Millard House is a residential care home providing personal care and accommodation for up to 43 older people, some of whom were living with a diagnosis of dementia. At the time of our inspection there were 32 people living in the service.
Our inspection was unannounced and took place on 8 July 2016. The service was last inspected on 12 August 2014 and we found the provider was meeting the regulations. The service had recently been taken over by a new provider and this was the first inspection of the home under the new leadership.
The service is spread across two floors. Some bedrooms were located on the ground floor but a majority were situated on the upper floor and accessed via stairs or a passenger lift. The service had two double rooms. On the day of the inspection one was being used as a single occupancy and the other was empty. There were several communal areas including a dining room and a quiet lounge area where people could sit and listen to music. People had access to a pleasant outside courtyard area within the grounds. A day centre was also located within the service and we saw that people living in the home were able to attend activities and eat their meals there if they chose to.
The service had 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 kept safe and protected from harm by staff who had a good understanding of what action to take if they suspected someone was being abused or mistreated. Accidents and incidents were monitored to identify themes and to help prevent any reoccurrence. There were sufficient numbers of experienced and caring staff to support people. Risks to people had been assessed and measures were taken to prevent avoidable harm and to help ensure their freedom was supported and respected.
Staff received training which enabled them to meet the needs of the people they cared for and provided them with continued personal development. Relatives were complimentary about the effectiveness of the care and many told us they had seen improvements in their family member's well-being since moving into the service.
The service had safe systems in place to ensure that appropriate recruitment checks had been carried out on staff before they were employed. This determined that new employees were suitable to work with the people living at the service. Staff received annual appraisals and supervision, which provided opportunities to discuss and monitor their performance and training needs.
There were robust measures in place to support people to take their prescribed medicines safely and staff competencies were maintained through annual training, spot checks and observations.
The environment was monitored and assessed to help ensure it was safe for people to live in.
The registered manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). MCA and DoLS are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals. People's best interests had been considered when decisions that affected them were made and applications for DoLS authorisations had been submitted where restrictions were imposed upon people to keep them safe.
People were offered a varied diet and could have alternatives to the menu if they chose. Where necessary, staff assisted people with eating and drinking. Systems were in place for staff to monitor people's nutrition and hydration with action being taking when concerns were identified. Staff ensured that people's health needs were effectively monitored. They supported people to access a range of health care services to maintain and improve their health and wellbeing.
Staff knew the people they supported and provided care in a consistent way. We saw that staff approached people in a friendly and respectful way and relatives said that staff were kind and patient when providing support. People were given choices in their daily routines and staff supported people to make day to day decisions which enabled them to remain as independent as possible. We saw people being treated with dignity and respect at all times.
People and their loved ones, where able, were involved in the planning and reviewing of how they received their care.
People knew how to complain and felt confident their concerns would be listened to and people's complaints were valued and used to improve the service.
People and their relatives were very complimentary of how the service was managed. The registered manager demonstrated strong leadership and expected high standards. Systems were in place to check the quality of the service and take the views and concerns of people and their relatives into account to make improvements to the service. There were strong links with the community to help people continue to be part of the local area.
Notifications were sent to us as required, so that we could be aware of how any incidents had been responded to.