Millcroft

Millcroft is a residential care home providing accommodation and personal care to 20 people at the time of the inspection, some of whom are living with dementia, mental health or frailty. The service can support up to 24 people. Millcroft accommodates people in one adapted building.

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

People told us they felt safe living at the service. One person said, “Yes I do feel safe. There are nice carers about. They are there if you need them.” Risks to people were managed effectively. Staff understood their responsibility for safeguarding people and knew how to report suspected abuse. There were enough suitable staff to care for people safely and the provider had robust recruitment procedures. People's medicines were administered safely, and infection control procedures were robust. Incidents were recorded and monitored, and lessons were learned when things went wrong.

People told us that staff had the skills to support them. One person said, “They try to do everything they can for us. I think it’s a difficult job.” Staff received the training and support they needed. 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. People's needs were assessed comprehensively and considered people's diverse needs and their preferences. People were supported to have enough to eat and drink and to access health care support when needed.

People told us that staff were kind and caring towards them. One person said, “I’m so happy here, comfortable. They look after me very well.” Good interactions were seen throughout the inspection. Peoples dignity and privacy was respected. One relative said, “Staff are all polite. Very respectful of mum’s privacy and they will always knock.” People were encouraged to be as independent as possible. One relative said, “They encourage her to do things herself, but she does need some support.”

Care was provided in a person-centred way. People were supported to maintain contact with people who were important to them. Staff were responsive to people's needs and ensured that people's information and communication needs were met. People were encouraged to access activities and to maintain their interests. People were confident that any complaints would be addressed. Staff supported people to plan for end of life care and respected their wishes.

The registered manager was well regarded. They had a clear vision for the service which was understood by the staff and embedded within their practice. There were effective quality assurance systems in place that were used to drive service improvements. People, their relatives and staff were asked for their feedback about the service and meetings were held regularly.

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 24 November 2016).

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.

Risks to people’s safety had been assessed and actions taken to protect people from the risk of harm. The provider had systems in place to protect people against abuse and harm. The provider had effective policies and procedures that gave staff guidance on how to report abuse. The registered manager had robust systems in place to record and investigate any concerns. Staff were trained to identify the different types of abuse and knew who to report to if they had any concerns.

Medicines were managed safely and people had access to their medicines when they needed them.

Staff were well trained with the right skills and knowledge to provide people with the care and assistance they needed. Staff met together regularly and felt supported by the manager. Staff were able to meet their line manager on a one to one basis regularly. There were sufficient staff to provide care to people throughout the day and night. When staff were recruited they were subject to checks to ensure they were safe to work in the care sector.

Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). An appropriate assessment of people’s ability to make decisions for themselves had been completed. Where people’s liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.

People had enough to eat and drink, and received support from staff where a need had been identified. People’s special dietary needs were clearly documented and staff ensured these needs were met.

The staff were kind and caring and treated people with dignity and respect. Good interactions were seen throughout the day of our inspection, such as staff sitting and sharing mealtimes with people as equals. Staff knew the people they cared for well and treated them with kindness, compassion, dignity and respect. People could have visitors from family and friends whenever they wanted. People spoke positively about the care and support they received from staff members.

People received a person centred service that enabled them to live active and meaningful lives in the way they wanted. People had freedom of choice at the service. People could decorate their rooms to their own tastes and choose if they wished to participate in any activity. Staff respected people’s decisions.

People felt well cared for and were supported with a variety of activities. However, activities were not always structured meaning that people could potentially become under stimulated. We have made a recommendation about this in our report.

Support plans ensured people received the support they needed in the way they wanted. Peoples health needs were well managed by staff so that they received the treatment and medicines they needed to ensure they remained healthy. Staff responded effectively to people’s needs and people were treated with respect. Staff interacted with people very positively and people responded well to staff.

The culture of the service was open and person focused. The registered manager provided clear leadership to the staff team and was an active presence in the home.

Audits to monitor the quality of service were effective and embedded. They identified actions to improve the service and these had been carried out.

We found that people's privacy, dignity and independence were respected. A person told us, "All the staff treat me with respect".

We found that people's care and treatment was planned and delivered in line with their care plan. One relative told us, "The care was always good but now it is even better".

We found that there was an appropriate recruitment procedure in place. A member of staff said, "We know and understand what is expected of us".

We observed care being given to people and found that that there were sufficient numbers of suitable persons employed. One person told us, "The staff never rush me, there are enough of them".

Staff were supported and received appropriate induction, training, supervision and opportunities for professional development. A staff member told us, "The heads of care and new acting manager are very approachable, we can talk freely and discuss any concern".

We found that people that lived in the home had been able to express their views and preferences and that these had been taken into consideration in the planning and delivery of their care. People had been treated with dignity and respect. We saw that people's needs had been assessed and care and treatment had been planned and delivered in line with their individual care plan. People's nutritional needs had been met.

We found that where people did not have the capacity to consent, the provider had ensured that they had acted in accordance with their legal requirements.

People told us they felt safe and the provider had taken steps to ensure that staff knew how to identify abuse and raise a safeguarding concern. People had been cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. People had been protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.