Mill Green

Updated 28 August 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection Team:

The inspection team consisted of one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type:

Mill Green is a care home. People in care homes receive accommodation and personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service had a manager registered with the Care Quality Commission (CQC). This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

The inspection visit took place on 4 June 2019 and was unannounced.

What we did when preparing for and carrying out this inspection:

We reviewed information we had received about the service since the last inspection. This included information received from the provider about deaths, accidents and incidents and safeguarding alerts which they are required to send to us by law. We used information the provider sent to us in the Provider Information Return. This is information we require providers to send us at least once a year to give some key information about the service, what the service does well and improvements they plan to make. We requested feedback from the Local Authority quality monitoring officers. We used all this information to plan our inspection.

During our inspection: We spoke with four people using the service and two people’s relatives. Some people living at the home, due to their complex health needs, were unable to give us their feedback about the service. We spent time with people to see how staff supported them. We also spoke with two care staff, the registered manager, a service manager, a quality assurance manager and a care coordinator. We later received feedback from health professionals and commissioners of services, which was also shared with the registered manager, about how the risk management of epilepsy could be improved at the home.

We reviewed a range of records, including four people's care records and medication records. We also looked at records relating to the management of the service, including audits and systems for managing any complaints. We reviewed the area manager’s records of their visits to the service; when checks were made on the quality of care provided.

Following the inspection: We received updated information from local commissioners of services.We also reviewed additional information that the registered manager sent us at our request regarding how they planned to improve epilepsy risk management.

Updated 28 August 2019

About the service:

Mill Green 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. Mill Green accommodates up to 15 people across one ground floor level.

What life is like for people using this service:

Staff were safely recruited. Where this was a part of their care plan, people's medicines were administered safely and in accordance with the prescribing instructions. However, risk management plans and the response to epileptic seizure required improvement to ensure people were always cared for in an effective and safe way.

The management team and staff placed people at the heart of their home. The provider and registered manager ensured their service was delivered according to their values. The home had a strong person centred and local community-based ethos. The staff team worked hard to promote people’s dignity and prevent people from becoming socially isolated within their home.

Respect and dignity were cornerstones of the values upheld by the staff and role modelled by the management team. Innovative approaches such as assisted access to electronic records and feedback tools, provided people and their relatives options in shaping a personalised service and making decisions.

People and their relatives were involved in choosing their care and support, from pre-admission to living in the home. 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.

Staff were aware of how to report any concerns about neglect or abuse and were confident they would be addressed. They felt they were listened to and were part of an organisation that cared for them and their wellbeing, as well as the people they were supporting.

Regular audits were carried out; people were asked their views in person and via questionnaires. Changes were quickly made if issues were identified. The service learned from recorded incidents, concerns or accidents to help prevent a reoccurrence.

Rating at last inspection:

The last comprehensive inspection report for Mill Green was published in August 2016 and we gave an overall rating of Outstanding. At this inspection we found the service was Good. Safe has been rated as Requires Improvement and all other areas have been rated Good.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

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