We carried out a review of the data available to us about MIG House Residential Care Homes on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about MIG House Residential Care Homes, you can give feedback on this service.
People’s experience of using this service and what we found
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 statutory guidance which supports the Care Quality Commission (CQC) to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
Right Support:
The service gave people care and support in a safe, clean and well-maintained environment that met their sensory and physical needs. People were supported to follow their interests. Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs. Staff supported people with their medicines safely. Staff followed positive behaviour support guidelines and worked in the least restrictive way when people who use the service showed signs of distress.
Right Care:
Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. People received kind and compassionate care. Staff protected and respected people's privacy and dignity. They understood and responded to their individual needs. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. The service had enough appropriately skilled staff to meet people's needs and keep them safe. Staff received training for their roles including how to safely undertake physical intervention as a last resort. Known risks were assessed, mitigated and reviewed regularly.
Right Culture:
People and those important to them were involved in planning their care. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity. Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. Staff knew and understood people well. The registered manager sought to drive continuous improvements in the service for the benefit of people living there.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update - The last rating for this service was good (published 20 February 2020)
Why we inspected
The inspection was prompted in part due to concerns received.
We received concerns in relation to people who use the service lacking food, choice of activities and poor management of the home by the registered manager. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.
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 COVID-19 and other infection outbreaks effectively.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, effective and well-led sections of this full report. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has remained good based on the findings of this inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
MIG House Residential Care Home is a residential care home for people with learning disabilities or autistic spectrum disorder. The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The service was a large home, bigger than most domestic style properties. It was registered for the support of up to seven people. At the time of the inspection six people were using the service. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
Relatives of people using the service told us they felt their loved one was safe. One relative said, “I’ve not had any incidents. I think [family member] is safe.” Systems were in place to protect people from abuse. Relatives told us they felt there were enough staff to meet people’s needs. Risk assessments were completed to identify and manage risks to keep people safe. Medicines were being managed safely and measures were in place to protect people from the spread of infection. Pre-employment checks were carried out to ensure staff were suitable to support people. Systems were in place to manage incidents and to minimise the risk of re-occurrence through learning from lessons.
The service carried out assessments of people’s needs prior to admission to the service to ensure they could meet their needs. 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; the policies and systems in the service supported this practice.
People were supported to eat and drink enough to meet their needs. Staff had completed required training to perform their roles effectively and felt supported in their role. The service worked with other agencies to promote people’s health, safety and well-being. Complaints and concerns were dealt with in a timely manner. One relative told us, “Any time I have a concern, they deal with it and put an action plan in place. It’s dealt with.”
Relatives told us they were happy with the care and support provided. One relative said, “They [staff] are doing really well with [family members] care.” Relatives were included in decisions about their family members care and support. People received care and support from staff who were caring and compassionate. Staff treated people in a respectful manner maintaining their dignity and encouraging independence. Systems were in place to protect people’s right to confidentiality. The service was inclusive and people, and staff were respected for their differences.
Support plans were person centred and included the individual needs of people. Support plans were reviewed monthly to reflect people’s changing needs. People had access to meaningful activities and were supported to maintain relationships with their family and friends.
Relatives of people using the service and staff told us they found the management team approachable and supportive. Staff were positive about the culture of the service. Effective quality assurance systems were in place to review and improve the quality of the service.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
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 on 10 May 2017 (published 28 June 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
There was a registered manager 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 and associated Regulations about how the service is run.
At the last inspection in April 2015, the service was rated good. At this inspection we found that the service remained Good.
People continued to receive safe care. Systems were in place to minimise risk and to ensure that people were supported as safely as possible. Staff were aware of their responsibilities to ensure people were safe and what to do if they had any concerns.
People were protected by the provider's recruitment process which ensured staff were suitable to work with people who needed support. There were enough staff to provide care and support to people and meet their needs. Medicines were administered by staff who were trained and assessed as competent to do this.
Staff were knowledgeable about people's individual needs and how best to meet these. Staff had access to the support, supervision, training and on going professional development that they required to work effectively in their roles. The training and support they received helped them to provide an effective and responsive service.
People received a person centred service and had detailed personalised plans of care in place. They were supported by kind, caring staff who treated them with respect. People were supported to do as much as possible for themselves and were encouraged to be as active as possible.
Care records contained detailed information about people's needs, wishes, likes, dislikes and preferences. Their cultural and religious needs were respected and celebrated. People were supported to maintain good health and nutrition.
People developed positive relationships with the staff who were caring and treated them with respect. People received very personalised care. Although some people could not communicate their needs verbally, the staff found creative ways to involve them and to understand what the person wanted. They displayed empathy and helped people overcome fears and challenges. This had resulted in positive and measurable changes for the individuals who lived at the service.
People and their representatives knew how to raise a concern or make a complaint and effective systems were in place to manage complaints.
People lived in an environment that was suitable for their needs. Specialised equipment was available and used for those who needed this.
The quality of the service was monitored by the service’s operations manager and the registered manager. The service had a positive ethos and an open culture. The registered manager and the deputy manager were visible role models in the home.
This unannounced inspection took place on 22 April 2015. At the last inspection in November 2013, the registered provider was compliant with all the regulations we assessed.
Mig House is registered to provide care and accommodation for up to six people with a learning disability. It is situated in a residential setting and close to local facilities. The home has six single bedrooms, a bathroom, a kitchen, a laundry. There is also a lounge, an activities room and a separate dining room. There is a garden at the rear of the property and car parking at the front. At the time of the inspection there were two people living in the home.
There was a registered manager in post who was supported by a service 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 2008 and associated Regulations about how the service is run.
People lived in a safe environment, where health and safety checks were carried out. Risk assessments were completed to help minimise risk in specific circumstances such as when supporting people in the community or within the home.
There were policies and procedures in place to guide staff. Training was provided for them in how to keep people safe from the risk of harm and abuse. In discussions, staff were clear about how they protected people from the risk of abuse.
There was a good recruitment system in place, which meant checks were carried out before new members of staff could start work at the service. We found the staff approaches to be caring and friendly. There was an easy rapport between people and the staff who supported them. People had been helped to maintain important relationships with their family. Staffing levels were adequate.
People’s health and social care needs were assessed and personalised support plans were developed to guide staff in how to care for them. They received their medicines as prescribed and had access to a range of professionals for advice, treatment and support.
People’s nutritional needs were met. Staff monitored people’s food and fluid intake and took action when there were any concerns.
People were encouraged to make their own choices. The manager had knowledge of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS). Staff had also received training in this subject. Deprivation of Liberty Safeguard authorisation allows for a person to be lawfully deprived of their liberty, where it is deemed to be in their best interests or for their own safety. Staff were aware that on occasions this was necessary. There were DoLS authorisations in place at the time of the inspection.
Staff spent time with people and supported them to participate in activities in the community such as day trips to the zoo, going to the local park, shopping with staff and planning and going on holidays.
There was a range of training and support systems in place to ensure staff were knowledgeable and skilled in supporting people who used the service.
There were systems in place to monitor the quality of the service, such as observations of staff practices, audits and surveys. Relatives knew how to raise concerns and felt the registered manager was approachable and would adequately deal with any issues. Relatives told us they did not have any concerns and felt the manager sought their views and was good at communicating changes.
People's interests were fully considered in regard to making decisions about their care and support. Arrangements were in place to involve family representatives or advocates where people lacked capacity. Staff understood their responsibilities for ensuring that people agreed to the care and support required.
Care plans were written in a personalised way with details about people's preferences and needs. Care plans were reviewed every three months or when needs changed and / or an issue was observed. Staff showed a good understanding of people's needs and preferences. We noted that people received good care and staff treated them with respect.
People who used the service, staff and visitors were protected against the risks of unsafe or unsuitable premises. The provider had up to date certificates for gas safety, electrical installation and fire fighting equipment.
We found the systems to recruit staff were robust and appropriate. Staff received the training they needed to provide care and support safely.
We found the service had an effective complaints system in place. The service responded to complaints and worked with the complainant to reach a satisfactory solution.
We looked at care plans that were personalised and comprehensive in nature. Care plans also showed us how people received a high quality of care and had good access to health care professionals such as doctors, district nurses, dentists and speech and social workers.
We spoke to people who told us that they felt safe at this home. Staff were aware of signs of abuse and training records showed us that safeguarding training was mandatory.
We spoke with staff and the manager who told us how there were always enough appropriately qualified staff on duty. This was confirmed by staff rotas and training records.
The provider's policies and procedures and health and safety checks were comprehensive. There was evidence that the provider was continually looking to improve the service and that all people were involved in this process.