection was announced. We gave one hour’s notice of the inspection as we were mindful of the impact and added pressures of COVID-19 pandemic on the service. This meant we took account of the exceptional circumstances and requirements arising as a result of the COVID-19 pandemic.
What we did before the inspection
Prior to the inspection, we reviewed the information that we held about the service and the provider, and notifications affecting the safety and well-being of people who used the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
Approximately a month before the inspection we contacted relatives of people living in the home to ask their feedback on the service. We spoke with a representative of seven of the nine people living in the home. This comprised five people’s relatives and two people’s social worker. We also spoke with three people living in the home by video call to ask their views on how things were at the service.
We used all this information to plan our inspection.
During the inspection
We spoke with four people using the service. We met four other people who were unable to speak with us and we observed interactions between those people and care staff and observed their appearance and apparent wellbeing. We spoke with the registered manager, quality assurance manager and a care worker.
We looked at four people’s care and five people’s medicines administration records. We also looked at the recruitment and training records of five staff. Other documents that we looked at relating to people's care included risk assessments, infection control and quality audits, financial records and policies and procedures.
We inspected the building for safety and hygiene issues.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We spoke with a further three care workers and a social worker on the phone.
Updated
23 June 2021
About the service
Millennium Care Limited – 1 Old Park is a residential care home providing accommodation and personal care for up to ten people with learning and physical disabilities. At the time of the inspection there were nine people living at the service.
People’s experience of using this service and what we found
People living in the home had lived there for several years and staff knew them and their needs well.
People were supported to have maximum choice and control of their lives within the limitations posed by lockdown restrictions due to the COVID-19 pandemic. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. People were supported to live stimulating lives within the confines of the national lockdown. People had been restricted from taking part in their usual leisure activities during the lockdown but had recently started going out again and told us they had been to a day service, for walks, shopping and out for coffee. Activities provision was individualised to some extent to people’s likes, hobbies and interests and promoted choice, control and independence.
The registered manager had worked at the home for many years and was respected by staff who told us they felt well supported and could approach the registered manager for advice at any time.
Safe staff recruitment processes were in place but checks were not robustly completed to ensure staff were appropriately assessed as safe to work with vulnerable adults. In one case references did not match the information in the interview record and application form and in two others there was no evidence on file that the references were verified as being from employers.
We have made a recommendation that the provider follow safer recruitment practice.
Records showed a lack of full understanding of the Mental Capacity Act (MCA). Where a person was not able to consent to an important decision, for example to staff giving them prescribed medicines or having a COVID-19 vaccination, records did not show that a best interest decision process had been properly followed.
We have made a recommendation that the service seek further training on best practice in following the MCA.
Staff understood safeguarding and how to keep people safe from abuse and knew how to report any concerns. Staff received training and supervision to support them in their role.
People received their medicines safely and as prescribed. They were supported with maintaining a balanced diet which met their individual dietary needs.
Relatives’ feedback about the registered manager and staff team was overall positive. The manager and quality assurance manager carried out regular audits of records, medicines management and health and safety of the premises.
Rating at last inspection and update
The last rating for this service was requires improvement (published 20 June 2019). The registered manager had made improvements in all areas since then and the rating has improved to good.
Why we inspected
At the last inspection there was a breach of regulation as there remained a lack of suitable handwashing facilities and failure to use personal protective equipment when serving food. Although we had carried out monitoring calls with the registered manager and received assurance that improvements had been made, we needed to inspect to ensure the risks had been addressed.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
The overall rating for the service has improved to good.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Millennium Care Limited – 1 Old Park on our website at www.cqc.org.uk.
Follow up
We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.