Mill Lodge Residential Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

This is the first assessment for this service which was previously registered under a different provider. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The registered manager shared with us examples of learning from incidents and events and records showed how actions had been taken in response to findings to improve the quality of care people received. For example, the registered manager conducted a review after any incidents and shared any changes to people’s care, or learning with the staff team. Staff told us updates were shared with them to ensure they supported people safely and in line with their current care needs.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The registered manager carried out assessments of people’s needs and worked alongside other professionals to ensure people’s holistic needs were met. Where people’s needs changed, the staff team sought advice from healthcare professionals, such as occupational therapists and physiotherapists to enable them to receive support for their mobility or physical health. Where people’s needs had changed to the extent they required a nursing or more specialist service, the registered manager worked with the person, their family and social workers to identify a more appropriate option for them.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People told us they felt safe living at Mill Lodge. One person told us, “I feel safe because the carers are always around and they know what they are doing. I like the atmosphere. It’s quiet and decent and always has been.”

The provider had clear safeguarding processes in place and staff were aware of how to raise concerns for people’s safety and well-being.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In [care homes/hospitals], this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that DoLS were applied for when necessary to ensure people who lacked mental capacity were lawfully supported.

The provider worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Staff had a good understanding of people’s risks and knew how to safely support people. We observed staff supporting people with their mobility and people were encouraged to do as much as possible for themselves while remaining safe. Where people experienced anxiety and distress, staff followed guidance in their care plans to ensure they and others were safe. One staff member told us, “Sometimes it’s just about giving people space. I found the more staff were there, the more distressed the person became. So, I left them alone briefly and this gave them time to calm.”

The deputy and registered managers regularly reviewed people’s risks and updated guidance for staff about how to support people safely. Records showed risks around mobility, skin integrity and distressed behaviours were documented and staff were knowledgeable about people’s current support needs.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. However, we found improvements were needed in relation to window restrictors, to ensure the risks to people were safely managed. Although window restrictors were in place, they did not meet current guidance and were not tamper proof. Following the inspection the registered manager submitted evidence to show the required improvements had been made.

The environment was clean and tidy. Some dementia friendly signage was in place, to assist people with making choices and aid orientation, but improvements were underway to develop this further. Personalised signage was being developed for people’s bedrooms, to assist those people living with dementia to identify their own bedrooms. Regular checks were carried out on the home environment and action plans were in place to support improvements.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

People’s needs were met by sufficient numbers of staff who were available to provide planned care as well as responding to people’s immediate needs. One person told us, “If you need anything at night, you ring the bell and they will come running. Carers are always around and they know where you are, they keep an eye on you.”

Staff told us they were confident there were enough staff members on each shift to meet people’s care needs and spend time with people. One staff member commented, “What drew me to the home is the atmosphere, it’s like a community. I feel like I get to spend time with people, talking with them, it helps you help people feel special, cared for.”

The registered manager used a dependency tool to calculate staffing levels, which reflected people’s current needs. This was regularly reviewed to make sure enough staff were available for people. Staff received training that was relevant to their role and the provider’s systems ensured that staff were safely recruited.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff and the management team followed safe infection control practices. The environment was clean and systems were in place to ensure regular cleaning took place. One person told us, “Nothing is too much trouble for them [staff]. It is spotlessly clean. After lunch when you go back into the lounge you find it tidied up and clean.”

Staff understood how to reduce the risk of cross infection and used Personal Protective Equipment (PPE) to help keep people safe from the risk of infection.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. People received their medicines as prescribed. There were systems in place to safely manage the storage and administration of medicines.

Staff had received training in the safe administration of medicines and had their competency checked to ensure they followed good practice guidance and were safe to support people with their medicines.

Checks on administration records showed people were supported with their medicines as prescribed, and stock balances were accurate. Controlled drugs, which are subject to specific storage and recording guidelines were managed in line with good practice guidance.

Where people were prescribed ‘as required’ medicines there were clear protocols in place to ensure these were given safely. Where people’s medicines were given covertly, records showed best interests meetings had been held to ensure this was done lawfully.