Archived: Mill Lodge Care Centre

Mill Lodge Care Centre provides nursing care for up to 42 older people, including some who are living with dementia. There were 39 people living at the home when we visited. Accommodation is provided in single en-suite bedrooms in two separate units; one on the ground floor and the other on the first floor. Lift access is provided between the floors. There is a communal lounge and dining room on each floor as well as toilets and bathroom facilities. A central kitchen and laundry are located on the ground floor. There is secure parking as well as garden areas.

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.

People living in the home told us they felt safe and well cared for. We found there were enough staff to support people effectively. The staff were knowledgeable about the individual needs of people and knew how to recognise signs of abuse.

The registered manager and provider followed a robust recruitment procedure to ensure new staff were suitable to work with vulnerable people. People were supported with their medicines in a safe way.

The premises and equipment were appropriately maintained and we noted safety checks were carried out regularly. Risks to people's health and safety had been identified, assessed and managed safely. However some staff did not always follow procedure when moving people in wheelchairs.

Staff followed the principles of the Mental Capacity Act 2005 to ensure that people's rights were protected and they were encouraged to make decisions for themselves.

People had their nutritional needs met and were offered a choice at every meal time. People were offered a varied diet and were provided with sufficient drinks and snacks. People with specific nutritional needs received support in line with their care plan. However one person was not receiving the meals they required to meet their cultural need.

Staff were able to maintain and develop their skills by on-going training. Staff spoken with told us they had access to a range of learning opportunities and said they were well supported by the registered manager and the provider.

We saw staff were caring, positive, encouraging and attentive when communicating and supporting people. Visitors were made welcome in the home and people were supported to maintain relationships with their friends and relatives.

Care records and risk assessments were person-centred and were an accurate reflection of the person's care and support needs. The care plans were written with the person so they were able to influence the delivery of their care. Care plans included people’s likes and preferences and were reviewed regularly to reflect changes to the person's needs and circumstances. People had good access to healthcare professionals.

People knew how to raise concerns and complaints if they needed and appropriate action was taken to address issues that were raised. People's views of the service were sought and responded to appropriately.

There was an open and friendly atmosphere in the home which showed the staff and registered manager had developed good relationships and knew people well. We observed staff treating people with respect whilst assisting them to maintain their independence.

People, relatives and staff spoken with had confidence in the registered manager and felt the home had clear leadership. We found there were effective systems to assess and monitor the quality of the service, which included feedback from people living in the home and their relatives.

Mill Lodge Care Centre provides nursing care for up to 42 older people, including some who are living with dementia. There were 37 people living at the home when we visited. Accommodation is provided in single en-suite bedrooms in two separate units, one on the ground floor and the other on the first floor. Lift access is provided between the floors. There is a communal lounge and dining room on each floor as well as toilets and bathroom facilities. A central kitchen and laundry are located on the ground floor. There is secure parking and garden areas.

The home did not have a registered manager. The registered manager resigned in December 2014. A manager had been appointed when we inspected in January 2015 and they remained in post until October 2015 but were not registered with the Commission. A new manager started in post in December 2015 and has submitted an application to register with the Commission. 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.

People told us they felt safe. Risks were well managed and there were sufficient staff to meet people’s needs and preferences. A staffing tool considered people’s dependencies and staffing levels were adjusted according to people’s needs.

Staff understood how to recognise and report abuse which helped make sure people were protected. We saw any allegations of abuse had been dealt with appropriately and reported to the local authority safeguarding team.

People told us they received their medicines when they needed them and we saw safe medicine systems were in place.

The home was clean and well maintained. Systems were in place to ensure the premises and equipment were serviced regularly so they were safe for use.

Staff knew people’s needs well and received the induction, training and support they required to fulfil their roles. Recruitment practices ensured people were suitable to work in the care service.

Generally people told us they liked the food although one person said they found it ‘a bit repetitive’. Menus showed a range of meals with snacks and drinks available in between meals. People’s weight was monitored to ensure they received enough to eat and drink.

People had access to healthcare services and we saw specialist advice was sought in a timely manner. For example, referrals to dieticians when people had lost weight.

The home was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and acting within the legal framework of the Mental Capacity Act (MCA).

People and relatives praised the care provided and spoke of the kindness and caring attitude of the staff. People were treated with respect and their privacy and dignity was maintained.

People received person-centred care. A range of activities were available although feedback from people was mixed with some stating there was little to do, whereas others felt there was sufficient.

People knew how to make a complaint. Two relatives told us of concerns they had raised which had been dealt with by the manager.

People, staff and relatives praised the manager who they described as friendly, open and accessible. We saw the manager led by example and staff said they felt supported. Quality assurance processes had improved and were effective. Although we were assured people were receiving the care they required we found inconsistencies in the care records which may lead to misunderstandings amongst staff about care delivery. We found this was a breach as accurate and complete care records were not maintained for each person. You can see what action we have told the provider to take at the back of the full version of the report.

People's needs were assessed and care and support was planned and delivered in line with their individual care needs. The care plans contained a good level of information setting out exactly how each person should be supported to ensure their needs were met. One person told us, 'I am well looked after. I am happy as I can be.' Another person told us, 'They certainly do look after me. It feels like home.'

Appropriate arrangements were in place in relation to management of medicines. The home had clear guidance that outlined how medicines should be obtained and protocols that staff must follow. Staff we spoke with said they had received medication training. People we spoke with said they received their medication on time and when they needed it. One person told us, 'I get my medication on time, they are on the ball.'

We found people were supported by sufficient numbers of qualified, skilled and experienced staff which met people's needs. People we spoke with told us there were generally enough staff to help them when they needed support.

There were quality monitoring programmes in place, which included people giving feedback about their care, support and treatment. This provided a good overview of the quality of the service's provided.

'The staff do their best but I think they are short staffed sometimes.'

'Sometimes I have to wait longer than I would like for staff to come and help me.'

'There is a choice of menu and you can have what you want.'

'The home is always clean and tidy.'

'If I had any problems I would tell the manager and she would sort it out. When I did raise something with her it was dealt with straight away.'

'We get some entertainment and the quizzes are very good. We had a Halloween party, the staff dressed up and it was very good.'

'Staff are very helpful, patient and friendly.'

'The food is good and there is plenty of it.'

'When my friend visits they can have a meal with me if they want to.'