We carried out a review of the data available to us about Mellish House Residential Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Mellish House Residential Home, you can give feedback on this service.
People’s experience of using this service and what we found
The management team conducted a variety of audits to assess the quality and safety of care provided. This included a report following a daily walk around the building. However, the shortfalls we identified in relation to fire safety, the dignified care of people’s belongings following death, medicines management and people’s access to personal care equipment had not been identified. In response to our findings the registered manager took action to update and improve systems to improve oversight and governance.
There were sufficient staff available to meet people’s needs. Staff were safely recruited and checks were made on their suitability.
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.
Relatives spoke positively about the caring culture of the service and felt that their loved ones were safe and well supported. They also told us the service was managed well, communication was good and their opinions were sought in the planning and review of people’s care and treatment.
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 outstanding (published 29 December 2017).
Why we inspected
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
The inspection was promoted in part due to concerns in relation to restrictive visiting procedures. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. The provider took action to mitigate the risks we identified.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from outstanding to good based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mellish House on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
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.
At our last inspection on 10 February 2016 we rated the service ‘Good’. At this inspection we found significant improvements people continued to receive a very good level of care and that further developments had been made under responsive and well-led. We have rated the service ‘Outstanding’ in responsive and well-led and therefore overall.
At this inspection we found that the service provided an outstanding level of responsive care and support that placed people at the centre of the care and enabled them to be instrumental in their support. The registered manager had a strong leadership presence All the people we spoke with had nothing but praise for the service and the excellent quality of life people living in the service experienced. There was an especially strong ethos within the home of respecting people as individuals. Information was given to people about how to raise any concerns they may have and where concerns were raised these were dealt with speedily and in detail. Relatives said they felt welcomed at the service and felt their family member was very well cared for.
The home was exceptionally well led. There were very effective quality monitoring processes in place which covered all areas of the home and care delivered to people. The registered manager was actively monitoring quality in the service in detail. People were routinely consulted and listened to. The registered manager undertook comprehensive audits to ensure areas for improvement were identified and addressed. We received feedback about the home and the standards of care and support people received from a number of healthcare professionals we spoke with. The home was described overall in outstanding terms.
There were robust systems and processes in place to protect people from the risk of harm. Staff were able to describe in detail different types of abuse and what their responsibilities were in protecting people and further reporting this. This ensured the welfare of people was protected through whistle blowing and safeguarding procedures.
Medicines were managed in accordance with best practice and the provider’s policies. Medicines were stored, administered and recorded safely. All staff administering medicines had received training in the correct procedures to follow.
The provider had followed a recruitment process that ensured people were supported by staff whose suitability had been checked. People received effective care because staff were appropriately trained and supported to do their jobs.
People's right to make decisions about their care was respected and those people, who lacked capacity to make their own decisions, had been appropriately supported under the principles of the Mental Capacity Act 2005.
People’s care needs were assessed before they made the decision to move to the home. This helped to ensure the home was able to meet their needs and preferences. Care plans were person centred and contained appropriate risk assessments. Care plans also contained important information about a person's social history which helped staff to get to know people. Staff demonstrated that this was effective through their knowledge of people as individuals.
The inspection took place on 10 February 2015 and was unannounced.
Mellish House residential service is based in Sudbury, Suffolk and can provide care for up to 48 people with dementia support needs. At the time of the inspection there were 46 people at the service.
There was a registered manager in place. 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.
Staff interacted with people who lived at their home in a caring and professional way. People were supported to attend planned activity sessions if they wished to do so. Staff talked with people individually and in groups using both photographs and everyday items to stimulate memories.
Staff and visitors described the management of the service as open and approachable.
People and their relatives considered that the service was safe and secure.
People had their mental health and physical needs monitored. Staff had received training in how to recognise and report abuse. Staff spoken with, were all confident that all situations arising would be fully investigated to ensure people were protected.
The service provided training in the form of an induction to new staff and comprehensive on-going training to existing staff. The senior staff of the service were knowledgeable with regard to Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The service had made referrals and worked with the Local authority to support people who used the service with regard to (MCA) and (DoLS)
People who used the service were content with the meals and staff supported people with their food and fluid intake. We saw that risk assessments and resulting plans of care had been recorded in the individuals care record.
People who used the service were consulted about the way in which the service should provide activities for people.
Care plans were written in a consistent way while being person-centred. The service carried out audits to monitor and improve the care to people as identified by the audits.
We learnt that the choice of lunch was decided on the day. The chef and staff were knowledgeable about people's needs regarding their diet. One person said 'I always eat everything it is lovely.'
We saw that staff had received training in the provision of dementia care and observed people being supported and not rushed to meet their needs. The service employs activity co-ordinators and we saw pictures of people enjoying a recent Spanish themed night. This was an opportunity to enjoy the food and look at the culture of another country which had been well supported by relatives and friends.
caring, respectful and professional manner and people who used the service were
given appropriate information and support regarding their care or treatment.
People told us that staff assisted them in all areas of their care where they needed it. One person stated that "People are very kind here and will always help me if I need it."
Three people told us that the staff treated them well and listened and acted on what they said.
One person spoken with said that they "Liked the staff and that they were kind." Another person was able to confirm that if they had a problem they would "Go to the staff and report it."
Two people were able to confirm that they had recently been consulted about the meals provided with a view to ensuring people are involved in the preparation of the menu's. One person we spoke with told us that "Staff do listen to me and understand what I need."