Archived: Milldene Nursing Home

At the time of the inspection there were 13 people living at the home. We spoke with 11 people who were able to share their views about the service they received and we observed their experiences to support our inspection. We spoke with the registered manager, two care staff and a nurse.

Is the service safe?

All the people we spoke with told us they felt safe. One person told us, 'If I had any concerns or issues I would speak with the staff. I like it here, the staff are so lovely.' Another person told us, 'It's really nice and homely here. I have no concerns. If I did have something I know I can talk with the staff.'

Staff understood how to safeguard the people and demonstrated how they managed risk in order to safeguard people they supported.

We saw the service was safe, clean and hygienic. The home had an effective infection control system. Equipment was well maintained and serviced regularly, so preventing any unnecessary risks. Staff told us how they worked to prevent infection and would know how to manage an outbreak at the home.

Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager understood the home's responsibilities under the Mental Capacity Act 2005 and DoLS. No deprivation of liberty application had been submitted to the local authority. Following a recent court ruling regarding DoLS in care settings, the provider may wish to review people's living arrangements to check whether their circumstances amount to a deprivation of liberty, according to the revised definition.

Is the service effective?

One person commented, 'I have diabetes I manage most of the time by myself. The staff help me when I am having problems. They help me with my treatment.' Another person told us, 'If I am not well the staff will always arrange for me to see the nurse or a doctor.' Another person told us, 'I have a care plan. If I need anything I just need to ask.'

People explained how their care and welfare needs were met. All people told us they felt the service was flexible. One person told us, 'I have health problems and the staff always make sure I have the right food and I drink enough water.' All the people we spoke with told us that they were always asked by staff if they needed help or assistance. The staff told us they always asked people if they were happy and if they required assistance before providing help.

We saw that the staff consulted and involved other professionals in people's care which ensured people received appropriate care and treatment.

Is the service caring?

We were able to observe the experiences of people. We saw that staff treated people with dignity and respect. We saw that staff communicated well with people and explained everything in a way that could be easily understood. Staff were attentive and interacted well with people. We observed that people were seen to respond positively to the staff throughout. Staff encouraged and supported people to make choices and be independent. On the day of the inspection people were going out shopping, sitting in the garden or watching a film. One person told us, 'It's smashing here. The people are lovely and the staff are so kind.'

All the people we spoke with told us that they were happy with the care and support they received.

Is the service responsive?

All the people we spoke to told us that staff would respond to any of their requests for support. One person told us, 'I like to have visitors. My family can come anytime here. We usually go out.' Another person told us, 'I am going out shopping today and a member of staff is coming with me.'

We saw that staff responded to people's requests for help in a timely way.

Some of the people we spoke with told us they were involved in decisions about their care. They told us that the staff were flexible and responded to their requests promptly. One person told us, 'I like to spend time in my room sometimes. I can have my meals here when I want.'

People's care needs had been reviewed every month. We saw that when people's requirements had changed the staff had responded and reviewed their care needs so that they could meet their changed support and care needs. We saw that staff had also consulted specialist services to meet people's changing care and support needs.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service well-led?

The registered manager showed us that there was an effective system to regularly assess the quality of service that people received. We found that the views and opinions of people, relatives and staff had been regularly recorded and responded to. The registered manager told us that the home was currently in the process of being taken over by another provider. They told us that people and their relatives had been kept informed about these plans.

We saw the home had systems in place that made sure managers and staff learnt from any accidents, complaints, whistleblowing reports or investigations. This helped reduce the risks to people and helped the service to continually improve.

We saw that when people were transferred to another service the provider provided appropriate information about the persons care to the new service.

Staff told us they understood their roles and responsibilities. Staff had a good understanding of the ethos of the service and quality assurance processes were in place. This helped to ensure that people received a good quality care service at all times.

We found that people's care was planned to meet their individual assessed needs and ensure their personal safety. The people we talked with told us they were happy with their care. Their comments included, 'The carers are nice, they fuss me'; 'I like the food, and the cook is good'; and, 'staff sit and talk about things'.

Work was being undertaken to improve conditions in the environment that people were cared for in.

Staff working at the home were checked and vetted to make sure they were suitable to work with vulnerable people.

Staffing was properly organised and enabled staff to give people consistent care and support.

There was a clear complaints procedure that people felt able to use if they had any concerns about their service.

People who used the service did not make comment on the care or level of support they received. One person said she had been at the home 'a number of years and it is alright'; she also confirmed that there were 'no complaints'.

We spent time observing how people were treated by staff and saw that they were treated appropriately, with respect and their dignity and wellbeing was looked after at all times.

The acting manager confirmed that people who used the service had limited contact with family members.

Members of staff confirmed they had received an induction and further training to enable them to do their job. We discussed training received that had given them the confidence to recognise and take action if they observed any safeguarding incidents. They said that they believed people who used the service were 'safe' and they 'would raise concerns when needed'.