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Millsted Support

Overall: Good read more about inspection ratings

4-6 Raglan Precinct, Town End, Caterham, CR3 5UG (01737) 241012

Provided and run by:
Millsted Care Ltd

All Inspections

6 July 2023

During a routine inspection

About the service

Millsted Support is a service which provides personal care to people living in a supported living setting. The service provides care to people with a learning disability or autistic people. At the time of our inspection, 4 people (all male) were receiving care from the service. Everyone lived together in one home.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Right Support:

People’s independence was promoted and people were able make decision about how they wished to receive their care.

People were being given the opportunity go out and to participate in activities of their choice.

People were respected by staff who engaged with them well and helped to ensure their privacy was upheld.

Staff followed safe systems in relation to a person’ medicines. They also followed infection control processes such as using gloves and masks when needed.

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.

Right Care:

People received care in a kind and respectful way by staff who knew people. Staff knew, how to communicate with people and how they liked their care to be provided.

People were supported to make their own decision around the care they received as well as the food they ate. Where people could prepare their own meals, they were supported to do so.

People were protected from possible abuse. People said they felt safe with staff and staff were trained in how to recognise abuse. Staff also knew of risks related to people and followed guidance to help people remain safe.

People were cared for by a sufficient number of staff who had received training in their role and were supported by management.

Right Culture:

Improvements had been made since our last inspection. People, relatives and staff all felt a positive shift in the service. They described the service as one that focused on a person as an individual and gave people the opportunity to decide how they wished to spend their time.

People, staff and relatives were involved in the running of the service. Management was approachable and willing to listen. Staff worked with external agencies to provide effective and appropriate care to people.

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

The last rating for this service was Requires Improvement (published March 2022).

We found the provider was in breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 as there was a lack of management oversight and governance arrangements in place. We also found the provider was in breach of Regulation 18 Registration Regulations 2009, as they had not submitted notifications of accidents or safeguarding concerns to CQC which is a requirement of registration.

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 these regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

21 December 2021

During a routine inspection

About the service

Millsted Care Office/Day Space is a supported living service where five people shared a single house and each have their own bedrooms with shared bathrooms. Staff are at the house during the day and night times to provide people with support.

People’s experience of using this service and what we found

The service was not consistently well-led. The provider and the registered manager did not always have oversight of what was happening at the service and the systems and processes to support them to do this were not in place. There had been three notifiable safeguarding incidents that had not been reported to CQC when necessary.

The registered manager and the provider had not always shared requested information with other healthcare professionals in a timely way which meant there was a delay to other professionals carrying out their role to keep people safe.

Medicines were given by staff who had received appropriate training and the provider told us that they were in the process of supporting more staff with their training. There were some issues with recording of medicines and the provider had not identified this through their own systems.

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; however, the policies and systems in the service did not support this practice.

We found one incident where a risk to a person was not appropriately managed, we have received assurances from the registered manager that this has now been rectified. Other risks to people were well managed and risk assessments gave staff specific details on how to support individuals.

People told us they felt safe and staff had a good understanding of what to do if they had a safeguarding concern. Accidents and incidents were investigated and lessons learnt were shared amongst the team.

Care plans were personalised and included information about how people liked to be supported. Before a person moved into the service an assessment was completed and this information was used to inform the care planning process.

Staff were kind and caring towards people and we saw that people had positive relationships with staff. People told us they were happy living at the service and could choose how they wanted to spend their time.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right support:

• People were supported to live independently and to carry out some tasks for themselves. However, as the service was still transitioning into the supported living approach staff and people were still adapting. Staff were completing one food shop for the whole house and people were not going out individually to complete these household tasks for themselves. The provider told us that ongoing training was in place to support staff to adapt to the supported living model.

Right care:

• Staff knew people well and would adapt the care they provided to meet how the person was feeling and responding. Care was personalised to meet individual needs.

Right culture:

• There was an open leadership culture and we saw examples of the management team modelling positive and inclusive ways of supporting people. Staff were encouraged to adopt a caring and proactive approach when delivering care and we saw examples of this happening.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 16 July 2021 and this is the first inspection.

Why we inspected

This was a planned inspection.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective and Well-Led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.