Archived: Mill House

The inspection took place on 5 August 2016 and was unannounced.

There was a registered provider in post , who was also the manager; there was not a legal requirement of this service to have a registered manager in post. Registered providers and registered managers 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 involved in decisions made about keeping them safe. People's freedom was encouraged and maintained, whilst ensuring their safety. Where possible, people administered their own medicines. People received their medicines safely and as prescribed by their GP.

People's health was maintained and they received input from a range of specialist health professionals. People were supported by staff who understood the importance of obtaining people's consent in the care they received and in offering choices. People enjoyed a healthy and varied diet, which included produce they had grown themselves.

People were supported by staff who had ongoing training, which was tailored to meets the needs of people living at the home.

People's beliefs, faiths and personal preferences were respected by staff. People's individual communication styles were known by staff, and they were involved in decisions about their care.

People's needs were assessed and reviewed. People were able to pursue a range of individual hobbies and interests and were encouraged to do so. People knew how to complain and to make suggestions about the service they received.

People were actively involved in their local community and in developing new community-based initiatives for the benefit of the wider community. People benefited from a positive, open and inclusive atmosphere where they were encouraged to lead the lives they chose.

Below is a summary of what we found. The summary describes what people using the service, two professionals and two staff told us, what we observed and the records we looked at.

When we visited we met the four people who lived at the home. People told us about their experience of living at the home. We observed people being supported by the provider, saw the equipment in use and looked at some of the records.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

Risks to people had been identified, assessed and kept under review. Staff had the skills and knowledge to know how to meet people's needs and keep them safe. They had undertaken training including fire safety and moving and handling.

People had been professionally assessed and provided with the equipment they needed to be as independent as possible. Adaptations had been made to allow people to stay in their home when their mobility had declined.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no application had needed to be submitted there were policies and procedures in place. Relevant staff had been trained and the provider understood when an application should be made and how to submit one.

Is the service effective?

We found that people's on going needs were regularly assessed and the care and support provided for them was well planned and purposeful. We found that people had activities planned ahead that were based on what they enjoyed. Each person had their own activities planned for the day we visited.

People were provided with a balanced and healthy, home cooked diet. One person told us, 'I can't complain, the food is lovely'. People's individual dietary needs were assessed and planned for. Risk areas had been assessed and people were supported to reduce risks to them such as dehydration and diabetes.

Feedback from professionals involved was positive. One wrote, 'Mill House have been very pro-active, co-operative and professional in their interactions with me. Mill House practiced in a person-centred manner during the various assessments I had there, which benefited the residents and myself'.

The systems in place to inform staff about changes in people's needs were effective. Staff were well supported and encouraged to attend training. This meant that staff were well trained and skilled in their work.

Is the service caring?

We saw that the provider engaged with people in a kind and patient way. They spoke clearly and gently encouraged people to give their own views and make choices. They gave them time to make their minds up. The atmosphere was relaxed and homely. Discussions and observation showed that people were encouraged to be independent and develop self-confidence and self-esteem. Some people had made great strides as a result of gentle encouragement from staff and now had interesting and fulfilling lives.

One person told us, 'I like it here, I like my baths, I have one every morning'. Another said 'The staff are very kind, I have no concerns'. A person with less verbal communication laughed a lot when we talked about living at the home.

Feedback from professionals involved was positive about the care provided. Both told us that they had confidence in the standard of care provided.

Is the service responsive?

We found that the service had been responsive to people's changing needs and circumstances. They had sought professional advice, appropriately requested additional funding and helped people explore new activity opportunities.

The service worked in close cooperation with other service providers and relatives to help ensure the best outcomes for people.

Is the service well led?

The provider was directly involved in giving care and support and knew people and their needs and preferences very well. We found that there were good care outcomes for people living at the home.

Staff told us that they felt part of a good team and that they were well supported. They were committed to keeping people as well and as independent as possible. They said the provider listened to any issues and took action quickly when needed.

The service operated in an open way and welcomed the involvement of people's relatives and other professionals.

People living at Mill House had varied lives and chose how to spend their time. The staff supported them to look after their health. People were supported to take part in a wide range of activities in the local community.

There were arrangements for people to give consent for care and treatment they could understand. Staff actively encouraged people to decide how they wanted things to be in all aspects of their lives.

The staff and provider did a range of training to help them do their job well. The staff group was well established with a low turnover. This meant that people received a consistent service from people who knew them well.

The provider worked at the home for at least 35 hours every week and had systems that helped her to manage the home safely.

The person we met was smiling and confident. They were relaxed and at ease with the provider. They said they liked living at Mill House. We saw information from a person's relative commenting on their life at Mill House. They had written, '... [ ] is more self assured and self confident and has really blossomed'.

People living at Mill House had varied lives and chose how to spend their time. The records showed that the staff supported them to look after their health. People were supported to take part in a wide range of activities in the local community.

The service had clear information available about the action to take if a person was at risk of harm due to abuse or neglect. Staff were trained so they would understand the local adult safeguarding procedures to follow if they needed to report any concerns.

There were well organised recruitment procedures. This reduced the risk of unsuitable people being employed to work at the home. The staff group was well established with a low turnover. This meant that people received a consistent service from people who knew them well.

There was information for people about how to make a complaint. This was easily available for anyone living at or visiting Mill House.