We carried out a review of the data available to us about Mill House 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 Mill House, you can give feedback on this service.
Mill House is a care home providing personal and nursing care for up to 45 people aged 65 and over. At the time of the inspection there were 24 people living at Mill House across two floors, each of which had separate adapted facilities.
People’s experience of using this service and what we found
A new manager had been appointed and planned to register with CQC. The existing interim manager had a clear vision for the service and spoke positively about the changes they needed to make. This was being handed over to the new manager who was taking over the service. The provider had organised additional support for the service whilst the new management team settled, and they were working together to complete their service improvement plan.
We found some improvements were needed to ensure some people's risk assessments and risk management plans were accurate and updated; for example, people's risk of choking needed to be reviewed and updated as their needs changed. This would ensure that staff had up to date care records to refer to when supporting people. The provider had identified this as an area that required improvement through their own quality monitoring. Some time was needed for the manager to settle within the role and to complete their improvement plan before we could judge it to be effective in bringing about the required improvements.
People’s relatives told us people felt safe living at Mill House. The provider was monitoring and reviewing the staffing levels to ensure sufficient numbers of staff remained deployed to meet people's needs.
People were supported to receive their medicines safely and as prescribed.
Staff understood their responsibility to report concerns and poor practices.
We observed staff were kind and caring and treated people with dignity and respect.
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 had access to a range of activities and events organised by the service's activities team.
Staff provided mixed feedback about the service and felt the changes in management over time had a detrimental impact on the moral of the team.
The service had infection control processes and systems in place to reduce the risk of people contracting COVID-19.
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 (report published 23 July 2019).
Why we inspected
We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Mill House is a care home providing personal and nursing care for up to 45 people aged 65 and over. At the time of the inspection there were 29 people living at Mill House.
Rating at last inspection
The last rating for this service was Good (report published 23 June 2018). At this inspection we found the rating remained Good.
Why we inspected
The inspection was prompted in part due to concerns received about people not being supported to meet their needs, provision of activities, the use of emergency equipment in end of life care and the management of the service. As a result, we undertook a focused inspection to review the Key Question of Responsive and Well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other Key Questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those Key Questions were used in calculating the overall rating at this inspection.
We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the Responsive and Well-Led sections of this full report.
People’s experience of using this service and what we found
Through speaking to one person, a relative and staff we heard that people sometimes experienced delays in receiving their care. The provider was calculating staffing hours using a dependency tool and had recently been providing more staff hours than indicted. We have made a recommendation about consulting people and their representatives about their experience of receiving care.
We found no concerns in relation to activities. People had opportunities to take part in activities both in the care home and in the wider community. Activities were provided throughout the week and checks were made on people’s experience of taking part in activities. Mill House had won awards for activity provision. People were supported to maintain contact with their relatives. Care was provided for people at the end of their life. There were arrangements in place for people and their representatives to raise concerns about the service.
At the time of our inspection visit there was no registered manager in post and the provider was actively recruiting a new manager. An interim manager was working at Mill House until the new manager started. The provider understood that a new registered manager application needed to be submitted as a priority to ensure they continued to meet their registration conditions.
Effective quality monitoring systems were in operation. The current manager was approachable to people using the service, their representatives and staff.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
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.
At the time of our inspection Mill House did not have a registered manager in post. An application for registration had been submitted by the current 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.
At our previous inspection in October 2015 the service was rated “Good”. At this inspection we found the service remained “Good”.
At our previous inspection we found people were not protected against the appointment of unsuitable staff because robust recruitment practices were not always followed. Attention had not been given to some aspects of recording how people should be given their medicines. At this inspection we found improvements had been made to staff recruitment procedures and the management of people's medicines.
We heard positive comments from people using the service at Mill House such as, “We feel very comfortable here”. “I looked at several homes so that I could choose the right place and I am very pleased with this place”.
People were protected from harm and abuse through the knowledge of staff and management. Risks in respect of people's daily lives or their specific health needs were assessed and appropriately managed with plans in place to reduce or eliminate those risks. Sufficient staff were deployed and robust staff recruitment procedures were used. We home was clean and had been well maintained.
Staff were supported to maintain their skills and knowledge to support people. People were assisted 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 were consulted about meal preferences and enjoyed a varied diet. People’s health care needs were met through on-going guidance and liaison with healthcare professionals.
People received support from caring staff who respected their privacy, dignity and the importance of their independence. People received personalised care and had opportunities to take part in activities both in the care home and in the wider community. People were supported to maintain contact with their relatives. Care was provided for people at the end of their life. There were arrangements in place for people and their representatives to raise concerns about the service. Effective quality monitoring systems were in operation. The current manager was approachable to people using the service, their representatives and staff.
Further information is in the detailed findings below.
This inspection took place on 21 and 22 October 2015 and was unannounced.
Mill House is a care home for up to 45 people. At the time of our inspection there were 34 people living at the home.
Mill House had a 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 2008 and associated Regulations about how the service is run.
People were not fully protected against the risk of being cared for by unsuitable staff because robust recruitment procedures were not always applied.
Medicines were stored and managed safely although we found the policy had not always been followed for counter-checking hand written directions for giving people their medicines.
People were protected from the risk of abuse by staff who understood safeguarding procedures.
There were sufficient numbers of staff who received appropriate training and had the right knowledge and skills to carry out their role.
Management and staff at Mill House protected people’s rights through an understanding of the Mental Capacity Act 2005 and the associated Deprivation of Liberty Safeguards (DoLS).
People received support to meet their health care needs and were consulted about the meals they were provided with.
People were treated with kindness, their privacy and dignity was respected and they were supported to maintain their independence.
People received personalised care and there were arrangements in place for people and their representatives to raise concerns about the service.
The vision and values of the service were communicated to staff. Quality assurance systems were in place to monitor the quality of care and safety of the home. As part of this, the views of people using the service were taken into account and responded to.
People who used the service told us they were satisfied with the service they received. Most people said the staff supported them and met their needs. One person who used the service said "I'm perfectly happy here."
Most people told us that staff treated them with dignity and respect. One person said 'staff respect me as a person.' We saw staff speaking and responding to people in a kind and respectful manner.
The care records showed us that people's health needs had been assessed before they came to live in the home. These records included information from health and social care professionals which helped ensure people got the care and treatment they needed.
Some recruitment records showed that new staff had been completely checked to make sure they were suitable to work with vulnerable people. The home trained their staff and had the procedures which protected people from any form of abuse. People told us they did not have any complaints but would speak to the manger or staff if they had any concerns. One person said 'I went to the manager and things got immediately resolved.'
The service and the building were monitored and risk assessed to ensure they were suitable for the people who used them.
The evidence we collected showed us the service kept people safe and met their care needs.