The Care Quality Commission
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Archived: Millfield Care Home

Overall: Good read more about inspection ratings

Bury New Road, Heywood, Lancashire, OL10 4RQ (01706) 621222

Provided and run by:
Bupa Care Homes (AKW) Limited

Important: The provider of this service changed. See new profile

All Inspections

12 July 2017

During a routine inspection

We inspected Millfield Care Home on 12 and 13 July 2017. The first day of the inspection was unannounced. There were 61 people using the service at the time of the inspection. We last inspected Millfield Care Home on 12 December 2016 when we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The breaches were in relation to the inaccurate recording of medicines and an unsatisfactory recruitment system. Following the inspection the provider sent us as action plan informing us of what action they had taken to put things right.

During this inspection we found the provider was meeting all the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Millfield Care Home is a purpose built home which is registered to provide accommodation for up to 92 people who require nursing and personal care. Millfield Care Home is situated on a main road in Heywood, close to public transport networks, local shops and facilities. The home operates with three units; On the ground floor there is the Wham Bar Unit that provides nursing care for younger adults. On the first floor there is Summit Unit that provides mainly general nursing care and Hopwood Unit that provides personal care. There is a fourth unit on the ground floor that is not in use.

The home had a manager registered with the Care Quality Commission (CQC) who was present on the day of the 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.

We found that suitable arrangements were in place to help safeguard people from abuse. Staff knew what to do if an allegation of abuse was made to them or if they suspected that abuse had occurred. Staff were able to demonstrate their understanding of the whistle blowing procedures (the reporting of unsafe and/or poor practice).

We found people were cared for by sufficient numbers of suitably skilled and experienced staff who were safely recruited. Staff received the essential training and support necessary to enable them to do their job effectively and care for people safely.

The medication system was safe and we saw how the staff worked in cooperation with other healthcare professionals to ensure that people received appropriate care and treatment.

Procedures were in place to prevent and control the spread of infection and risk assessments were in place for the safety of the premises. All areas of the home were secure, clean, well maintained and accessible for people with limited mobility; making it a safe environment for people to live and work in.

We saw that appropriate environmental risk assessments had been completed in order to promote the safety of people who used the service, members of staff and visitors. Systems were in place for carrying out regular health and safety checks and equipment was serviced and maintained regularly.

Procedures were in place to deal with any emergency that could affect the provision of care, such as a failure of the electricity and water supply.

People told us they received the care they needed when they needed it. They told us they considered staff were kind, had a caring attitude and felt they had the right skills and knowledge to care for them safely and properly. We saw that staff treated people with dignity, respect and patience.

Specialised training was provided to help ensure that staff were able to care for people who were very ill and needed end of life care.

We saw people looked well cared for and there was enough equipment available to ensure people's safety, comfort and independence were protected. People's care records contained enough information to guide staff on the care and support required. The records showed that risks to people's health and well-being had been identified and plans were in place to help reduce or eliminate the risk. We saw that people were involved and consulted about the development of their care plans.

Staff were also able to demonstrate their understanding of the principles of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be unable to make their own decisions.

People were provided with a choice of suitable and nutritious food and drink to ensure their health care needs were met. Some people however, did comment that the meals were at times monotonous. The registered manager told us that this would be looked into. We saw that food stocks were good and there was always a choice of meal.

To help ensure that people received safe and effective care, systems were in place to monitor the quality of the service provided. Regular checks were undertaken on all aspects of the running of the home and there were opportunities, such as resident/relative meetings and satisfaction surveys for people to comment on the facilities of the service and the quality of the care provided.

12 December 2016

During a routine inspection

This was an unannounced inspection, which took place on the 12 December 2016. The service was last inspected in December 2015 and was rated ‘requires improvement’. At that time the service did not have a registered manager. Whilst no breaches in regulation were identified at the December 2015 inspection we did receive conflicting information regarding staffing levels. We also found medication records were not always accurate and plans to help reduce or eliminate the risk to people had not always completed. We reviewed what progress had been made during this inspection.

Millfield Care Home is a purpose built care home which is registered to provide accommodation for up to 92 people who require nursing and personal care. At the time of this inspection there were a total of 61 people accommodated at the service across three units: Summit provides general nursing care, Hopwood provides accommodation for people who require support with their personal care needs and Wham Bar provides general nursing care to people under the age of 65. A fourth unit was not open. We were told there were currently no plans to re-open this part of the service.

It is a condition of the provider’s registration to ensure that the manager carrying on the regulated activities at Millfield Care Home is registered with the Care Quality Commission (CQC The provider has failed to comply with this condition since the last inspection in October 2015. A registered manager is a person who has registered with the CQC 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. During this inspection we were told that a new manager had been appointed and would be taking up the position in January 2017.

We have identified two breaches in regulation. You can see what action we have told the provider to take at the back of the full version of the report.

We found the overall system in place for managing oral medicines was safe. However clear and accurate records were not maintained to demonstrate people were receiving their prescribed creams and thickeners safely and effectively.

We found that all relevant information and checks were not in place when recruiting new staff ensuring their suitability for the position.

The provider was meeting the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be unable to make their own decisions.

People were involved a making decisions about their care and support. Where necessary those people unable to make certain decisions for themselves were supported and decisions were made in their ‘best interests’.

Care records provided good information about people’s needs, wishes, likes, dislikes and preferences. Risk assessments were completed where areas of concern had been identified and guided staff on how to minimise potential risks to people so that their health and well-being was maintained.

A range of opportunities where provided both in and outside of the home enabling people to maintained their independence and community presence.

People were offered adequate food and drink throughout the day. Where people’s health and well-being was at risk, relevant health care advice had been sought so that people received the treatment and support they needed.

People and their visitors told us that staff were kind and helpful. We saw staff respond quickly to calls for support from people. Staff were seen to support people in a patient and unhurried manner. Staff respected people’s privacy and were seen knocking on bedroom doors before entering.

During the inspection staff we spoke with were able to clearly demonstrate their understanding of their role and what was expected of them.

Staff had access to procedures to guide them and had received training on what action to take if they suspected abuse.

We saw there were sufficient numbers of suitably trained and experienced staff available to support people in meeting their emotional, social and physical needs so their health and well-being was maintained.

Suitable arrangements were in place in relation to fire safety and the servicing of equipment was undertaken so that people were kept safe. All areas of the home were clean, well maintained and accessible; making it a safe environment for people to live and work in.

We saw effective systems were in place to monitor, review and assess the quality of service so that people were protected from the risks of unsafe or inappropriate care. Opportunities for people and their visitors to comment on their experiences were also provided.

The provider had a system in place for the reporting and responding to any complaints brought to their attention. Records demonstrated that people comments were listened to and acted upon.

9 December 2015

During a routine inspection

This was an unannounced inspection which took place on 9 December 2015. We had previously inspected this service in October 2014 when we identified five breaches of the regulations we reviewed; these related to the administration of medicines, staffing and the training and support provided to staff.

Following the inspection in October 2014 the provider wrote to us to tell us the action they intended to take to ensure they met all the relevant regulations. This inspection was undertaken to check whether the required improvements had been made.

Millfield Nursing Home is a purpose built care home which is registered to provide accommodation for up to 92 people who require nursing and personal care. At the time of this inspection there were a total of 57 people accommodated at the service across three units: Summit provides general nursing care, Hopwood provides accommodation for people who require support with their personal care needs and Wham Bar provides general nursing care to people under the age of 65. A fourth unit for people with living with a dementia was not open. We were told there were no plans to re-open this part of the service.

The service did not have a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. An interim manager had been in post since August 2015. They had applied for the manager position on a permanent basis and were due to be interviewed by the provider before the end of December 2015. They told us that if they were successful in this interview they would immediately submit their application to register as manager for the service with CQC.

People told us they felt safe in the service and had no concerns about the care and support they received. They told us staff were always kind and caring and supported them to be as independent as possible.

Staff had received training in safeguarding adults and knew the correct action to take if they witnessed or suspected abuse. All staff we spoke with were aware of the provider’s confidential ‘Speak Up’ telephone line which they could use to raise any concerns about the service.

Staff were safely recruited and received the induction, training and supervision they required to be able to deliver effective care. Although we received conflicting information regarding staffing levels in the service, our observations during the inspection showed staff responded to people’s requests for support in a timely manner.

We noted improvements had been made to way medicines were stored and disposed of in the service. People told us they received their medicines as prescribed. Although three of the medication administration record (MAR) charts we reviewed contained some minor inaccuracies, we were able to confirm that all medicines had been administered as prescribed.

All areas of the home were clean and well maintained. Procedures were in place to prevent and control the spread of infection, although we noted one person’s care records had not been fully completed to advise staff of the action to take to minimise the identified risk of cross infection.

Systems were in place to deal with any emergency that could affect the provision of care, such as a failure of the electricity and gas supply. At the time of the inspection the passenger lift was out of order. However, appropriate arrangements had been made, including the installation of a stair lift to help ensure people could exit the service should they so wish. Regular checks were also in place to ensure staff were aware of the action they should take in the event of a fire at the service.

People told us they always received the care they needed. Nine of the ten care records we reviewed showed that risks to people’s health and well-being had been identified and plans were in place to help reduce or eliminate the risk. Care records had been regularly reviewed to help ensure they accurately reflected people’s needs.

Systems were in place to help ensure people’s health and nutritional needs were met. Records we reviewed showed that staff were proactive in contacting relevant health professionals to ensure people received the care and treatment they required.

We saw that appropriate arrangements were in place to assess whether people were able to consent to their care and treatment. The manager was aware of the action to take to ensure any restrictions in place were legally authorised under the Deprivation of Liberty Safeguards (DoLs).

A programme of activities was in place to help promote the well-being of people who used the service. Records we reviewed showed people were supported to access activities on both a group and individual basis.

There were effective systems in place to investigate and respond to any complaints received by the service. All the people we spoke with told us they would feel confident to raise any concerns they might have with the manager.

There were a number of quality improvement processes in the service; these included audits in relation to care records and the environment. The manager demonstrated a commitment to continuing to drive forward improvements in the service. However, the provider needed to ensure there was consistent leadership in the service.

14 October 2014

During an inspection looking at part of the service

Millfield Nursing and Residential Home is situated close to Heywood town centre. The home is able to accommodate up to 92 people. There are four separate units provided over two floors. A passenger lift services both floors and there is level access to the entrance. There is ample parking to the front of the building for visitors. The home is accessible to all local amenities, with easy access to the local bus network which runs between Bury and Rochdale. At the time of our inspection there were 62 people living at the home.

This was an unannounced inspection carried out on the 14 October 2014.

At the time of the inspection the home did not have a registered manager. A new manager had been appointed who intended to submit an application to register with the Care Quality Commission. 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.

We carried out a routine inspection in June 2013. All areas we assessed at that time met the regulations. Wee inspected the home again in October 2013 due to concerns that had been raised about the care and welfare of people who lived at Millfield Nursing and Residential Home. However, we did not find any evidence to support the concerns raised and the provider was meeting regulations.

At this inspection we spent time observing care and support in communal areas, spoke to people in private, and looked at care and management records.

Although people told us they felt safe living at the home, staff had not received specific areas of training and support enabling them to develop the knowledge and skills needed. Staff levels were not sufficient throughout the day to meet the current and changing needs of people.

Prior to our inspection we had been told that people were being woken in the mornings and dressed ready for when day staff commenced their shift. We found this had been occurring and raised this with the manager. Following our inspection the manager told us they had spoken with all staff about this poor practice and night visits were planned to check this practice had stopped.

We found people did not always receive their medicines as prescribed. Arrangements for the disposal of medicines was not adequate and at risk of being abused.

Audits and checks were in place to monitor and review the service provided. Where improvements were needed, plans had been put in place and were monitored by managers to check this was done so that people received a safe and effective service.

Staff told us that clear leadership and support was needed to improve morale within the home. Visitors and staff spoken with were happy with the recent appointment of the new manager.

Staff were able to demonstrate their understanding of the safeguarding and whistle blowing procedures in order to safeguard the health and welfare of people who used the service. Managers were aware of their responsibilities with regards to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). We saw systems to protect those people who potentially lacked capacity to make decisions for themselves were in place. A programme of staff training and development was provided to help staff understand how to promote and protect the rights of people.

Thorough systems were in place with regards to the recruitment of new staff, safety checks to the building and emergency procedures, which helped to keep people safe.

People and their visitors told us they had been involved in the planning of their care and support so their individual needs and wishes were taken into consideration. Care records contained enough information to show how people were to be supported and cared for. Records showed that people had access to all health care professionals ensuring their health and well-being was maintained. Suitable equipment and aids were provided to meet the assessed needs of people and promote their independence.

People and their visitors spoke positively about the care and support provided. We saw staff respected people’s privacy and dignity and interactions were pleasant and friendly. People said they were able to see their friends and families when they wished. There were no restrictions on when people could visit the home. All the visitors we spoke with told us they were made welcome by the staff in the home. People told us they had opportunities to take part in activities both in and away from the home.

People were offered a varied and nutritious diet. We saw the lunchtime experience was not well organised and did not provide people with a relaxed sociable occasion.

Systems were in place for the reporting and responding to any complaints or concerns raised with the provider.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 in relation to sufficient numbers of staff to support people and the training, professional development, medication management` and support of staff in carrying out their role You can see what action we told the provider to take at the back of the full version of this report.

28 October 2013

During an inspection in response to concerns

The purpose of this inspection was to follow up on a number of concerns raised with us about people’s care and welfare, staffing and accessibility to healthcare support and equipment.

During the inspection we spent time on three of the units; Pilsworth, Hopwood and Summit. We also spoke with people who use the service, a visitor, staff and members of the management team.

The visitor for one person told us; “I’m very happy, they have been brilliant” and “I’ve got no concerns at all”. They also gave us examples of how the changing needs of their relative had been effectively met by staff.

Care records contained detailed information to show how people were to be supported and cared for. Records showed that people had access to all health care professionals ensuring their health and well-being was maintained.

Suitable equipment and aids were provided to meet the assessed needs of people.

The service had taken action to recruit permanent staff to the home so that the need for agency staff was reduced. Sufficient numbers of staff were available to meet the needs of people.

28 May 2013

During a routine inspection

During our visit we spoke with four people who lived at the home and a visitor. We ask them to tell us about their experiences whilst living at or when visiting the home.

Most people spoke positively about the care and support provided. Their comments included; “The staff are very nice, all the carers are good, “They [the staff] are very kind” and “I’m quite happy with everything”. One person did say there were times when they had to wait a long time for staff to respond when they pressed their call bell or when they needed to use equipment that was required to meet their needs.

Care plans contained sufficient information to show how people were to be looked after. These could be enhanced further with more comprehensive person centred information based on their individual needs and wishes.

Adequate arrangements were in place to meet the nutritional needs of people. Consideration needed to be given to the mealtime arrangements so that people’s nutritional needs were met and mealtimes were more enjoyable.

Systems were in place to help protect people by ensuring that staff were suitably trained in areas of safety and protection.

Appropriate arrangements were in place when recruiting new staff ensuring their suitability to work at the home.

Systems to monitor and review the quality of service provided were in place. This information helped the management team to identify where improvements were needed and any action required was planned for.

10 October 2012

During a routine inspection

During our visit we spent time observing care practices and staff interactions on three of the units, Pilsworth, Summit and Hopwood. We also spoke with five people who lived in the Hopwood and Summit units.

We saw that staff spoke to people in a quiet and respectful way. People were encouraged to be as independent as possible, and where necessary, were assisted in a gentle and unhurried way.

People who we spoke with also told us, 'There's always something going on' and 'You can please yourself with what you want to do'. One person said, 'Nothing is too much trouble' and 'The girls [care staff] are marvellous'. Another person added, 'Yes I'm very settled' and 'They've been so helpful'.

We saw that people received plenty of visitors to the home. One person spoken with said, 'I'm always made welcome, there's no restriction on when I want to visit'.

From our observations we saw that people had been assisted with their appearance. People were well kept and were nicely dressed.

We also received comments from people on the recent refurbishment of the home. People were happy with the changes. Comments from two people included, 'They have worked hard getting it all done and it's not taken very long' and 'The refurbishment has been smashing, it's lovely'. Another person offered to show us their bedroom, which they described as 'very comfortable' and a visitor also commented, 'The environment is smashing, it was needed and they have done a grand job'.

4 October 2011

During an inspection in response to concerns

During our visit on the 21 October 2011 we spoke with someone who lives at the home about the care they received. They told us; 'There's no problem, if I need the Dr, then they just call', 'They provide all the care I need' and 'They keep the family informed'.

We also spoke with the relative of one person. They told us: 'There was one issue when mum first moved in, we raised it with the manager and it was dealt with, there have been no further issues'.

Other comments received included; 'Sometimes there are not enough staff', 'Sometimes I have to wait a long time when I ring for help' and 'Some of the staff are lovely'.

We observed how busy staff were during our visit. At times people and visitors had to wait for staff as they were busy carrying out other tasks. We discussed this with the manager during feedback.

20 April 2011

During a routine inspection

Both people living and working at the home told us that recent improvements made have had a positive impact on the service provided.

Staff told us that 'morale has improved' and 'the systems introduced have improved safety and good practice'. One person said that the 'new management team worked well, complimenting each other which was having a positive effect on the service'.

People living at Millfield and there relatives spoke positively about the home. They told us that they 'feel listened to when we raise any issues', 'the staff are good, very helpful', 'there's been no problems, couldn't ask for more', 'they have been excellent', 'things appear to be a lot more settled' and 'the manager is approachable'.