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Archived: Mill House Requires improvement

The provider of this service changed - see old profile

The provider of this service changed - see new profile

Reports


Inspection carried out on 4 January 2016

During a routine inspection

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.

Inspection carried out on 27 January 2015

During a routine inspection

We carried out our inspection on 27 January 2015. This was an unannounced inspection. We previously inspected the home on 7 November 2013. The service was found to be meeting all of the standards inspected at that time.

The service had a  registered manager who was responsible for the overall management of the home. A registered manager is a person who has registered with The Care Quality Commission (CQC) to manage the service. Like registered providers, they are 'registered persons'. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

Mill House is a care home providing nursing care for up to 35 people. At the time of our visit there were 32 people living at the home.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager had made applications for Deprivation of Liberty Safeguards but these were not always appropriate.

People were not always supported to provide consent to care and treatment in line with legislation and guidance. Not all staff had awareness of the relevant legislation which put people at risk of being deprived of their liberty without authorisation.  

People told us they felt safe. However staff were not always clear about their responsibilities to report abuse and where to report concerns outside of the organisation.

People told us they received the care they needed. However people's care plans contained conflicting information and did not always contain up to date guidance from professionals. There were systems in place to review care plans. However systems were not always effective as they had not identified issues found during the inspection.

The atmosphere in the home was calm and relaxed. Interactions were kind and caring and people were treated with dignity and respect. Although staff were busy, people were not rushed.

People told us their physical needs were met but there was not a lot to do. People who remained in their rooms had little social interaction. The provider was in the process of recruiting an activity coordinator. However no interim measures had been put in place to meet people's social needs.

The home had quality assurance systems in place but these were not always used effectively to improve the quality of the overall service.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. The breaches correspond to breaches of the Health and Social Care Act 2008 (Regulated Activities) 2014. You can see what action we told the provider to take at the back of the full report.

Inspection carried out on 7 November 2013

During a routine inspection

We spoke with five people and three people's relatives. We also spoke with four care workers and one nurse. At the time of our visit 34 people lived at Mill House.

We looked at five people’s care files and noted that the provider sought the consent of people and their relatives regarding care. One person told us, “Staff are lovely, they don’t do anything I don’t want them to, if I say no they respect me”.

During our observations we observed that people benefited from meaningful engagement. We saw staff providing people with regular drinks and assisting them to move in a caring and reassuring manner. People and their relatives were complimentary about the care they received. One person told us, “They are fantastic, very dedicated”.

We observed the home to be clean on the day of our visit. The provider audited the cleanliness of the home on a daily basis. We saw that hand hygiene procedures were clearly documented in staff areas and that all hand gel dispensers and soap dispensers were working. One member of care staff told us, “It’s important we look after the home as much as the people, it’s where they live” and One relative told us, “it’s always clean, that is something my mum always comments on”.

All care staff we spoke with felt supported. One care worker told us, “I like working here. I feel very supported”. Another care worker told us, “If we have any worries we can talk to the manager anytime, she always around and interested in what we have to say”. Appropriate training was offered for all staff.

People and people’s relatives we spoke with told us they felt able to raise concerns. One relative told us, “The manager has always been happy to hear what we have to say, and always get back to us” another relative told us, “Communication is very good, they are happy to receive our thoughts and keep up to date”.

Inspection carried out on 20 March 2013

During a routine inspection

We found people were involved in decisions about their care and made sure they could make choices about their daily life. One person told us “I had lots of discussion with them and social workers, I came to stay, then I tried being back at home we had another meeting and I chose to come here”.

We found people were treated with dignity and respect. A relative told us “the carers are fabulous” another relative told us “they couldn’t take more care of her”. One person told us “I am looked after very well”; another person told us “the staff here are fantastic”.

We found care was delivered safely and people felt safe. One person said “safe, definitely safe”. A relative we spoke with said I know she is very safe; they couldn’t take more care of her”.

People were supported by experienced and skilled staff. One member of staff told us “the induction is good and support from the seniors and nurses is really good “.

We found staff were supported and trained to deliver good care. One member of staff said the training is fine, we have in-house and external training here”. One person told us “the staff here are excellent, very professional”.

People we spoke with were happy with the service they received and knew how to complain if they had a concern. One person said “If I wanted to complain I would go to the person in charge”.