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Millenium Care Limited - 1 Old Park Inadequate

We are carrying out a review of quality at Millenium Care Limited - 1 Old Park. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Inadequate

Updated 5 February 2019

This inspection took place on 9 and 11 October 2018 and both days of the inspection were unannounced. When we last inspected in July 2017, the service was rated Good.

Millennium Care – 1 Old Park Road 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. The care home accommodates 10 people in a converted Victorian building across two floors. People had access to a large garden at the rear of the building.

Millennium Care – 1 Old Park Road had been built and registered before Registering the Right Support (RRS) had been published. The provider had not developed the service in response to the values that underpin RRS or changes in best practice guidance for providers of learning disability and autism services. These values and guidance includes advocating choice and promotion of independence and inclusion, so people using learning disability or autism services can live as ordinary a life as any other citizen. We found the service did not always conform to this guidance and values when supporting people.

There was a registered manager in place at the time of the inspection. However, they were not present in the home in the two months preceding the inspection. A deputy manager was overseeing the running of the service with support from senior management at provider level. 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.

The premises and equipment were not always maintained in a safe condition. Areas of the home were unclean. People were not adequately protected from the risk of infection as staff were not always adhering to basic infection control procedures.

People's health, safety and wellbeing was at risk because management at home level and above failed to adequately assess risk and provide sufficient guidance to staff on how to keep people safe from harm. We observed poor moving and handling practices during the inspection.

Medicines were not stored, documented and administered safely.

The provider did not always adhere to the Mental Capacity Act 2005. Where restrictive practices were in place, such as use of video monitoring and administering medicines covertly, documentation was not in place to ensure this was in the person’s best interests.

People were not consistently supported by staff in a respectful and kind manner. Care records contained insensitive terminology regarding people’s behaviours due to their learning disability or mental health condition.

People were not always receiving care in line with their needs and preferences. Although reviewed regularly, some care plans contained inaccurate or insufficient information. There was a lack of meaningful activities observed for people who remained at the service during the day.

People were not always supported to eat and drink. There was a lack of drinks at mealtimes and some people did not receive support to eat and drink in a timely manner.

There were not always enough staff deployed in the service to consistently meet people's needs. Care staff were deployed to non-care tasks such as cooking and cleaning. Staff were safely recruited.

Overall governance of the service was ineffective. Despite regular quality checks completed at both service and provider level, these had failed to identify the concerns identified on inspection. Where these checks had identified concerns with aspects of care delivery, sustained improvements had not been made.

Staff had received regular training, supervisions and an annual appraisal. However, we found that not all staff were competent in areas su

Inspection areas

Safe

Inadequate

Updated 5 February 2019

The service was not safe. There were not enough staff deployed at the service to meet people's needs.

The service had failed to identify and address risks to people's health and well-being.

Medicines were not being managed safely.

People were not always protected from environmental and infection risks.

Staff were knowledgeable around what to do if they had safeguarding concerns.

Staff were safely recruited.

Effective

Requires improvement

Updated 5 February 2019

The service was not always effective. People were not adequately supported to have sufficient drinks.

The service was generally compliant with the Mental Capacity Act 2005, however we found instances restrictive care practices in which there was no documentation to support that the decision had been made in the person’s best interests.

Staff received appropriate training, but did not always put this training into practice.

Staff received regular supervisions and an annual appraisal.

People were supported to access routine health services such as the GP.

Caring

Requires improvement

Updated 5 February 2019

The service was not always caring. Staff did not always treat people with dignity and respect. People's privacy was not always respected.

People living at the service had developed friendly and caring relationships.

People were supported to maintain contact with their families. Relatives told us they were welcome to visit the service.

Responsive

Requires improvement

Updated 5 February 2019

The service was not always responsive. People were not always supported to access meaningful and stimulating activities.

Some care plans contained inaccuracies and did not provide staff with sufficient guidance on how to work with people when they displayed behaviour that challenged.

There was a complaints process in place and complaints were investigated and resolved informally.

Well-led

Inadequate

Updated 5 February 2019

The service was not well-led. The provider did not have effective systems and processes in place to assess, monitor and improve the service.

The provider had not submitted all required notifications to CQC.

Although people told us they felt safe living at the home, they raised dis-satisfaction with certain aspects of the service they received, namely around food and activity provision.

Staff and residents’ meetings took place on a regular basis.