Background to this inspection
Updated
29 April 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
This inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is someone who has experience of care related to this inspection setting.
Service and service type Millfield Nursing and Residential Home is a registered care home. People in care homes receive accommodation and nursing or personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
There was a manager for the service registered with the Care Quality Commission for this location. Like the registered provider, they are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection The inspection was unannounced.
Before the inspection We looked at information we held about the service to help us plan the inspection. This included written notifications the provider had sent to us about any important events that happened at the service. We also contacted local care commissioners who contract with the provider for people’s care at the service. On this occasion we did not ask for a Provider Information Return. This is information we ask the provider to send us; to give some key information about the service, what the service does well and any improvements they plan to make. However, we gave the provider opportunity to provide us with any related information, to help inform this inspection.
During the inspection We spoke with 10 people receiving care at the service and seven relatives. We spoke with two nurses, including the deputy home manager; a senior care staff member, three care staff, a kitchen assistant and a domestic. We also spoke with the registered manager and an external regional manager for the provider. We reviewed parts of four people’s care records to check they were accurately maintained, and a range of records relating to the management of the service. This included staffing, medicines and complaints records. We also reviewed some of the provider’s recorded management checks of the quality and safety of people’s care.
After the inspection The registered manager sent us additional information we asked for. This included the provider’s end of life care policy, staff meeting minutes and care quality survey results.
Updated
29 April 2020
About the service
Millfield Nursing and Residential Home provides accommodation in one adapted building; nursing and personal care for up to 48 adults, including some older people living with dementia. At this inspection there were 47 people accommodated for care at the service, including 23 people receiving nursing care.
People’s experience of using this service and what we found
The provider’s staffing, risk management and medicines arrangements for people’s care, helped to ensure people’s safety at the service. People were protected from the risk of harm or abuse through effective safeguarding and emergency contingency planning measures. The provider took action when things went wrong at the service and referred to relevant authorities involved with people’s care when required to do so. People and their relatives were confident in people’s safety at the service.
People’s care needs and choices were effectively assessed and met within an environment that was suitably adapted and equipped. Staff supported people to maintain or improve their health and nutrition. This was done in accordance with guidance and the law, and through timely consultation with relevant external health professionals, when needed.
Staff were trained, supported and deployed to provide an effective skill mix for people’s care. People were supported to have maximum control of their lives and staff supported them in the least restrictive way possible. The provider’s related policies and systems supported this practice. Standardised and lawful information sharing, helped to ensure people received timely, consistent care as agreed with them, including when they needed to move between services.
People received care from kind, caring staff who ensured their dignity, equality, choice, independence and rights in their care. Staff knew people well, how to communicate with them and understood what was important to people them for their care. People were informed, involved and supported to understand, agree and make ongoing decisions about their care in accordance with their diverse needs.
People received timely, personalised care that was tailored to their individual needs, daily living and lifestyle preferences. This was provided in a way which optimised people’s independence, inclusion and engagement in home life; and also with their friends, family and local community as they chose. Related arrangements were under review against nationally emerging contagion control measures, to help protect people from the risk of Covid 19 infection.
People who were living with a life limiting illness were effectively consulted and supported, to receive care against nationally recognised standards concerned with end of life care.
People and their relatives were informed and confident to make a complaint or raise any concerns about the service, if they needed to. People’s views and feedback were regularly sought and used to help inform service planning or improvement
The service was well managed and led by the registered manager. The provider’s governance and oversight arrangements were effectively operated, to ensure the quality and safety of people’s care and timely service improvement when needed.
Management and staff understood their role and responsibilities for people’s care and any related legal requirements. There were effective arrangements for communication, record keeping, accountability and information handling at the service. The provider’s operational care policies, timely engagement and partnership working with external agencies and authorities, helped to ensure people received care that was effectively informed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection The last rating for this service was Good. (Report published August 2018).
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.