Mill House

Updated 18 January 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was completed by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Mill House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We used all of this information to plan our inspection.

During the inspection

We spoke with 10 people who used the service and seven relatives of people. We talked about their experience of the care provided. We used the Short Observational Framework for Inspection (SOFI). The SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. These included five people's care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including staff training, policies and procedures were reviewed.

After the inspection

We obtained clarification from the provider to validate evidence found. We contacted five health professionals to obtain their opinion on the service provided by Mill House.

Updated 18 January 2020

About the service

Mill House is a care home registered to provide care for up to 43 people. At the time of our visit there were 33 elderly people living at the service, all of whom required nursing and personal care. The accommodation was arranged on two floors of the service’s building.

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

Activities were provided by a passionate and experienced activity team. A wide variety of relevant and meaningful activities was offered both inside and outside of the service. Staff were creative in how they engaged people in the activities and prevented people from feeling isolated. The service went the extra mile to find out what people had done in the past and evaluated whether activities could be accommodated in line with people's previous employment, interests and hobbies. People received exceptionally personalised and responsive service that was tailored to their needs and wishes. People were valued and placed at the heart of the service. Feedback from people and their relatives was exceptionally positive.

The provider valued their staff team and endeavoured to take steps to retain and develop staff to their full potential. They believed this was the key to delivering high quality, consistent care. People and relatives were delighted with the kindness and thoughtfulness of staff, which exceeded their expectations of how they would be cared for and supported. People explained how staff went over and above what they expected from them and they couldn't ask for anything more. People told us the support they received improved their well-being

People were protected from the risk of abuse. Staff were trained in recognising and reporting any concerns. There were suitable numbers of appropriately recruited staff. Medicines were safely stored and administered.

People received care and treatment from competent and skilled staff who had the relevant knowledge to meet people's needs. The provider had a system to ensure all staff had regular training to keep them up to date with best practice. Training courses and events were relevant to the needs of the people living at the service and staff ensured they put learning into practice.

People had access to food and drinks throughout the day and the meals were individualised to suit people's tastes and needs. People told us the food was very good and there was plenty of choice. Meals were appetising and served in a calm and organised manner, creating a sociable and pleasant meal experience.

People's care needs were identified and assessed before they moved into the home to enable staff to know and understand how people wanted to be supported. Risk management plans were in place to protect people from harm and to support them to remain independent. People were supported to access healthcare services as staff recognised changes in people's health, and sought professional advice appropriately.

People were supported to have maximum choice and control of their lives and staff assisted them in the least restrictive way possible; the policies and systems in the service promoted this practice.

Staff interacted with people at their pace, were unrushed and we observed lots of positive interaction between staff and people living at Mill House. People were treated with dignity and respect by staff who understood the importance of this.

The service established relationships with and worked with local groups, including schools and colleges, to improve the experience and understanding of people living with dementia.

The registered manager and staff team all had a very good understanding of their roles and were empowered to make suggestions to keep improving the care. The provider's quality assurance processes were effective and there was a focus on continuous improvement and continuously seeking out ways to offer personalised care. The registered manager continued to build on the culture of openness and transparency. Staff were proud of the service and felt well supported by the registered manager and the provider.

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 23 November 2018) and there were multiple 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

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.