Archived: Mill House

Updated 4 February 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 5 January 2016. This was an unannounced inspection. The inspection team consisted of 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.

Before the inspection we reviewed information we held about the home, this included previous inspection reports and notifications we had received. A notification is information about important events which the provider is required to tell us about by law.

During the inspection we spoke with 13 people who were living at the service and five relatives. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with 9 staff which included nursing, care, activity and housekeeping staff. We also spoke with the registered manager and the area manager. We looked around the home and observed the way staff interacted with people.

We looked at records which included the care records for 8 people, medication administration records for all people living at the service and six staff files. We also looked at records of feedback received by the service and records relating to the management of the service.

Updated 4 February 2016

We inspected this service on 5 January 2016. This was an unannounced inspection.

Mill House is a care home providing nursing care for up to 35 people. At the time of our visit there were 33 people living at the service.

At a comprehensive inspection of this service in January 2015 we identified four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to Safeguarding service users, the provision of person centred care, acting on and managing complaints, maintaining accurate care records and monitoring the quality of the service people received. The provider sent us an action plan to tell us how they would ensure the service met the legal requirements of the regulations. At this inspection in January 2016 we found the required actions had been taken.

The home had a registered manager. 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. The registered manager was supported by an area manager.

People, their relatives and staff felt the service was well led. The registered manager and management team sought feedback from people and their relatives and was continually striving to improve the quality of the service. There was a detailed plan of further changes and improvements that were going to be made to the service.

Staff were clear about the action they would take to keep people safe from abuse. People and staff were confident they could raise any concerns and these would be dealt with.

People felt supported by competent staff. Staff were motivated to improve the quality of care and benefitted from regular supervision, team meetings and training to help them meet the needs of the people they were caring for.

There was a calm, warm and friendly atmosphere at the service. People told us staff were kind and caring and we observed many interactions to support this. However, some improvements were required to ensure people were always spoken about and treated in a dignified and respectable way.

People were supported to maintain their health and were referred for specialist advice as required. People were provided with person-centred care which encouraged choice and independence. Staff knew people and understood their individual preferences. Risks to people’s health were identified and plans were in place to manage the risks.

People were supported to have their nutritional needs met. People were complementary about the food and were given choice and variety. The menu was flexible to ensure people were able to have what they wanted at each mealtime.

Medicines were administered in a safe way. However, people did not always have protocols in place to provide advice and guidance to staff on when to administer the medicine. One medicine was not stored in line with safe storage guidance.

There was enough staff to meet peoples needs. However, call bells were not always answered promptly.

People told us and the service they enjoyed the activities on offer but would like more things to do. The service had acted on this feedback and had increased the activity budget and were in the process of employing more activity staff.

The provider, registered manager and staff understood their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be unable to make their own decisions or who may be deprived of their liberty for their own safety.

We have recommended the provider consult national guidance on Medicine Management and treating people with dignity and respect.