Archived: Old Mill House

Old Mill House is a residential care home that was providing personal care to 5 people with learning disabilities at the time of the inspection. The service can support up to 6 people. Old Mill House accommodates people across two separate floors. The home is situated close to the centre of Chorley.

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. 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:

Most people using the service could not speak to tell us they felt safe but some indicated they were safe by gestures such as putting their thumbs up. A relative said their relative was safe. We also noted that people were supported to be safe. Staff received robust safeguarding training and had a good understanding of the principals involved in taking action when abuse was suspected. There was an open and transparent culture in relation to accidents and incidents. Medicines were managed safely. The provider had a robust recruitment process.

People's needs were met through robust assessments and support planning. The service worked with healthcare and social professionals to achieve positive outcomes for people. Staff had good knowledge and skills and this ensured people's needs were well met. We saw good examples of when people had been supported to maintain a healthy and balanced diet.

People's relatives indicated that staff were compassionate and kind and during the inspection, we observed this to be the case. The manager and staff knew people well. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People received care and support that was person-centred. We saw good examples of how the care and support people received enriched their lives through meaningful activities. People were supported properly to access the community. The service had a robust complaints policy. There was an end of life policy that could be used if appropriate.

The values and culture embedded in the service ensured people were at the heart of the care and support they received. The manager and provider planned and promoted holistic, person-centred, high-quality care resulting in good outcomes for people. People knew how to feedback their experiences and this was considered and acted upon by the manager and provider. Staff told us they received good support from management.

The outcomes for people using the service also 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 and update:

At the last inspection, the service was rated requires improvement (published 14 December 2016). This was because there had been a breach of the regulations around a safety issue. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected:

We carried out this inspection based on the previous rating of the service.

Follow up:

We will continue to review information we receive about the service until we return to visit as part of our re-inspection programme. If any concerning information is received we may inspect sooner.

Dalesview Partnership Limited - Old Mill House 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.

Old Mill House is registered to provide accommodation and personal care for up to six people with learning disabilities. There were five people living in the service on the day of our inspection.

At the last inspection on 19 October 2015, the service was rated 'Good' although improvements were required around the making of safeguarding referrals and the administration of medicines. At this inspection on 24 April 2018 we found the service had made improvements around the issues seen at the last inspection. However other safety issues were noted relating to the absence of window restrictors to prevent people falling and uncovered heat sources to prevent people burning themselves. This has led to a breach of the regulations and the service is now rated as 'Requires improvement'. You can see what action we have asked the service to take around this breach of regulation at the back of this report.

The service was managed by a registered manager who was registered on 18 January 2014. 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.

Recruitment checks took place before staff started work but some issues were seen and additional checks were required during the inspection to ensure that some staff had been safely recruited.

People received their medicine as prescribed by healthcare professionals. Medicines were stored securely to ensure they were safe. There were risk assessments which identified risks to people and management plans had been put in place to ensure people's health and well-being were maintained.

People were protected from the risks of abuse and improper treatment. Staff had received training on safeguarding and they were knowledgeable on the procedure to follow if they had any concerns. There were sufficient staff available to safely meet people's needs.

The registered manager and staff had a good understanding of the Mental Capacity Act (MCA) 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

A person's relative told us staff were kind and caring. We observed that staff treated people with respect and promoted their dignity.

People were supported to communicate their views about the choices available in relation to what food and drink they preferred and participation in activities.

People's nutritional needs were met. People told us they enjoyed the choice of food that was available to them. People had access to food and drinks throughout the day.

Systems were in place to help ensure the safety and cleanliness of the environment. People who used the service were encouraged to participate in cleaning the home.

Staff were trained on various areas to ensure they had the relevant skills, knowledge and experience to provide good care to the people they looked after. Staff received regular support and supervision to help them carry out their duties effectively.

Staff we spoke with told us they enjoyed working in the service and felt valued by both colleagues and the manager. Staff felt able to raise any issues of concern or make suggestions to improve the service in supervision and staff meetings.

The service liaised with various health and social care professionals to meet the needs of people.

People had their individual needs assessed and their care planned in a way that met their needs. Reviews were held with people and their relatives to ensure people's support reflected their current needs.

People's relatives had opportunities to share their views and give feedback about the service and these were acted upon. The service was subjected to regular quality checks to ensure the care was of good quality and met people's needs.

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

Further information can be found in the detailed findings below.

We noted that Old Mill House provided comfortable and homely accommodation. The expert by experience commented that the home was clean and well furnished, but felt some communal areas would benefit from an update. The expert by experience also reported, 'We saw that there was a nice garden area with flowers and vegetables in it and at least one resident helped in the garden.'

We saw that there was information posted about the home for the benefit of residents, which included pictorial menus, activity timetables and a pictorial staff rota. There was also easy read information available regarding how to make a complaint and how to raise concerns about abuse.

Standards relating to people's care and welfare, management of health needs and medication were assessed. We also looked at arrangements for recruiting and training staff. Finally, we assessed processes for monitoring the quality of services provided. The service was compliant in all the areas we inspected.