Miller House 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 newly registered service. 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.

There were systems in place to learn when things went wrong. Staff reported and documented all accidents, incidents and complaints and these were investigated by the management team. There was regular oversight of all such events by the provider, and this included trend analysis to help identify themes, such as falls, or behavioural incidents between people living at the service. Any lessons learned were shared with staff so improvements could be made. We saw evidence of how a particular serious concern had been investigated and the learning that had come from it.

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.

When people were transferred to hospital from the home, staff ensured all relevant information about their care and support needs, any potential risks to their health and safety and any medicines they used was sent with them. This gave hospital staff the appropriate information to care for the person while they were away from the service.

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.

Staff completed safeguarding training and knew how to recognise and report safeguarding concerns. Staff told us they would be comfortable reporting poor practice to management. Policies and procedures supported the safeguarding process and provided guidance and information for staff. The registered manager reported safeguarding concerns appropriately to the local authority and CQC.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act 2005 (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. We found all applications had been made to ensure people’s rights were respected and lawful.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Risk assessments relating to the health, safety and welfare of people using the service were completed. Equipment to help staff minimise risks was used. For example, the use of sensor alarms when people were at risk of falling. People’s risk assessments and care plans were regularly reviewed to ensure they continued to reflect their needs and remained effective in keeping them safe.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The purpose-built care home was clean and well-maintained. Checks of the environment and equipment were up to date. Fire exits were clear and regular fire safety checks had been completed. There was a large communal area which served as the dining room and lounge, with well-maintained furniture. Bathrooms and toilet facilities were of a high standard.

However, the provider had not considered best practice in relation to the environment for people living with dementia. Improvements were needed, for example, to colour schemes and signage to make it easier for people living with dementia to find their way around the building. We discussed this with the registered manager.

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.

Relatives told us there were enough staff to meet people’s needs. One relative commented, “There are a good number of staff.” We observed there were sufficient staff on duty throughout our visit to the service.

Staff had completed training relevant to their role and received supervision from more senior staff. One relative commented, “The nurses are knowledgeable. They know [person] and they understand [person].” Processes were in place and followed to ensure staff were recruited properly and safely. All necessary checks had been completed, including verification of identity, employment history, references and Disclosure and Barring Service (DBS) checks.

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.

The environment was clean. One person commented, “The home is clean and my room is cleaned regularly.” A relative said, “The rooms are kept clean and tidy.” Infection prevention and control policies were in place and staff completed training and competence checks in this area, including checks on the correct handwashing procedure. Staff had access to personal protective equipment (PPE) and knew when to use this. The service had scored 96% in a recent infection control audit carried out by the local authority public health team.

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Systems were in place to ensure medicines were ordered, received, stored, administered, and disposed of safely. Fluid thickeners, used to minimise the risk of people choking on drinks, were administered and stored correctly (locked away). Where medicines were given to peoplecovertly, for example hiddenin their food, this was done in line with the principles of the Mental Capacity Act 2005. Appropriate action was taken following any medicine errors.