Archived: Millfield Lodge Care Home

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well led?

Below is a summary of what we found. It is based on our observations during the inspection, speaking with people who used the service; the staff supporting them and from looking at a range of records.

SAFE

People were protected from the risk of abuse because there were clear and well publicised procedures in place to respond to abuse, and staff had received regular training in how to protect people. Staff had also received training in the Mental Capacity Act 2005, and we saw that an appropriate application to deprive someone of their liberty had been made so that the person could be protected.

Each person had a personal evacuation and support plan to ensure staff had the information they needed to move people out safely in the event of an emergency.

Equipment at the home was regularly maintained and serviced to ensure its safety for people. However there were a number of shortfalls in the environment of the home which compromised people’s safety and privacy.

EFFECTIVE

We found that people’s health was regularly monitored to identify changes to their needs and that they were supported to see a range of health care professionals to maintain their well-being. However, people were not actively involved in reviewing their care plans and the monitoring of people’s fluid intake continued to be poor.

CARING

We observed positive interaction between staff and people using the service on the day of our inspection. Staff actively engaged with people, showing them kindness and respect. People told us that staff treated them in a way that they liked, and that their decisions were respected by them.

However, people’s expressed preferences and choices for their end of life care were not clearly recorded so that they could be acted upon.

RESPONSIVE

People told us there were enough staff available when they needed them and that their requests for help were met quickly. There were also regular residents’ meetings where people could raise any concerns or issues they had.

One family member told us that her mother used to be given her morning tablet at 8 am. However, as her mother regularly got up at 7 am, staff had changed the time her mother received her medication to 7 am to better meet her needs.

People we spoke with told us they knew how to raise their concerns and the complaints procedure was well advertised around the home. Complaints we had passed onto the provider, although not always responded to within timescales, had been fully investigated. The provider has responded appropriately to safeguarding concerns about the home and had attended meetings as required.

WELL LED

Many of the issues we found during this inspection (such a fluid intake monitoring, end of life care, involving people in monthly care plans reviews and record keeping) had been raised at our previous inspections, and still required improvement. This demonstrated that the manager had been ineffective in implementing and sustaining the necessary changes to improve the service people received.

There continued to be a high turnover of staff in the home, with 15 staff having left in the last year. Leadership too had been unstable in this time, with a number of senior nurses only staying a few months before resigning or having their employment terminated by the manager.

Although there were some systems were in place to monitor the quality of service people received, these had proved ineffective in identifying many of the shortfalls we found during our inspection.

A recent Cambridgeshire County Council contracts monitoring visit carried out in March 2014 had found the home was not compliant with any of the contractual standards assessed during their visit.

Overall, we found that the provider had taken adequate action to improve the standard of monitoring of people’s fluid intake and pressure sore care. We also noted improvement in how people’s medicines were administered and recorded. The provider must now ensure that these improvements are sustained in the long term, and that the minor shortfalls noted in this report are rectified.