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Millfields Residential Care Home Good

Inspection Summary


Overall summary & rating

Good

Updated 11 October 2018

This inspection took place on 21 June 2018 and was unannounced. Our last inspection of this service took place in August 2017. At that inspection we identified breaches of regulation in relation to staffing, dignity and respect, consent, nutrition and good governance.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions to at least good. The action plan was submitted as requested and gave detail about the actions they had already taken and were addressing in relation to making sure people were safe, people received adequate nutrition, people’s rights were upheld as required by the Mental Capacity Act, people’s needs in relation to privacy and dignity were met and making sure the service was well led.

Millfields Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Millfields Residential Care Home provides accommodation and personal care for up to 38 older people, some of whom are living with dementia. Accommodation is provided over two floors with communal areas, including two lounges and a dining room, on the ground floor. There were 30 people using the service when we visited. This included one person who was in hospital.

Since the last inspection a new registered manager had been appointed. 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 living at the service told us they felt safe. Staff had received safeguarding training and knew what to do if they thought somebody was at risk.

Medicines were generally managed safely. Action was taken during the inspection to improve systems for safe and appropriate storage.

Risk assessments had been completed to mitigate risks to people's safety.

There was a robust system for monitoring and detailing accidents and incidents with lessons learned and action plans formulated where required.

The premises were clean, well maintained and appropriate safety checks were in place.

Effective recruitment processes were in place and systems for staff training had been developed to make sure staff had the skills and knowledge they needed to provide good and effective care.

Staff were well supported through effective training, regular supervisions and annual appraisals.

Staffing levels were kept under review to make sure they were responsive to the needs of the people living at the service.

People were supported to have 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. We saw evidence of consent being sought and best interest meetings where appropriate.

People were complimentary of the care and support they received. Staff were respectful of people’s privacy and dignity needs.

People enjoyed the food at the home and their dietary needs were assessed and met.

Care was planned and delivered with a person-centred approach and people were supported with their wishes in relation to the care they received at the end of their lives.

People enjoyed a range of meaningful activities and had choice of communal areas in which to spend their time.

The service was managed well. There was an inclusive culture and people’s views and opinions were sought and valued.

Inspection areas

Safe

Good

Updated 11 October 2018

The service was safe.

People told us they felt safe and staff knew what to do if they thought somebody was at risk. Risks to people were managed well.

Staffing was organised to meet people’s needs and was kept under review.

Medicines were generally managed safely. Action was taken during the inspection to improve systems for safe and appropriate storage.

Effective

Good

Updated 11 October 2018

The service was effective.

The service was meeting the requirements of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) but needed to make sure systems for best interest decisions were followed consistently.

Staff received the induction, training and support they required to fulfil their roles and meet people’s needs

People enjoyed the food and their nutritional needs were met. People’s healthcare needs were assessed and staff supported people to access health professionals as needed.

Caring

Good

Updated 11 October 2018

All of the people we spoke with told us staff were caring. One person said, “I’m definitely looked after here visitors can come when they want, I have company all the time and people to visit.” Another said, “The care here is very good they are all very good to me.” Another person told us “They don’t always have time to sit and talk because they are so busy but they are caring.”

A visiting relative told us I think (person) is very happy here they know and understand (them), they know (their) personality and have a joke with (them), from the first day (they) came (they) never looked back.” Another relative said, “They are extremely good with (relative) they talk to (them) and have a very good rapport with (them).”

At our last inspection we found staff did not always treat people with respect or consider their dignity needs. On this inspection we observed staff to be caring and respectful. People had clearly been supported well in their personal care and staff were discreet in their support of people. For example, when assisting people to the bathroom or when offering clothes protectors at meal times.

We observed staff chatting with people. We saw one member of care staff bending down and kneeling on the floor to talk to people and gently holding one person’s hand whilst they chatted. Staff clearly knew people well and people responded fondly to staff, using their names, as they chatted.

We saw one person go into the dining room confused as to whether they had had breakfast. Staff checked and reassured the person they had but gave them a cup of tea and biscuits and sat with the person engaging them in meaningful chat about the person’s interests and home life which person clearly enjoyed.

We saw little evidence of people having been involved in the development or review of their care plans but did see life story books and personal profiles which people had been involved in developing which contained detail to help staff get to know and appropriately support people. These documents included details about people’s families, their backgrounds, school and work life, hobbies and interests and cultural and spiritual needs. They also contained details of days and events important to the person such as anniversaries and family birthdays and a section about what people who know the person admire about them.

Care plans included information about how best to communicate with the people particularly when they became confused, worried or anxious.

Responsive

Good

Updated 11 October 2018

The service was responsive.

Care was planned and delivered with a person-centred approach. People were supported to make sure their wishes for end of life care were met.

People enjoyed a range of meaningful activities.

Effective systems were in place to record, investigate and respond to complaints.

Well-led

Good

Updated 11 October 2018

The service was well led.

Systems for auditing the quality and safety of the service were robust and effective.

There was an inclusive culture and people’s views and opinions were sought and valued.