We carried out a review of the data available to us about Mill Lodge 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 Mill Lodge, you can give feedback on this service.
About the service
Mill Lodge is a residential care home in a converted period building that was full at the time of the inspection, providing personal care to three younger adults all living with a learning disability and additional health needs.
People’s experience of using this service and what we found
Right Support
Mill Lodge is situated in a seaside resort with good public transport links meaning people had opportunities to fully engage with the local community. The model of care maximised people’s choice, control and independence and this was evidenced at this inspection.
Care plans showed people were fully involved in the support they received, and staffing arrangements meant people could be flexible in how they wished to spend their day. The provider’s values were embedded within the service meaning people were supported with life skills and seeking job opportunities. People’s relatives told us the service achieved positive outcomes for people that had improved the quality of their lives.
Right Care
People benefitted from being supported by staff who had been trained, supported and felt valued. Staff had the skills and training to provide person-centred care that met people’s needs and placed them at the heart of the care they received. Care plans showed discreet, respectful and dignified care was considered and our observations and discussions with people confirmed this was in place.
The risks to people had been identified, assessed and mitigated and the environment met people’s needs. Medicines were administered safely, and people received the health care they needed to keep them well. The service adhered to the Mental Capacity Act 2005 and consent was consistently sought. People’s hydration and nutritional needs were met, and people received a varied and nutritious diet of their choosing.
The relatives we spoke with told us the service was well-managed, communicative and effective. They shared examples of how the service had had a positive impact on their family members lives, all describing their family members as happy and fulfilled.
Whilst people received a dedicated, person-centred and meaningful service, the governance systems in place did require some improvement. For example, end of life care needs to be explored with people and they need to ensure consistent recruitment checks are in place. Additionally, audits need to be meaningful and the provider needs better oversight of the service in case of deterioration. Recommendations made by other stakeholders need to be actioned in a more timely manner.
Right Culture
The service had a positive, nurturing culture that placed the people who used it at the centre of it. People were encouraged to participate in activities, community events and to seek volunteering opportunities if they so wished. This was achieved by a provider ethos that supported and encouraged this with systems in place to achieve it. Staff told us they felt supported, listened to, valued and able to contribute to the care people received and the success of the service.
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 (published 24 April 2019) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We undertook this inspection as part of a random selection of services which have had a recent Direct Monitoring Approach (DMA) assessment where no further action was needed to seek assurance about this decision and to identify learning about the DMA process.
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.
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.
Mill Lodge provides care and support for up to three people with learning disabilities. On the day of our inspection three people were living in the service.
People’s experience of using this service:
People living at the service told us that staff were kind and caring. People felt listened to and well supported.
Further improvements were needed to ensure care plans and risk assessments were accurate and sufficiently detailed. Environmental risks had not always been addressed promptly to ensure people lived in a safe environment.
There were auditing systems in place, but these had not identified the issues we found during this inspection.
People were supported by staff to take their prescribed medicines. Improvements were required where people were away from the service on social leave to ensure best practice was being followed and that people received their medicines in the safest way. The provider was in the process of addressing this.
Staff understood the importance of supporting people make their own decisions and followed the principles of the Mental Capacity Act 2005 when delivering people’s care. However, the service needed to implement a system to ensure that any DoLS were reviewed promptly and new applications made where necessary.
There were sufficient staff working in the service. Recruitment procedures were in place to ensure staff were suitable for their roles.
Food and fluid charts were in place for people at risk of malnutrition or dehydration so staff could monitor this.
People had regular access to activities they enjoyed. People were encouraged to take part in activities which helped them gain confidence and feel they were positively contributing.
Staff understood the need to keep people safe from abuse and what was required to do this. Staff had received training in this area, and were clear they would report concerns to a manager or appropriate outside agency without delay.
Each person had their own bedroom with a communal lounge, dining room and kitchen that they could access.
The service worked within the principles and values that underpin Registering the Right Support and other best practice guidance. This ensured that people could live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence.
Rating at last inspection:
At the last inspection the service was rated Good. (Report published October 2016).
Why we inspected:
We inspected this service in line with our inspection schedule for services currently rated as Good.
Enforcement:
Action we told the provider to take is outlined at the back of the report.
Follow up:
We will continue to monitor this service according to our inspection schedule in line with the rating of ‘Requires Improvement’.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
There was a registered manager in post. 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.
People were supported by staff who understood safeguarding procedures and were able to recognise the signs of potential abuse.
Risks to people had been thoroughly assessed and plans put in place to manage these risks while enabling people to live their lives without unnecessary restriction.
Robust recruitment procedures had been employed to ensure that staff were suitable to work with people who used the service. There were sufficient numbers of staff deployed to meet people’s needs. Staff received comprehensive training to enable them to meet people’s needs.
People were given support to take their medicines as prescribed or to administer their own medicines if they chose. People’s nutritional needs were met and they were supported to access healthcare if they needed it.
People were supported by staff who showed respect and cared for them as individuals whilst maintaining their dignity. People were encouraged to make their own decisions where possible and their consent was sought appropriately.
People and those important to them were involved in planning their care, how it was delivered and their independence was promoted. People’s care was delivered in the way they wished by staff who were knowledgeable about their needs.
People who used the service and staff who supported them were able to express their views on the service. People were supported to make complaints and were confident that these would be heard and acted upon. The service maintained good communication with people who used the service and their families.
The management maintained a good overview of the service and had systems in place to monitor the safety and quality of the service. Staff were supported by the management and felt valued by the organisation.