Archived: New Mill House

Updated 27 October 2016

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.

This inspection took place on September 1 and September 7 and was unannounced.The membership of the inspection team consisted of one inspector and one inspection manager.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also looked at the provider’s website.

Information was gathered and reviewed from notifications and correspondence sent to CQC. A notification is information about important events which the service is required to tell us about by law.

As part of the inspection we talked to two people who had used the service and looked closely at the care those two people had received by examining their care files. We interviewed five members of staff, four of which were permanent and one relief worker. We also interviewed the registered manager .We looked at the recruitment files for three members of staff including the most recent recruit.

Records we looked at included staff rotas for a four-week period, induction and training checklists and records, and a range of policy and practice documents, including policies on safeguarding, whistleblowing, safe administration of medicines. Examples of feedback from people using the service and minutes of residents and staff meetings were also reviewed.

A tour of the building and informal observation of social interaction in the home took place. Four health and social care professionals were contacted for feedback. Two replies were received.

Updated 27 October 2016

The inspection took place on September 1 and 7 2016 and was unannounced. The service is a small care home offering accommodation and support for six people with mental ill health. There was a mixture of long-term and short stay residents. People on the "step down" process were offered a bed for up to 4 weeks as the "halfway house" between leaving hospital and returning home. Other people combined living at the home with attending long-term therapy. The overall aim is to promote independence and assist people to return to independent living.

At the time of the inspection there were three people living at the service. At the previous inspection the service was found to be compliant in the standards we looked at. This was the first inspection using a new methodology for inspection.

There is a registered manager who divides their time between this home and two others operated by the same provider. 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.

Risk assessments were undertaken regularly on the premises and equipment. Individual risk assessments and the admissions screening process were done well but not all environmental risks had been formally assessed and recorded. Following the inspection, the registered manager started writing a new policy to address this issue.

Staff had a good understanding of safeguarding people from abuse and harm. Staff dealt really well with individual mental health crises. Staffing levels were managed flexibly in order to support clients at times of need. People said that they felt safe and that they were always able to find support from staff regardless of time of day or night.

All staff had undertaken induction, training and supervision which gave them the skills and knowledge required to give people effective care. Regular staff meetings ensured people's knowledge was kept up-to-date. People had requested and received training in specific aspects of mental health which had enabled them to provide enhanced care.

Staff enjoyed high levels of supervision and support from the registered manager and within the staff group, where the ethos was on mutual group support. The registered manager was praised for being very accessible and supportive. Healthcare professionals working with the service praised the staff for being flexible and caring.

A good range of healthy food and drink was supplied and meals were prepared using fresh food. Staff acted as role models for healthy eating. Meals were shared in the evening with residents and staff eating together to promote social skills and a homely informal atmosphere.

People living at the service praised the staff who were observed interacting with people in a gentle and compassionate manner. Staff used the key worker model to develop close working relationships with individual clients, enabling them to get to know their needs well and to monitor changes and respond appropriately. People appreciated having regular discussions with the key workers.

Personalised care included person centred assessment planning, use of contracting to modify people’s behaviour and timely regular reviews. Records demonstrated progress made and showed that people were engaged in a range of activities and interests outside the home to enable them to achieve the long-term goal of returning to independent living. People really valued the key worker model and the opportunity to develop close supportive relationships. Communication was a key strength.

All feedback received, both from people using the service and from healthcare professionals working with the service, was overwhelmingly positive.

The home had a very positive homely atmosphere with the emphasis on developing and maintaining independence. Leadership was strong and empathetic. There were good management structures in place and a range of quality assurance processes had picked up key issues. There was a history of successful partnership working.