23 July 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check 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.
The inspection was conducted by one inspector.
Service and service type:
Old Mill House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager who had applied for registration with the Care Quality Commission. Registered managers and providers are legally responsible for how a service is run and for the quality and safety of the care provided.
Notice of inspection:
We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that a provider representative or manager would be in the office to support the inspection.
Inspection site visit activity started on 18 June 2019 and ended on 19 June 2019.
What we did before the inspection:
Our inspection was informed by evidence we already held about the service. We also checked for feedback we received from members of the public, the local authority and health care professionals.
Our plan took into account information the provider sent us since the last inspection. We also considered information about matters the provider must notify us about, such as events involving injury. We obtained information from the local authority commissioners and safeguarding team and other professionals who work with the service.
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.
During the inspection:
We visited the home and met people. We also saw the manager, deputy, a representative of the provider and care staff. We contacted a relative on the phone. We reviewed care records and policies and procedures. We reviewed three people's care records, three staff recruitment and personnel files, staff training documents and other records about the management of the service.
After the inspection:
We continued to seek clarification from the provider to corroborate evidence we found. We looked at training data and quality assurance records.
23 July 2019
About the service:
Old Mill House is a residential care home that was providing personal care to 5 people with learning disabilities at the time of the inspection. The service can support up to 6 people. Old Mill House accommodates people across two separate floors. The home is situated close to the centre of Chorley.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The service was a large home, bigger than most domestic style properties. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People's experience of using this service and what we found:
Most people using the service could not speak to tell us they felt safe but some indicated they were safe by gestures such as putting their thumbs up. A relative said their relative was safe. We also noted that people were supported to be safe. Staff received robust safeguarding training and had a good understanding of the principals involved in taking action when abuse was suspected. There was an open and transparent culture in relation to accidents and incidents. Medicines were managed safely. The provider had a robust recruitment process.
People's needs were met through robust assessments and support planning. The service worked with healthcare and social professionals to achieve positive outcomes for people. Staff had good knowledge and skills and this ensured people's needs were well met. We saw good examples of when people had been supported to maintain a healthy and balanced diet.
People's relatives indicated that staff were compassionate and kind and during the inspection, we observed this to be the case. The manager and staff knew people well. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People received care and support that was person-centred. We saw good examples of how the care and support people received enriched their lives through meaningful activities. People were supported properly to access the community. The service had a robust complaints policy. There was an end of life policy that could be used if appropriate.
The values and culture embedded in the service ensured people were at the heart of the care and support they received. The manager and provider planned and promoted holistic, person-centred, high-quality care resulting in good outcomes for people. People knew how to feedback their experiences and this was considered and acted upon by the manager and provider. Staff told us they received good support from management.
The outcomes for people using the service also reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update:
At the last inspection, the service was rated requires improvement (published 14 December 2016). This was because there had been a breach of the regulations around a safety issue. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected:
We carried out this inspection based on the previous rating of the service.
We will continue to review information we receive about the service until we return to visit as part of our re-inspection programme. If any concerning information is received we may inspect sooner.