Archived: Mill Rise

Mill Rise is an extra care housing scheme on the outskirts of Newcastle-under-Lyme. This building complex consists of 60 flats which are people’s own homes; these are looked after by a separate housing provider. At the time of inspection, the care provider’s staff supported 11 people living at Mill Rise with personal care. People using the service were of different ages and included those with a learning disability and/or autism, as well as people living with dementia or other health and care needs.

Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

People’s experience of using the service was overall very positive and people felt safe with the support from staff. One person told us, “The [staff] are very nice. They are polite, some of them do the job more efficiently than others, but they are all well-meaning. I have never experienced any unkindness.” Another person said, “If ever any of them left, I would not know what to do.”

Due to the service supporting fewer people within the scheme, staffing numbers had reduced. Measures taken to protect staff at resulting times of working alone needed to be updated in relevant risk assessments. We made a recommendation about this, as well as the service’s staffing flexibility around people’s needs and wishes. However, we also heard good examples of the service being responsive to people’s changing circumstances. There were enough staff to meet people’s needs. Shift patterns had been changed which had led to greater reliability and consistency in staffing. People told us staff were usually on time and they did not have to wait long to be helped if they needed assistance urgently.

Staff felt well supported and praised managers, as well as the positive team culture and morale of the service. People using the service and staff were involved in the development of care through regular reviews, meetings and surveys. The latest survey showed that people were either satisfied or very satisfied with their care. People told us they either had no complaints or were confident they would be listened to if they did. People’s care records provided detailed information about individual backgrounds and needs, to guide staff effectively. The service worked with a variety of professionals to maintain people’s health and wellbeing. Feedback from the local authority confirmed they had no concerns about the service.

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence and inclusion. We discussed further opportunities with the registered manager to support people having as many opportunities as possible to gain new skills, become more independent and involved in the wider community.

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

Rating at last inspection

The last rating for this service was good (published 15 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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

This inspection took place on 4 January 2017and was announced. Mill Rise is a care service for people who have a variety of support needs, such as older people and people with dementia and people who have a learning, physical or sensory disability. The service is split between people who live in their own homes in the community and also people that live in apartments within a complex where the service has an office. There were 23 people being supported by the service at the time of the inspection.

There was a Registered Manager in post at the time of our inspection. 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.

People told us they felt safe and we saw risk assessments and plans had been put in place to keep people safe.

Medicines were managed safely. There was clear guidance available for staff to follow and checks were made to ensure people were receiving their medicine as prescribed. PRN protocols were also in place for people that needed their medicine ‘as and when required’.

There were appropriate amounts of staff to deliver care to people and people did not have to wait for support. Staff were aware of their responsibilities to safeguard people from abuse and referrals had been made if there had been an incident.

Safe recruitment practices were in place and staff had appropriate checks prior to starting work to ensure they were suitable to work with people who use the service.

The principles of the Mental Capacity Act 2005 were being followed. Mental capacity assessments were being carried out where needed and people were encouraged to make their own decisions.

Staff had sufficient training to support people effectively and staff were able to refresh this training when required. Staff were also supported in their role and had regular supervisions to discuss their needs.

People were supported to have food and drinks if they needed support however most people were independent.

People had access to other health professionals in order to maintain their health and wellbeing.

People felt staff were caring and that they were treated with dignity and respect, and people were encouraged to maintain as much independence as possible.

Care plans contained good personal detail so that staff could get to know the people they supported and people had their preferences documented and catered for where possible. People and family were involved in reviews and when people’s needs had changed plans had been updated.

People were encouraged to partake in activities that interested them and staff were able to support people with this.

People and relatives were encouraged to provide feedback or complain if they needed to and it was recorded that this feedback was acted upon. We saw that complaints were recorded, investigated and responded to.

Effective quality monitoring systems were in place. Care files and associated documentation was audited and action was taken when omissions had been identified.

Spot checks were in place to ensure staff were fulfilling their role sufficiently.

Staff all felt they could approach the registered manager and the other staff in the team. There was an open door policy and staff all said they could raise things if necessary.

The registered manager felt supported by the provider and shared information from the provider with the staff. They had also submitted notifications about the service, which they are required to do by law.

We spoke with six people using the service, a relative, four members of staff and the registered manager.

We saw people being treated with dignity and respect by staff. People told us they liked the staff. One person said, 'The staff are lovely to me. You couldn't wish for better people'. A relative told us, 'They provide good care. They always let me know if there is a problem'.

Staff told us they received training and support to meet the needs of the people they cared for. A member of staff told us, 'The manager is very supportive'.

The staff we spoke with demonstrated a good understanding of the types of abuse and their responsibilities to protect people and keep them safe.

People who used the service told us the staff requested consent prior to delivering care or support. This meant people using the service were enabled and encouraged to make their own decisions.

We saw that people received care and support that met their individual needs and they were happy with the care they received. Records were kept up to date and included information about people's needs and preferences.

Discussions confirmed people received their care and support around the times arranged. This meant people received their care and support as agreed.

We looked at the way medication was managed and saw that medication systems and practices were safe and suitable.

We looked at the recruitment procedures for staff and found that appropriate systems were in place to protect people.

We found that complaints were dealt with quickly and they were being recorded in the complaints register. Information was available in different formats, including large print, to support people using the service to complain or raise concerns if they wished to.