Millfield Nursing and Residential 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. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 75 (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.

Staff meetings took place monthly, learning from any recent incidents was shared with staff during staff meetings. Feedback forms for relatives, staff and people using the service were available in the main entrance area of the home. Feedback shared through the feedback forms were then actioned appropriately where possible. For example, people told the registered manager they had they had enjoyed a particular themed day activity, therefore more of those activities were put in place as a response to feedback.

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.

People’s care plans and daily care documentation evidenced the service worked closely with other health care professionals to ensure people’s needs were appropriately met.

The deputy manager and registered manager were responsible for assessing all new referrals to the care home. The provider had a robust process in place to assess people’s individual needs. People’s relatives and external health care professionals were also consulted. That helped ensure the person’s care needs were understood before they moved into the care home.

Soon after moving into the care home, people met with the activity staff who assessed the person’s activity preferences, including their cultural beliefs and requirements, to ensure they were fully reflected in the person’s care plan.

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 at the service were protected from the risk of abuse, preventative measures were in place to safeguard people from harm.

The provider recorded all safeguarding incidents onto a structured log which evidenced how the issue had been dealt with. It also recorded that the relevant notifications have been raised to external agencies, actions had been taken, and any learning from the event had been identified and shared.

For any individuals deemed to be lacking capacity the appropriate assessments, deprivation of liberty safeguards and best interest decisions were in place, with clear input from families and other health care professionals involved in their care.

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.

People had individual risk assessments in their care plans to ensure all individual risks had mitigation measures in place. Relatives were invited to monthly care review meetings to share their insight into the care of their family member.

Positive behaviour support plans were in place for individuals who experienced periods of anxiety and distress. These support plans contained person specific coping mechanisms and guidance for staff on how to reassure and settle people in accordance with their needs and preferences.

Staff had regular communication with relatives when a person’s individual risks changed. For example, a relative told us, “Yes, I have a meeting with them, I’m kept informed and give my views.”

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 care home was free from clutter which could present environmental risks. Fire drills were completed monthly and fire alarm tests weekly. Emergency planning was in place to ensure the safety of people using the service, should an event such as fire or flooding occur.

Comprehensive environmental risk assessments were completed and reviewed quarterly for events such as fires, flooding, and general environmental hazards. A maintenance log was available to all staff to add concerns to. The provider’s maintenance team member was regularly on site to rectify those concerns and reduce environmental risks.

Equipment used to meet the needs of people using the service was stored appropriately, clean and regularly serviced.

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. The registered manager used a dependency assessment tool as an aid to calculate how many staff were required to be on shift to provide safe care to people. New care staff completed induction training and were subject to a probationary period during which their competency was assessed. Induction training also included periods of shadowing existing staff to learn how to provide person centred care effectively. Staff received training to ensure they understood the expectations of their role and had the knowledge to provide safe and effective care to people. Staff received refresher training to ensure they remained compliant with changes in legislation and best practice, enabling them to provide quality care. Staff told us they felt able to approach the registered manager to request additional training or support if they needed it.

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 provider employed cleaning and laundry staff to ensure hygiene was maintained. This helped reduce the likelihood of health infections spreading. Effective processes’ were in place for managing laundry when health infections were present in the care home.

Cleaning staff had schedules in place which ensured the cleaning of the care home was well co-ordinated. Staff had access to appropriate personal protective equipment (PPE) and received training on infection prevention and control.

People were happy with the cleanliness of the care home. Relatives confirmed this. For example, 6 relatives who gave input during our inspection told us ‘Yes, it is clean.’

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

The service stored and administered medicines safely. Medicines were stored in the appropriate locked settings. Medicines requiring refrigeration were in the appropriate fridge.

The provider had effective processes in place for the administration and recording of people’s prescribed medicines.

People received their prescribed medicines at the right time, and they also had access to local GPs when medicine reviews were required. Staff responsible for administering prescribed medicines to people had received appropriate medicines training.

The provider had an electronic medicine records system in place. This helped ensure staff were alerted when people’s medicines required a GP review. It also helped to ensure staff were reminded when people needed to receive their medicines at specific times.