Millbrook House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good: This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The provider was committed to ensuring safety, continuous learning and improvement at Millbrook House.

Accidents and incidents were recorded on the electronic care record and any themes and trends noted were shared with staff. Daily ‘flash meetings and regular team meetings also provided a forum to share learning and good practice. Openness and transparency about safety was actively encouraged and embedded in the service. Staff told us, “Any accidents and incidents are shared in the flash meeting every morning and reported on resident’s notes”.This created a learning culture where staff were encouraged to reflect on events and understand how improvements could be made. By reviewing incidents collectively and promoting open discussion, the provider ensured learning was embedded across the team and supported continuous improvement.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Prior to admission into the home, an initial assessment was completed. Where possible, this was completed face to face to ensure the provider could meet the persons’ assessed needs. People told us the provider encouraged them to visit the home. Comments included, “I came to visit here with my daughter before deciding to move here. They [staff] walked me around and they answered all my questions,” and “When I looked around, the staff was so helpful.”

The provider ensured people were supported to receive appropriate health care as needed. Should staff be concerned about people they would contact relevant healthcare professionals. Staff also work alongside community nurses. Healthcare professionals were positive about how the staff interact and communicate with them, comments made included, "They [staff] are very good at picking up on things and often ask for advice - very proactive".

Staff supported people to attend medical appointments and shared information when they were admitted to hospital. This helped ensure the person received care that was in line with their wishes and preferences.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People were protected from the risk of abuse and avoidable harm. All staff received regular safeguarding training. Staff had a clear understanding of their responsibility to report any safeguarding concerns. Staff we spoke with told us, “I am aware of reporting concerns.” And I know the channels required to report abuse and I am aware of our safeguarding policies”.

Daily handover meetings were used to share information from one staff shift to another. This ensured any new risks or safeguarding issues were communicated to staff promptly. A daily ‘flash’ meeting was held with the registered manager, senior staff on duty, activities, domestic, administration, activities and chef. All key staff were informed of any accidents or concerns which may affect people or staff health and welfare.

The provider had a robust process in place to ensure concerns were reported to the local authority without delay. The manager had oversight of all concerns raised, this allowed them to identify patterns and monitor outcomes. This supported continuous improvement in safeguarding practices.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risks to people had been assessed and steps taken to mitigate risks to people’s safety. These were completed in partnership with people whenever possible to ensure they understood what steps to take to minimise risks and maintain their independence.

Risk assessments did not prevent people from participating in fulfilling lives but enabled people to participate more safely. A range of risk assessments were completed and regularly updated including falls, personal care and when accessing the community for trips or functions. Changes to the person or the risks were noted and reassessed as needed and residual risks minimised as far as possible.

People had personal emergency evacuation plans (PEEPs) in place, which were easy to locate. PEEPs provide staff and emergency service personnel with critical information on the evacuation needs of each person in the event of an emergency.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

We found Millbrook House to be homely and clean. Comments we received included “The building is always immaculately clean, with beautiful gardens for people to enjoy.” And “It’s a lovely place and I feel safe here.”

There were appropriate checks in place to ensure the home was safe and well maintained. Logs in place actioned when maintenance tasks had been completed, and daily environmental checks were carried out. Staff received effective training around fire safety, fire drills were carried out regularly and records demonstrated actions and improvements required which were followed up on the next fire drill.

The home incorporated safety features consistent with Health and Safety Executive (HSE) guidance to protect people. Windows were fitted with restrictors and specialist equipment such as falls sensors and air mattresses were in place and well maintained where required.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Staff were supported in their role with good access to training and supervision. Staff told us, “We have our regular supervision, I do feel comfortable to raise my concerns to the management they listen and easy to bring up any concern specially if it comes with the matter of our clients.”

However, staff described being paid for the whole duration of the training, instead of the one hour paid for every three courses completed would encourage them to “Take up an offer for additional training.”On the whole there were enough staff to meet people’s needs, however some comments from staff suggested ‘busy times’ such as mornings and evenings could benefit from slightly more staff to ensure people’s individual needs are met. We fed this back to the registered manager who had planned to alter the shift times slightly to resolve this.

Recruitment checks were carried out by the provider to ensure staff were safe to work with vulnerable adults. People were encouraged to participate in the recent interview for the chef. Pre-employment checks included a job application form, an interview, and references. All staff were required to complete an enhanced Disclosure and Barring Service (DBS) check before starting employment. A DBS check provided information about any convictions and cautions held by police.

Once recruited, staff members completed an induction including online and in person training. Competencies in moving and assisting, medicines and infection prevention and control (IPC) were assessed before staff worked with people.

The electronic system highlighted when staff needed any refresher training. This ensured staff were up to date with their knowledge and skills.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The provider maintained a high standard of cleanliness and infection prevention throughout the building. People lived in a clean, comfortable, and well-presented environment.

Records showed the provider had systems in place to monitor and manage the cleanliness of the environment. Regular checks and cleaning audits were completed, and any issues identified were promptly addressed.

All staff completed infection control training. During our inspection, we observed staff wearing personal protective equipment (PPE) such as gloves and aprons.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

We observed medicines being given by a safe method during our visit, and people were asked if they need any ‘when required’ medicines such as painkillers. Staff who administered medicines knew people well and were knowledgeable about their medicines and needs.

Medicines records were clear, and current records we checked showed that people received their medicines in the way prescribed for them, including for creams and external preparations. When medicines were prescribed ‘when required’ there were protocols in place to guide staff on when these might be needed. People’s preferences were recorded about how they liked to take their medicines.

Medicines were well managed. Checks were carried out daily on stock checks and temperatures and people had guidance in place on how they would like to take their medicines. People’s independence around medicines was promoted and where possible, people self-administered their own medication. Staff carried out regular audits and ordered medication to make sure prescribed medicines were available when people needed. Staff told us they had regular competency checks regarding the safe management of peoples’ medicines. Comments received included “My latest competency check was last month”.