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Mill River Lodge Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 9 April 2021

About the service

Mill River Lodge is situated in Horsham, West Sussex. It is one of a group of services owned by a national provider, Shaw Healthcare Limited. It is a residential ‘care home’ providing care for up to 70 people who may be living with dementia, physical disabilities, older age or frailty as well as up to 20 people who may require nursing care. At the time of inspection there were 60 people living at the service.

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

Risks to people had not always been mitigated to help ensure their safety. We found concerns in relation to infection prevention and control practice. The registered manager and provider had not ensured staff were provided with correct and current guidance on infection prevention and control (IPC)practices or the appropriate use of personal protective equipment (PPE). They had failed to identify that staff were working in a way that increased the risk of exposure and spread of infection for people and themselves. When our concerns in relation to IPC practices were immediately fed back to the registered manager and provider, they did not respond in a timely way to help ensure risks to staff and people were minimised. This further increased the risk of harm to both people and staff.

Two people had not always received care that met their assessed needs and preferences in relation to personal and oral hygiene and following health professional's guidance. Shortfalls in infection control identified during the inspection had not been identified by the provider's quality assurance processes. This raised concerns about their effectiveness.

Improvements had been made regarding the quality and oversight of most people's healthcare. Staff’s competence had been assessed to provide assurances their practices were safe when supporting people to move and position or when administering medicines. Risk in relation to people’s hydration, nutrition, falls and specific healthcare needs were well-managed and people had received effective care.

People were complimentary about the care they received. They told us staff made them feel safe and they were happy living at the service. Staff told us they felt well-supported and valued by the registered manager and the leadership of the service had improved.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was Requires Improvement (Report published 7 April 2020). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection improvements of the oversight of people's care had been made. The provider had not met all of their action plan that was sent to us after the last inspection. They had not ensured that the quality assurance systems they had introduced were always effective in identifying the shortfalls found in relation to oral and personal hygiene and the implementation of health professional's guidance.

Why we inspected

We undertook this targeted inspection to check whether the Requirement Action we previously served in relation to Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met and to see if the concerns found at the last inspection had improved. We also looked at the care people had received in response to concerns that had been raised to us since the last inspection. The overall rating for the service has not changed following this targeted inspection and remains Requires Improvement.

CQC have introduced targeted inspections to follow up on enforcement action or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

Inspection areas

Safe

Requires improvement

Updated 9 April 2021

At our last inspection we rated this key question Requires Improvement. We have not reviewed the rating at this inspection. This is because we only looked at the parts of this key question we had specific concerns about.

Effective

Requires improvement

Updated 9 April 2021

At our last inspection we rated this key question Requires Improvement. We have not reviewed the rating at this inspection. This is because we only looked at the parts of this key question we had specific concerns about.

Caring

Good

Updated 9 April 2021

Responsive

Requires improvement

Updated 9 April 2021

At our last inspection we rated this key question Requires Improvement. We have not reviewed the rating at this inspection. This is because we only looked at the parts of this key question we had specific concerns about.

Well-led

Requires improvement

Updated 9 April 2021

At our last inspection we rated this key question Requires Improvement. We have not reviewed the rating at this inspection. This is because we only looked at the parts of this key question we had specific concerns about.