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Inspection Summary


Overall summary & rating

Good

Updated 23 June 2018

We carried out an unannounced inspection on 25 April 2018. During our last inspection in January 2017 we rated the service as Requires Improvement. During this inspection the rating changed to Good.

Milliner House is a ‘care home without nursing’. 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.

Milliner House accommodates up to 40 people in one purpose built building across two separate units. One unit is primarily for people with needs related to their mental health, and the second is for people who are living with dementia. At the time of the inspection there were 35 people living at the home.

At the last inspection in January 2017 the service was in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014. At this inspection we found that the necessary improvements had been made and the service met the standards required by law.

There was a registered manager in post. 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.

Medicines were administered safely and people were supported to access health and social care services when required.

The provider had effective recruitment processes in place. Although we identified some gaps in the employment history for some staff recently employed, information was obtained and records were rectified during the course of the inspection. There were sufficient staff to support people safely.

Staff understood their roles and responsibilities in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff gained people’s consent before they provided any care or support to them.

People were supported to have choice and control of their lives and there were risk assessments in place that gave guidance to staff on how risks to people could be minimised without compromising people’s independence.

Staff supervision was provided regularly and training to enable staff to support people well was all up to date.

Staff were kind and respectful to people and we saw some very positive interactions during the inspection. People were supported to pursue their interests and to maximise their independence.

Care plans took account of people’s individual needs, preferences, and choices and were reviewed regularly.

The provider had a formal process for handling complaints and concerns. They encouraged feedback from people and acted on the comments received to continually improve the quality of the service.

The provider had a clearly defined set of values to underpin the service that were known and understood by staff. The registered manager promoted a person centred culture within the service.

The provider had robust quality monitoring processes in place to ensure they were meeting the required standards of care and these were used effectively to support continuous improvements to the service.

Inspection areas

Safe

Good

Updated 23 June 2018

The service was safe

There were systems and processes in place to safeguard people from harm.

Risks to people were assessed and their safety monitored and managed so they could be supported to stay safe and their freedom was respected.

Staff were safely recruited. There was sufficient numbers of staff to support people to stay safe and meet their needs.

The provider had policies and systems in place to protect people from the risk of infection.

Medicines were managed safely

When errors were made by the provider or staff, these were acted on and lessons learned and improvements were made.

Effective

Good

Updated 23 June 2018

The service was effective.

Training relevant to the needs of people living at the service had been completed by all staff to ensure people received effective care from knowledgeable staff.

People were supported to eat and drink a nutritionally balanced diet.

People�s needs were met by the adaptation, design and decoration of the premises.

People were supported to live healthier lives and had access to

healthcare services and on-going healthcare support.

Consent to care and treatment was sought in line with legislation and guidance.

Caring

Good

Updated 23 June 2018

The service was caring

People were treated with kindness, respect and compassion.

People�s privacy and dignity was respected.

The service supported people to express their views and be involved in making decisions about their care, support and treatment as far as possible.

People were supported to maximise their independence.

Responsive

Good

Updated 23 June 2018

The service was responsive

People received personalised care that was responsive to their needs.

A wide range of activities were provided which had been developed in response to people�s interests.

People�s concerns and complaints were listened and responded to and used to improve the quality of care.

People�s wishes for the end of their life were documented within people�s care plans

Well-led

Good

Updated 23 June 2018

The service was well led

The provider had a clear vision and credible strategy in place to deliver high quality care and support, and promote a positive culture that was person-centred, open, inclusive and empowering, and achieved good outcomes for people using the service.

The registered manager demonstrated a good understanding of regulatory requirements and their responsibilities as a registered person.

Systems to monitor the quality of the service were used effectively to ensure that people received a consistently good service.

The people who used the service, the public and staff were engaged and involved in the service.

The service worked in partnership with other agencies.