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Inspection Summary


Overall summary & rating

Good

Updated 6 January 2018

The inspection took place on 10 November and was unannounced. The inspection continued 13 November and was again unannounced.

The Mellowes is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care home accommodates 40 people across two floors, each of which has separate adapted facilities.

Our last inspection on 10 and 11 May 2017 found that systems and processes were not in place to ensure robust assessing and monitoring of quality, safety and risks. We found that some people did not receive safe care and treatment. Staff did not receive regular supervision and appraisal. Risks were not assessed or mitigated effectively. People did not always receive personalised care and consent was not always sought. During this inspection we found that improvements had been made.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions safe, effective, caring, responsive and well led to at least good. We found that during this inspection the action plan had been followed and improvements had been made.

The service had 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.

Risk assessments in relation to people’s care and treatment were completed, regularly reviewed and up to date. However, risk assessments associated to activities inside and away from the service were not in place.

Specific care plans were not completed to reduce the risk of infections and guidelines to include the use of some personal protective equipment was not always in place. The registered manager told us that this would be completed as a priority.

People, relatives, a health professionals and staff told us that the service was safe. Safeguarding alerts were being managed and lessons learnt by the home. Professionals confirmed that improvements had been made. Staff were able to tell us how they would report and recognise signs of abuse and had received training in safeguarding.

Care plans were in place which detailed the care and support people needed to remain safe whilst having control and making choices about their lives. Each person had a care plan and associated files which included guidelines to make sure staff supported people in a way they preferred.

Medicines were managed safely, securely stored, correctly recorded and only administered by on duty nurses and team leaders that were trained and assessed as competent to give medicines.

Staff had a good knowledge of people’s support needs and received regular local mandatory training as well as training in response to people’s changing needs for example some people were receiving end of life care and staff had been trained in this area.

Staff told us they received regular supervisions which were carried out by the management team. Staff told us that they found these useful. We reviewed records which confirmed this.

Staff were aware of the Mental Capacity Act and training records showed that they had received training in this. Capacity assessments were completed and best interest decisions recorded as and when appropriate.

People and relatives told us that the food was good. We reviewed the menu which showed that people were offered a variety of healthy meals. We saw that food was regularly discussed and recorded on food preference sheets. The chef told us that the majority of meals are home cooked.

People were supported to access healthcare appointments as and when required and staff followed professi

Inspection areas

Safe

Good

Updated 6 January 2018

The service was mostly safe. People were not at a reduced risk of harm when participating in activities inside and away from the home because risk assessments were not in place.

Policies, systems and equipment were in place to minimise the risk of infection.

There were sufficient staff available to meet people’s assessed care and support needs.

Staff had completed safeguarding adults training and were able to tell us how they would recognise and report abuse.

Medicines were managed safely, securely stored, correctly recorded and only administered by nurses and team leaders that were trained and competent to give medicines.

Lessons were learnt and improvements were made when things went wrong.

Effective

Good

Updated 6 January 2018

The service was effective. People’s needs and choices were assessed and effective systems were in place to deliver good care and treatment.

The service was acting in line with the requirements of the MCA.

Staff received training and supervision to give them the skills they needed to carry out their roles.

Staff were supported and given opportunities for additional training and personal development.

People were supported to eat and drink enough and dietary needs were met.

The service worked within and across other healthcare services to deliver effective care.

The premises met people’s needs and they were able to access different areas of the home freely.

People were supported to access health care services and other professionals as and when required.

Caring

Good

Updated 6 January 2018

The service was caring. People were supported by staff that treated them with kindness, respect and compassion.

Staff had a good understanding of the people they cared for and supported them in decisions about how they liked to live their lives.

People were supported by staff who respected their privacy and dignity.

Responsive

Good

Updated 6 January 2018

The service was responsive. People were supported by staff that used person centred approaches to deliver the care and support they required.

People were supported by staff that recognised and responded to their changing needs.

People were supported to access the community and take part in activities within the home.

A complaints procedure was in place. Relatives, professionals and people told us they felt able to raise concerns with staff and/or the management.

Resident meetings took place which provided an opportunity for people to feedback and be involved in changes.

People were support with end of life care. Preferences and choices were respected by staff.

Well-led

Good

Updated 6 January 2018

The service was well led. The registered manager and customer experience manager promoted inclusion and encouraged an open working environment.

Staff received feedback from the management and felt recognised for their work.

Quality monitoring systems were in place which ensured the management had a good oversight of service delivery

The home was led by a management team that was approachable and respected by the people, relatives and staff.

The home was continuously working to learn, improve and measure the delivery of care to people.